Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Gachon University College of Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Department of Surgery, Seoul National University Hospital, Seoul, Korea; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Surg Obes Relat Dis. 2024 Jul;20(7):695-704. doi: 10.1016/j.soard.2024.01.014. Epub 2024 Jan 30.
Obesity is known to increase overall disease burden but does obesity management actually help reduce disease burden?
To investigate the effects of weight loss on disease burden in people with obesity using the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) in Korea.
Pure longitudinal observational study using Nationwide cohort database.
Out of 514,866 NHIS-HEALS cohort, participants with class II obesity in Asia-Pacific region (30 ≤ body mass index [BMI] < 35) who underwent health check-up provided by NHIS during 2003-2004 (index date) were included. All final participants continued to receive a total of 5 biennial health check-ups over the next 10 years without missing. A group-based trajectory model (GBTM) was used to categorize subjects based on 10-year BMI change patterns. The changes of co-morbidities, healthcare resource utilization, and medical cost were analyzed.
The final study subjects (9857) were categorized into 3 trajectory clusters based on the pattern of BMI (kg/m) change: maintenance (57.35%) with an average change of -.02 ± .06, loss (38.65%) with -.04 ± .08, and substantial loss (4.0%) with -.10 ± .18. The annual increases in the number of co-morbidities per subject in each cluster were .18, .18, and .16 (all P < .001), respectively. The increase of healthcare resource utilization over time was lowest for the substantial loss compared to maintenance and loss. With each passing year, the average annual total healthcare cost increased by ₩21,200 ($16.48, P = .034) and ₩10,500 ($8.16, P = .498) in the maintenance and loss, respectively, but decreased by ₩62,500 ($48.59, P = .032) in the substantial loss.
Weight loss in people with obesity was associated with a reduced burden of disease, as evidenced by lower co-morbidity, healthcare resource utilization rate, and decreased medical costs. This study highlights the potential positive long-term impact on Korean society when actively managing weight in individuals with obesity.
肥胖已知会增加整体疾病负担，但肥胖管理实际上是否有助于减轻疾病负担？
使用韩国国民健康保险服务-健康筛查队列（NHIS-HEALS）研究减肥对肥胖人群疾病负担的影响。
使用全国队列数据库进行纯纵向观察研究。
从 NHIS-HEALS 队列的 514866 名参与者中，纳入亚太地区（30≤BMI＜35）II 类肥胖的参与者，他们在 2003-2004 年（索引日期）期间接受了 NHIS 提供的健康检查。所有最终参与者在接下来的 10 年内继续总共接受 5 次两年一次的健康检查，没有遗漏。使用基于群组的轨迹模型（GBTM）根据 10 年 BMI 变化模式对受试者进行分类。分析了合并症、医疗资源利用和医疗费用的变化。
最终研究对象（9857 人）根据 BMI（kg/m）变化模式分为 3 个轨迹群：维持组（57.35%）平均变化为-.02±.06，减轻组（38.65%）为-.04±.08，大量减轻组（4.0%）为-.10±.18。每个群组中每个受试者每年合并症数量的增加分别为.18、.18 和.16（均 P＜.001）。与维持组和减轻组相比，大量减轻组的医疗资源利用增加率最低。随着时间的推移，维持组和减轻组的患者每年的平均总医疗费用分别增加₩21200（16.48 美元，P=0.034）和₩10500（8.16 美元，P=0.498），而大量减轻组则减少₩62500（48.59 美元，P=0.032）。
肥胖患者减肥与疾病负担减轻相关，表现为合并症、医疗资源利用率降低和医疗费用减少。本研究强调了在韩国社会积极管理肥胖人群体重时可能产生的长期积极影响。
