Marsh Kevin, Möller Jörgen, Basarir Hasan, Orfanos Panagiotis, Detzel Patrick
Evidera, Metro Building, 1 Butterwick, London W6 8DL, UK.
Roche, Konzern-Hauptsitz, Grenzacherstrasse 124, CH-4070 Basel, Switzerland.
Nutrients. 2016 Jan 2;8(1):18. doi: 10.3390/nu8010018.
The global prevalence of obesity is rising rapidly, highlighting the importance of understanding risk factors related to the condition. Childhood obesity, which has itself become increasingly prevalent, is an important predictor of adulthood obesity. Studies suggest that the protein content consumed in infanthood is an important predictor of weight gain in childhood, which may contribute to higher body mass index (BMI). For instance, there is evidence that a lower protein infant formula (lpIF) for infants of overweight or obese mothers can offer advantages over currently-used infant formulas with regard to preventing excessive weight gain. The current study used health economic modelling to predict the long-term clinical and economic outcomes in Mexico associated with lpIF compared to a currently-used formula. A discrete event simulation was constructed to extrapolate the outcomes of trials on the use of formula in infanthood to changes in lifetime BMI, the health outcomes due to the changes in BMI and the healthcare system costs, productivity and quality of life impact associated with these outcomes. The model predicts that individuals who receive lpIF in infancy go on to have lower BMI levels throughout their lives, are less likely to be obese or develop obesity-related disease, live longer, incur fewer health system costs and have improved productivity. Simulation-based economic modelling suggests that the benefits seen in the short term, with the use of lpIF over a currently-used formula, could translate into considerable health and economic benefits in the long term. Modelling over such long timeframes is inevitably subject to uncertainty. Further research should be undertaken to improve the certainty of the model.
全球肥胖患病率正在迅速上升，凸显了了解与该病症相关风险因素的重要性。儿童肥胖本身也日益普遍，是成人肥胖的重要预测指标。研究表明，婴儿期摄入的蛋白质含量是儿童期体重增加的重要预测指标，这可能导致更高的体重指数（BMI）。例如，有证据表明，对于超重或肥胖母亲的婴儿，低蛋白婴儿配方奶粉（lpIF）在预防体重过度增加方面可能比目前使用的婴儿配方奶粉更具优势。本研究使用健康经济模型来预测与目前使用的配方奶粉相比，lpIF在墨西哥产生的长期临床和经济结果。构建了一个离散事件模拟，以推断婴儿期使用配方奶粉的试验结果对终身BMI变化、BMI变化导致的健康结果以及与这些结果相关的医疗系统成本、生产力和生活质量影响。该模型预测，婴儿期接受lpIF的个体在其一生中的BMI水平较低，肥胖或患肥胖相关疾病的可能性较小，寿命更长，医疗系统成本更低，生产力更高。基于模拟的经济模型表明，短期内使用lpIF而非目前使用的配方奶粉所带来的益处，从长期来看可能转化为可观的健康和经济效益。在如此长的时间范围内进行建模不可避免地存在不确定性。应开展进一步研究以提高模型的确定性。
