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美国成年人中与体重增加相关的处方药物使用情况,1999-2018 年:一项全国代表性调查。

Use of prescription medications associated with weight gain among US adults, 1999-2018: A nationally representative survey.

机构信息

Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland, USA.

National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.

出版信息

Obesity (Silver Spring). 2022 Jan;30(1):229-239. doi: 10.1002/oby.23299. Epub 2021 Dec 14.

Abstract

OBJECTIVE

This study aimed to evaluate trends in the use of obesogenic medications among adults.

METHODS

Cross-sectional data on adults aged ≥20 years are from the 1999 to 2018 National Health and Nutrition Examination Survey (n = 52,340). Obesogenic medications were defined according to the 2015 Endocrine Society guidelines on the pharmacological management of obesity. Weight status was categorized according to BMI. Trends in prior 30-day use were evaluated.

RESULTS

In NHANES 2017-2018, 20.3% of US adults used an obesogenic medication. Beta-blockers (9.8%) and antidiabetics (5.7%) were the most common; antipsychotics (1.0%) were the least common. Most common indications were disorders of glucose metabolism, hypertension, neuralgia or neuritis, heart disease, and musculoskeletal pain and/or inflammation. From 1999 to 2018, the proportional use of obesogenic medications increased for anticonvulsants (34.4% to 55.0%) but decreased for antidepressants (32.1% to 18.8%), antidiabetics (82.9% to 52.5%), and beta-blockers (83.9% to 80.7%). The proportional use of obesogenic medications was not associated with weight status, except for antipsychotics.

CONCLUSIONS

Use of obesogenic medications was common. Differences in the proportional use of obesogenic medication may reflect changing availability of obesogenic versus nonobesogenic medications over time. The decision to prescribe a nonobesogenic alternative, if one exists, is guided by weighing the risks and benefits of available treatments.

摘要

目的

本研究旨在评估成年人使用致肥胖药物的趋势。

方法

横断面数据来自于 1999 年至 2018 年全国健康和营养调查(n=52340),对象为年龄≥20 岁的成年人。致肥胖药物根据 2015 年内分泌学会肥胖药物治疗指南进行定义。体重状况根据 BMI 进行分类。评估了过去 30 天内的使用趋势。

结果

在 NHANES 2017-2018 年,20.3%的美国成年人使用致肥胖药物。β受体阻滞剂(9.8%)和抗糖尿病药物(5.7%)最常见;抗精神病药物(1.0%)最不常见。最常见的适应证是葡萄糖代谢紊乱、高血压、神经痛或神经炎、心脏病以及肌肉骨骼疼痛和/或炎症。从 1999 年到 2018 年,抗惊厥药的致肥胖药物使用比例从 34.4%增加到 55.0%,而抗抑郁药(32.1%至 18.8%)、抗糖尿病药(82.9%至 52.5%)和β受体阻滞剂(83.9%至 80.7%)的使用比例则下降。致肥胖药物的使用比例与体重状况无关,除了抗精神病药物。

结论

使用致肥胖药物很常见。致肥胖药物与非致肥胖药物的使用比例差异可能反映了随时间推移致肥胖药物和非致肥胖药物的可获得性的变化。如果存在非致肥胖的替代药物,处方非致肥胖替代药物的决定是基于权衡现有治疗方法的风险和益处。

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