Boyers Dwayne, Avenell Alison, Stewart Fiona, Robertson Clare, Archibald Daryll, Douglas Flora, Hoddinott Pat, van Teijlingen Edwin
Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom; Health Economics Research Unit, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom.
Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom.
Obes Res Clin Pract. 2015 Jul-Aug;9(4):310-27. doi: 10.1016/j.orcp.2015.03.001. Epub 2015 Apr 1.
Increasing obesity related health conditions have a substantial burden on population health and healthcare spending. Obesity may have a sex-specific impact on disease development, men and women may respond differently to interventions, and there may be sex-specific differences to the cost-effectiveness of interventions to address obesity. There is no clear indication of cost-effective treatments for men.
This systematic review summarises the literature reporting the cost-effectiveness of non-surgical weight-management interventions for men. Studies were quality assessed against a checklist for appraising decision modelling studies.
Although none of the included studies explicitly set out to determine the cost-effectiveness of treatment for men, seven studies reported results for subgroups of men. Interventions were grouped into lifestyle interventions (five studies) and Orlistat (two studies). The retrieved studies showed promising evidence of cost-effectiveness, especially when interventions were targeted at high-risk groups, such as those with impaired glucose tolerance. There appears to be some sex-specific elements to cost-effectiveness, however, there were no clear trends or indications of what may be contributing to this.
The economic evidence was highly uncertain, and limited by variable methodological quality of the included studies. It was therefore not possible to draw strong conclusions on cost-effectiveness. Future studies are required to demonstrate the cost-effectiveness of interventions specifically targeted towards weight loss for men.
与肥胖相关的健康问题日益增多，给人群健康和医疗支出带来了沉重负担。肥胖可能对疾病发展产生性别特异性影响，男性和女性对干预措施的反应可能不同，而且在解决肥胖问题的干预措施的成本效益方面可能存在性别差异。目前尚无针对男性的具有成本效益的治疗方法的确切证据。
本系统评价总结了报告男性非手术体重管理干预措施成本效益的文献。根据评估决策模型研究的清单对研究进行质量评估。
尽管纳入的研究均未明确旨在确定男性治疗的成本效益，但有七项研究报告了男性亚组的结果。干预措施分为生活方式干预（五项研究）和奥利司他（两项研究）。检索到的研究显示出成本效益的有力证据，尤其是当干预措施针对高危人群时，如糖耐量受损者。在成本效益方面似乎存在一些性别特异性因素，然而，对于可能导致这种情况的原因没有明确的趋势或迹象。
经济证据高度不确定，且受纳入研究方法质量参差不齐的限制。因此，无法就成本效益得出强有力的结论。未来需要开展研究，以证明专门针对男性减肥的干预措施的成本效益。
