DiBonaventura Marco, Nicolucci Antonio, Meincke Henrik, Le Lay Agathe, Fournier Janine
Kantar Health, Health Outcomes Practice, New York, NY, USA.
Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
Clinicoecon Outcomes Res. 2018 Aug 24;10:457-475. doi: 10.2147/CEOR.S157673. eCollection 2018.
This study investigated the association between body mass index (BMI) and three comorbid conditions (type 2 diabetes [T2D], prediabetes, and hypertension) on humanistic and economic outcomes.
This retrospective observational study collected data from German (n=14286) and Italian (n=9433) respondents to the 2013 European Union National Health and Wellness Survey, a cross-sectional, nationally representative online survey of the general adult population. Respondents were grouped, based on their self-reported BMI, and stratified into three other comorbid conditions (T2D, prediabetes, and hypertension). Generalized linear models, controlling for demographics and health characteristics, tested the relationship between BMI and health status, work productivity loss, and health care resource utilization. Indirect and direct costs were calculated based on overall work productivity loss and health care resource utilization, respectively. The same generalized linear models were also performed separately for those with T2D, prediabetes, and hypertension.
The sample of German respondents was 50.16% male, with a mean age of 46.68 years (SD =16.05); 35.24% were classified as overweight and 21.29% were obese. In Italy, the sample was 48.34% male, with a mean age of 49.27 years (SD =15.75); 34.85% were classified as overweight, and 12.89% were obese. Multivariable analyses demonstrated that, in both countries, higher BMI was associated with worse humanistic outcomes and only those from Germany also reported greater direct and indirect costs. Differences in the impact of BMI on outcomes by country were additionally found when the sample was stratified into those with prediabetes, T2D, and hypertension.
The high percentage of patients who are overweight or obese in Germany and Italy remains problematic. Better elucidating the impact of overweight or obese BMI, as well as the incremental effects of relevant comorbid conditions, on humanistic and economic outcomes is critical to quantify the multifaceted burden on individuals and society.
本研究调查了体重指数（BMI）与三种共病情况（2型糖尿病 [T2D]、糖尿病前期和高血压）在人文和经济结果方面的关联。
这项回顾性观察性研究收集了参与2013年欧盟国家健康与幸福调查的德国（n = 14286）和意大利（n = 9433）受访者的数据，该调查是一项针对一般成年人群的具有全国代表性的横断面在线调查。受访者根据自我报告的BMI进行分组，并进一步分层为三种共病情况（T2D、糖尿病前期和高血压）。采用广义线性模型，控制人口统计学和健康特征，检验BMI与健康状况、工作生产力损失和医疗资源利用之间的关系。间接成本和直接成本分别根据总体工作生产力损失和医疗资源利用情况进行计算。对于患有T2D、糖尿病前期和高血压的患者，也分别进行了相同的广义线性模型分析。
德国受访者样本中男性占50.16%，平均年龄为46.68岁（标准差 = 16.05）；35.24%被归类为超重，21.29%为肥胖。在意大利，样本中男性占48.34%，平均年龄为49.27岁（标准差 = 15.75）；34.85%被归类为超重，12.89%为肥胖。多变量分析表明，在两个国家中，较高的BMI均与较差的人文结果相关，并且只有德国的受访者还报告了更高的直接和间接成本。当样本按糖尿病前期、T2D和高血压分层时，还发现了BMI对结果的影响在不同国家之间存在差异。
德国和意大利超重或肥胖患者的高比例仍然是个问题。更好地阐明超重或肥胖BMI以及相关共病情况的增量影响对人文和经济结果的作用，对于量化个体和社会所面临的多方面负担至关重要。
