Micro Health Simulations, London, United Kingdom.
PLoS One. 2013 Jul 11;8(7):e68785. doi: 10.1371/journal.pone.0068785. Print 2013.
Higher and lower-middle income countries are increasingly affected by obesity. Obesity-related diseases are placing a substantial health and economic burden on Brazil. Our aim is to measure the future consequences of these trends on the associated disease burden and health care costs.
A previously developed micro-simulation model is used to project the extent of obesity, obesity-related diseases and associated healthcare costs to 2050. In total, thirteen diseases were considered: coronary heart disease, stroke, hypertension, diabetes, osteoarthritis, and eight cancers. We simulated three hypothetical intervention scenarios: no intervention, 1% and 5% reduction in body mass index (BMI).
In 2010, nearly 57% of the Brazilian male population was overweight or obese (BMI ≥25 kg/m(2)), but the model projects rates as high as 95% by 2050. A slightly less pessimistic picture is predicted for females, increasing from 43% in 2010 to 52% in 2050. Coronary heart disease, stroke, hypertension, cancers, osteoarthritis and diabetes prevalence cases are projected to at least double by 2050, reaching nearly 34,000 cases of hypertension by 2050 (per 100,000). 1% and 5% reduction in mean BMI will save over 800 prevalence cases and nearly 3,000 cases of hypertension by 2050 respectively (per 100,000). The health care costs will double from 2010 ($5.8 billion) in 2050 alone ($10.1 billion). Over 40 years costs will reach $330 billion. However, with effective interventions the costs can be reduced to $302 billion by 1% and to $273 billion by 5% reduction in mean BMI across the population.
Obesity rates are rapidly increasing creating a high burden of disease and associated costs. However, an effective intervention to decrease obesity by just 1% will substantially reduce obesity burden and will have a significant effect on health care expenditure.
中高收入国家正日益受到肥胖问题的影响。肥胖相关疾病给巴西带来了巨大的健康和经济负担。我们的目标是衡量这些趋势对相关疾病负担和医疗保健成本的未来影响。
使用先前开发的微观模拟模型来预测肥胖、肥胖相关疾病和相关医疗保健成本到 2050 年的程度。总共考虑了 13 种疾病:冠心病、中风、高血压、糖尿病、骨关节炎和 8 种癌症。我们模拟了三种假设的干预情景:不干预、体重指数(BMI)降低 1%和 5%。
2010 年,近 57%的巴西男性人口超重或肥胖(BMI≥25kg/m²),但模型预测到 2050 年这一比例将高达 95%。对于女性来说,情况略不悲观,从 2010 年的 43%增加到 2050 年的 52%。到 2050 年,冠心病、中风、高血压、癌症、骨关节炎和糖尿病的患病率预计至少会翻一番,到 2050 年将达到近 34000 例高血压(每 10 万人)。BMI 平均降低 1%和 5%将分别在 2050 年节省 800 多例和近 3000 例高血压(每 10 万人)。仅 2050 年,医疗保健费用就将从 2010 年的 58 亿美元翻一番至 101 亿美元。40 多年来,成本将达到 3300 亿美元。然而,通过有效的干预措施,将人口 BMI 平均降低 1%和 5%,可以将成本降低至 3020 亿美元和 2730 亿美元。
肥胖率迅速上升,导致疾病负担和相关成本居高不下。然而,通过降低 1%的肥胖率来进行有效的干预将大大减轻肥胖负担,并对医疗保健支出产生重大影响。