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肥胖导致的健康状态效用损失。

Loss of Health State Utilities Attributable to Obesity.

机构信息

Addiction Unit, Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile.

Public Health Department, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Value Health Reg Issues. 2023 Jul;36:92-97. doi: 10.1016/j.vhri.2023.02.007. Epub 2023 Apr 14.

Abstract

OBJECTIVES

This study aimed to quantify the association between the loss of health state utilities (LHSU) and obesity, considering different obesity categories. This is relevant to interventions economic evaluations and for public policy decision planning.

METHODS

Using data from the Chilean National Health Survey, this study uses linear regression models and counterfactual scenarios to calculate the prevalent burden, population averages, and total sum of LHSU attributable to obesity for the Chilean national level on people older than 15 years, year 2017. Adjustments for socioeconomic status and associated noncommunicable diseases (NCDs) are considered. Calculating the LHSU using these methods enables the approximation of loss of prevalent quality-adjusted life-years (QALYs).

RESULTS

The raw obesity LHSU burden was 9.1% (95% uncertainty interval [UI] 5.1-13). When adjustment is considered, the LHSU attributable to obesity reaches 4.6% (95% UI 0.6-8.5) being responsible for 121 045 prevalent QALYs. Socioeconomic status adjusted analysis of higher body mass index (BMI, in kg/m) categories of obesity shows a dose-response effect for LHSU, being the BMI ≥ 40 category with the highest population average of attributable LHSU (10.1; 95% UI 5.5-14.5, scale 0 [full health] to 100 [dead]). Burden for BMI ≥ 35 categories showed the biggest change after NCD adjustment.

CONCLUSIONS

Obesity carries a significant burden of QALY loss. Policy decision-making addressing obesity should focus specially on the BMI ≥ 40 group. NCD comorbidity should be considered for policies addressing the BMI ≥ 35 group.

摘要

目的

本研究旨在量化健康状态效用损失(LHSU)与肥胖之间的关联,并考虑不同的肥胖类别。这对于干预措施的经济评估和公共政策决策规划具有重要意义。

方法

本研究使用来自智利国家健康调查的数据,采用线性回归模型和反事实情景,计算了 2017 年智利全国 15 岁以上人群中肥胖的普遍负担、人群平均值和归因于肥胖的总 LHSU。考虑了社会经济地位和相关非传染性疾病(NCDs)的调整。通过使用这些方法计算 LHSU,可以估算出普遍存在的质量调整生命年(QALY)损失。

结果

肥胖的原始 LHSU 负担为 9.1%(95%置信区间 [CI] 5.1-13)。当考虑调整时,归因于肥胖的 LHSU 达到 4.6%(95%CI 0.6-8.5),导致 121045 例常见的 QALY 损失。对肥胖更高 BMI(kg/m)类别的社会经济地位调整分析显示,LHSU 呈剂量反应效应,BMI≥40 类别具有最高的归因 LHSU 人群平均值(10.1;95%CI 5.5-14.5,0[完全健康]至 100[死亡])。NCD 调整后,BMI≥35 类别的负担变化最大。

结论

肥胖会导致大量的 QALY 损失。针对肥胖问题的政策决策应特别关注 BMI≥40 组。针对 BMI≥35 组的政策应考虑 NCD 合并症。

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