预测肥胖症和2型糖尿病的发病率及负担：ViLA-肥胖症模拟模型

Forecasting Obesity and Type 2 Diabetes Incidence and Burden: The ViLA-Obesity Simulation Model.

作者信息

Nianogo Roch A, Arah Onyebuchi A

机构信息

Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, United States.

California Center for Population Research (CCPR), Los Angeles, CA, United States.

出版信息

Front Public Health. 2022 Apr 5;10:818816. doi: 10.3389/fpubh.2022.818816. eCollection 2022.

DOI:10.3389/fpubh.2022.818816

PMID:35450123

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9016163/

Abstract

BACKGROUND

Obesity is a major public health problem affecting millions of Americans and is considered one of the most potent risk factors for type 2 diabetes. Assessing future disease burden is important for informing policy-decision making for population health and healthcare.

OBJECTIVE

The aim of this study was to develop a computer model of a cohort of children born in Los Angeles County to study the life course incidence and trends of obesity and its effect on type 2 diabetes mellitus.

METHODS

We built the Virtual Los Angeles cohort-ViLA, an agent-based model calibrated to the population of Los Angeles County. In particular, we developed the ViLA-Obesity model, a simulation suite within our ViLA platform that integrated trends in the causes and consequences of obesity, focusing on diabetes as a key obesity consequence during the life course. Each agent within the model exhibited obesity- and diabetes-related healthy and unhealthy behaviors such as sugar-sweetened beverage consumption, physical activity, fast-food consumption, fresh fruits, and vegetable consumption. In addition, agents could gain or lose weight and develop type 2 diabetes mellitus with a certain probability dependent on the agent's socio-demographics, past behaviors and past weight or type 2 diabetes status. We simulated 98,230 inhabitants from birth to age 65 years, living in 235 neighborhoods.

RESULTS

The age-specific incidence of obesity generally increased from 10 to 30% across the life span with two notable peaks at age 6-12 and 30-39 years, while that of type 2 diabetes mellitus generally increased from <2% at age 18-24 to reach a peak of 25% at age 40-49. The 16-year risks of obesity were 32.1% (95% CI: 31.8%, 32.4%) for children aged 2-17 and 81% (95% CI: 80.8%, 81.3%) for adults aged 18-65. The 48-year risk of type 2 diabetes mellitus was 53.4% (95% CI: 53.1%, 53.7%) for adults aged 18-65.

CONCLUSION

This ViLA-Obesity model provides an insight into the future burden of obesity and type 2 diabetes mellitus in Los Angeles County, one of the most diverse places in the United States. It serves as a platform for conducting experiments for informing evidence-based policy-making.

摘要

背景

肥胖是一个影响数百万美国人的主要公共卫生问题，被认为是2型糖尿病最主要的风险因素之一。评估未来疾病负担对于为人口健康和医疗保健的政策决策提供信息至关重要。

目的

本研究的目的是建立一个洛杉矶县出生队列的计算机模型，以研究肥胖的生命历程发病率和趋势及其对2型糖尿病的影响。

方法

我们构建了虚拟洛杉矶队列（ViLA），这是一个基于主体的模型，已根据洛杉矶县的人口进行校准。特别是，我们开发了ViLA-肥胖模型，这是我们ViLA平台内的一个模拟套件，整合了肥胖原因和后果的趋势，重点关注糖尿病作为生命历程中肥胖的一个关键后果。模型中的每个主体都表现出与肥胖和糖尿病相关的健康和不健康行为，如饮用含糖饮料、体育活动、食用快餐、新鲜水果和蔬菜。此外，主体可能会根据其社会人口统计学、过去的行为以及过去的体重或2型糖尿病状况，以一定概率增重或减重并患上2型糖尿病。我们模拟了98230名居民从出生到65岁的情况，他们生活在235个社区。

结果

肥胖的年龄别发病率在整个生命周期中总体上从10%增加到30%，在6至12岁和30至39岁时有两个明显的峰值，而2型糖尿病的发病率通常从18至24岁时的<2%增加到40至49岁时的峰值25%。2至17岁儿童肥胖的16年风险为32.1%（95%CI：31.8%，32.4%），18至65岁成年人肥胖的16年风险为81%（95%CI：80.8%，81.3%）。18至65岁成年人2型糖尿病的48年风险为53.4%（95%CI：53.1%，53.7%）。