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2 型糖尿病合并与不合并肥胖症患者的医疗结果。

Healthcare outcomes for patients with type 2 diabetes with and without comorbid obesity.

机构信息

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46225, United States of America.

HealthMetrics Outcomes Research, 27576 River Reach Drive, Bonita Springs, FL 34134, United States of America.

出版信息

J Diabetes Complications. 2020 Dec;34(12):107730. doi: 10.1016/j.jdiacomp.2020.107730. Epub 2020 Sep 5.

Abstract

AIMS

Examine the burden of comorbid obesity associated with type 2 diabetes (T2D).

METHODS

The IBM® MarketScan® Explorys Claims Electronic Medical Records Data were used to identify adults with T2D, two recorded body mass index (BMI) values, and continuous insurance coverage from 1 year prior through 1 year post index date. Patients with index BMI ≥18 kg/m and <30 kg/m (normal/overweight) were matched to patients with index BMI ≥ 30 kg/m (obese) using propensity score matching (PSM). Using the PSM cohort, multivariable analyses examined the association between obesity and patient comorbidities, healthcare costs, and resource utilization.

RESULTS

In the matched cohort (16,006 normal/overweight; 16,006 obese), multivariable analyses showed that obesity, compared to normal/overweight, was associated with increased odds of a diabetes-related comorbidity (Odds Ratio [OR] = 1.29; 95% Confidence Interval [CI] 1.21-1.38) and an obesity-related comorbidity (OR = 1.42; 95% CI 1.29-1.56). Obesity was also associated with significantly higher annual diabetes-related and all-cause total costs and resource utilization.

CONCLUSIONS

This research increases the knowledge of how patients with T2D and obesity should be of greater concern for healthcare providers compared to T2D patients without comorbid obesity, given their worse comorbidity profile, increased resource utilization, and higher healthcare costs.

摘要

目的

探讨与 2 型糖尿病(T2D)相关的合并肥胖症的负担。

方法

使用 IBM® MarketScan®Explorys 索赔电子病历数据,确定 T2D 患者,记录两次体重指数(BMI)值,并在指数日期前 1 年至后 1 年期间连续投保。BMI 指数≥18kg/m 和<30kg/m(正常/超重)的患者与 BMI 指数≥30kg/m(肥胖)的患者使用倾向评分匹配(PSM)进行匹配。使用 PSM 队列,多变量分析考察了肥胖症与患者合并症、医疗保健成本和资源利用之间的关联。

结果

在匹配队列(16006 例正常/超重;16006 例肥胖)中,多变量分析显示,与正常/超重相比,肥胖与糖尿病相关合并症(优势比 [OR] = 1.29;95%置信区间 [CI] 1.21-1.38)和肥胖相关合并症(OR = 1.42;95%CI 1.29-1.56)的发生几率增加。肥胖症还与糖尿病相关和所有原因的年度总费用和资源利用率显著增加相关。

结论

与无肥胖合并症的 T2D 患者相比,该研究增加了关于肥胖合并 T2D 患者的知识,因为这些患者的合并症谱更差、资源利用率更高、医疗保健成本更高,因此应引起医疗保健提供者的更大关注。

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