Hatanaka Yoko, Tamakoshi Akiko, Tsushita Kazuyo
DENSO Health Insurance Society, 2-41 Shintomichou, Kariya, Aichi 448-0045, Japan.
Sangyo Eiseigaku Zasshi. 2012;54(4):141-9. doi: 10.1539/sangyoeisei.b11018. Epub 2012 May 29.
To investigate the impact of body mass index (BMI) of men in their 20s and the effects of subsequent changes in body weight upon medication rates, prevalence of hypertension and diabetes, and medical costs in their 40s.
A total of 10,125 men who were in their 20s in 1989 were recruited as subjects and grouped according to their BMI and a combination of BMI and increase in body weight over a 20-year period. A logistic regression analysis was performed to evaluate subsequent medication rates, prevalence of hypertension and diabetes, and consultation rate. Analysis of covariance was performed for mean medical costs on the basis of the BMI value in their 20s. All data were adjusted for age in 1989 and changes in body weight over the subsequent 20 yr.
A mean increase of 7 kg in body weight was observed over the 20-year period. Medication rates and prevalence of hypertension and diabetes in the men in their 40s increased significantly in correlation with the BMI values in their 20s (men with higher BMI showed higher medication and symptom prevalence rates). The 25.0 or higher BMI group showed a 6.81-fold higher prevalence of hypertension and a 16.62-fold higher prevalence of diabetes than the 18.5-19.9 BMI group. Similarly, men with higher BMI values in their 20s incurred greater outpatient and total medical costs in their 40s. The mean total medical costs in 2009 of men in the 18.5 or lower BMI group in their 20s was 818.7 yen and that for men in the 25.0 or higher BMI group was 5,311.5 yen. Furthermore, men in their 40s showed increased risk of hypertension and diabetes, if their body weight increased by 10 kg or more in the subsequent 20 yr, even when they had BMI values between 20.0 and 24.9 in their 20s.
Men with high BMI values in their 20s showed higher prevalence of hypertension and diabetes and incurred greater medical costs in their 40s. Even men with a BMI of less than 25.0 in their 20s, showed increases in the prevalence of hypertension and diabetes which were dependent on their weight gain in the subsequent years. Healthcare activities in Japanese corporations based on lifetime employment should promote anti-obesity strategies among young employees and help not only those employees who are obese but also those who are not controlling their weight.
研究20多岁男性的体重指数（BMI）及其随后体重变化对40多岁时用药率、高血压和糖尿病患病率以及医疗费用的影响。
选取1989年时20多岁的10125名男性作为研究对象，根据其BMI以及BMI与20年间体重增加情况的组合进行分组。采用逻辑回归分析来评估随后的用药率、高血压和糖尿病患病率以及就诊率。基于20多岁时的BMI值对平均医疗费用进行协方差分析。所有数据均根据1989年的年龄以及随后20年的体重变化进行了调整。
在20年期间观察到体重平均增加了7千克。40多岁男性的用药率、高血压和糖尿病患病率与20多岁时的BMI值显著相关（BMI较高的男性用药率和症状患病率更高）。BMI为25.0及以上的组高血压患病率比BMI为18.5 - 19.9的组高6.81倍，糖尿病患病率高16.62倍。同样，20多岁时BMI值较高的男性在40多岁时门诊和总医疗费用更高。20多岁时BMI为18.5及以下组的男性在2009年的平均总医疗费用为818.7日元，而BMI为25.0及以上组的男性为5311.5日元。此外，40多岁的男性如果在随后20年体重增加10千克或更多，即使他们20多岁时BMI值在20.0至24.9之间，患高血压和糖尿病的风险也会增加。
20多岁时BMI值高的男性在40多岁时高血压和糖尿病患病率更高，医疗费用也更高。即使20多岁时BMI小于25.0的男性，其高血压和糖尿病患病率的增加也取决于其随后几年的体重增加情况。基于终身雇佣制的日本企业的医疗保健活动应在年轻员工中推广抗肥胖策略，不仅要帮助肥胖员工，也要帮助那些体重未得到控制的员工。
