Health Economics and Outcomes Research, Alkermes, Inc., 900 Winter St., Waltham, MA, 02451-1420, USA.
Cerner Enviza, an Oracle Company, North Kansas City, MO, USA.
Adv Ther. 2024 Oct;41(10):3807-3819. doi: 10.1007/s12325-024-02953-3. Epub 2024 Aug 8.
Bipolar I disorder (BD-I) is associated with an increased risk of obesity, but few studies have evaluated the real-world clinical, humanistic, and economic effects associated with obesity in people with BD-I.
This was a retrospective, cross-sectional analysis of responses to the 2016 and 2020 National Health and Wellness surveys. Respondents (18-64 years) with a self-reported physician diagnosis of BD-I were matched to controls without BD-I based on demographic and health characteristics. Respondents were categorized by body mass index as underweight/normal weight (< 25 kg/m), overweight (25 to < 30 kg/m), or obese (≥ 30 kg/m). Multivariable regression models were used to compare obesity-related comorbidities, healthcare resource utilization (HCRU), health-related quality of life (HRQoL), work productivity, and indirect and direct costs.
Before matching, the BD-I cohort was younger than the non-BD-I cohort and included more female and white respondents and a greater proportion covered by Medicaid or Medicare. After matching, the BD-I and non-BD-I cohorts had similar characteristics. A total of 5418 respondents (BD-I, n = 1806; matched controls, n = 3612) were analyzed. Obese respondents with BD-I reported the highest adjusted prevalences of high blood pressure (50%), high cholesterol (35%), sleep apnea (27%), osteoarthritis (17%), type 2 diabetes (12%), and liver disease (4%). Obesity in respondents with BD-I was associated with the lowest HRQoL scores. Measures of work impairment were highest in respondents with BD-I and obesity, as was HCRU. Respondents with BD-I and obesity had the highest associated total indirect and direct medical costs ($25,849 and $44,482, respectively).
Obese respondents with BD-I had greater frequencies of obesity-related comorbidities, higher HCRU, lower HRQoL, greater work impairments, and higher indirect and direct medical costs. These findings highlight the real-world burden of obesity in people with BD-I and the importance of considering treatments that may reduce this burden.
双相情感障碍 I 型（BD-I）与肥胖风险增加有关，但很少有研究评估肥胖对 BD-I 患者的临床、人文和经济影响。
这是对 2016 年和 2020 年国家健康和健康调查的回应进行的回顾性、横断面分析。根据人口统计学和健康特征，将自我报告有医生诊断为 BD-I 的受访者与没有 BD-I 的对照者相匹配。根据体重指数将受访者分为体重不足/正常体重（<25kg/m）、超重（25 至 <30kg/m）或肥胖（≥30kg/m）。使用多变量回归模型比较肥胖相关合并症、医疗资源利用（HCRU）、健康相关生活质量（HRQoL）、工作生产力以及间接和直接成本。
在匹配之前，BD-I 组比非 BD-I 组年轻，并且包括更多的女性和白人受访者，以及更多的人通过医疗补助或医疗保险覆盖。匹配后，BD-I 和非 BD-I 队列具有相似的特征。共分析了 5418 名受访者（BD-I，n=1806；匹配对照，n=3612）。BD-I 肥胖患者报告的高血压（50%）、高胆固醇（35%）、睡眠呼吸暂停（27%）、骨关节炎（17%）、2 型糖尿病（12%）和肝病（4%）的调整后患病率最高。BD-I 患者肥胖与最低的 HRQoL 评分相关。BD-I 和肥胖患者的工作障碍指标最高，HCRU 也是如此。BD-I 和肥胖患者的总间接和直接医疗费用最高（分别为 25849 美元和 44482 美元）。
BD-I 肥胖患者的肥胖相关合并症频率更高、HCRU 更高、HRQoL 更低、工作障碍更大、间接和直接医疗费用更高。这些发现强调了肥胖对 BD-I 患者的现实负担，以及考虑可能减轻这种负担的治疗方法的重要性。
