Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA.
Liver Transplant Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Adv Ther. 2023 Mar;40(3):1114-1128. doi: 10.1007/s12325-022-02415-8. Epub 2023 Jan 12.
Obesity and its complications are associated with morbidity, mortality and high economic cost in Saudi Arabia. Estimating this impact at the population level and potential benefits to be gained from obesity reduction is vital to underpin policy initiatives to prevent disease risks.
We combined data in an adapted version of the value of weight loss simulation model, to predict reductions in complication rates and cost savings achievable with 15% weight loss in Saudi Arabia over 10 years. To obtain model inputs, we conducted a systematic literature review (SLR) to identify data on the prevalence of obesity and its complications in Saudi Arabia, and surveyed specialist physicians and hospital administrators in public (governmental) and private healthcare sectors. We used combinations of age, sex, obesity and type 2 diabetes (T2D) rates in Saudi Arabia to sample a United Kingdom (UK) cohort, creating a synthetic Saudi Arabia cohort expected to be representative of the population.
The synthetic Saudi Arabia cohort reflected expected comorbidity prevalences in the population, with a higher estimated prevalence of T2D, hypertension and dyslipidaemia than the UK cohort in all age groups. For 100,000 people with body mass index 30-50 kg/m, it was estimated that 15% weight loss would lead to a 53.9% reduction in obstructive sleep apnoea, a 37.4% reduction in T2D and an 18.8% reduction in asthma. Estimated overall cost savings amounted to 1.026 billion Saudi Arabian Riyals; the largest contributors were reductions in T2D (30% of total cost savings for year 10), dyslipidaemia (26%) and hypertension (19%).
Sustained weight loss could significantly alleviate the burden of obesity-related complications in Saudi Arabia. Adopting obesity reduction as a major policy aim, and ensuring access to support and treatment should form an important part of the transformation of the healthcare system, as set out under 'Vision 2030'.
肥胖及其并发症与沙特阿拉伯的发病率、死亡率和高经济成本有关。在人口层面上估计这种影响，以及从肥胖减轻中获得的潜在益处，对于支持预防疾病风险的政策举措至关重要。
我们结合了适应性减肥模拟模型中的数据，以预测在沙特阿拉伯，10 年内体重减轻 15%可降低并发症发生率和节省成本。为了获得模型输入，我们进行了系统文献综述（SLR），以确定沙特阿拉伯肥胖及其并发症的患病率数据，并调查了公共（政府）和私营医疗保健部门的专科医生和医院管理人员。我们使用沙特阿拉伯的年龄、性别、肥胖和 2 型糖尿病（T2D）的组合，对英国队列进行抽样，创建了一个预期代表人口的合成沙特阿拉伯队列。
合成的沙特阿拉伯队列反映了人群中预期的合并症患病率，在所有年龄段中，T2D、高血压和血脂异常的估计患病率均高于英国队列。对于体重指数为 30-50 kg/m2 的 10 万人，估计体重减轻 15%将导致阻塞性睡眠呼吸暂停减少 53.9%，T2D 减少 37.4%，哮喘减少 18.8%。估计的总节省成本为 10.26 亿沙特里亚尔；最大的贡献者是 T2D（第 10 年总成本节省的 30%）、血脂异常（26%）和高血压（19%）的减少。
持续减肥可以显著减轻沙特阿拉伯肥胖相关并发症的负担。将减少肥胖作为主要政策目标，确保获得支持和治疗，应构成“2030 年愿景”下医疗保健系统转型的重要组成部分。
