Eli Lilly and Company, Indianapolis, Indiana, USA.
Diabetes Obes Metab. 2024 Nov;26(11):5005-5012. doi: 10.1111/dom.15914. Epub 2024 Sep 11.
To comprehensively examine the range of co-morbidities among males and females with a diagnosis of obesity.
This cross-sectional retrospective study used US commercial and Medicare claims data from Merative MarketScan Research Databases to identify adults (age ≥ 18 years) with a diagnosis of obesity with continuous insurance coverage from 2018 to 2020. Co-morbidities were tabulated based on coded diagnoses, and prevalences were calculated in males and females across age groups. Age-adjusted odds ratios (ORs) determined differences in co-morbidities between the sexes.
Of an eligible sample of 6.9 million, we identified 2 028 273 individuals with at least one obesity-related International Classification of Diseases, 10th Revision, Clinical Modification code. The proportions of males and females with obesity were 43.0% versus 57.0%. The most prevalent co-morbidities among males and females were hypertension (62.8% vs. 52.2%), dyslipidaemia (63.3% vs. 50.3%) and depression and/or anxiety (D/A; 29.7% vs. 48.5%). The prevalence of D/A was high in the younger age group, but steadily decreased with age in both sexes; however, hypertension and dyslipidaemia continued to increase with age. The presence of diagnosis of hypertension and dyslipidaemia was 6-8 years earlier in males than in females. Females had higher odds than males for osteoarthritis (OR 1.33), depression (OR 2.22) or osteoporosis (OR 7.10); all P < .0001.
Males with obesity received a diagnosis of cardiovascular risk factors at an earlier age than females, which may have contributed to the higher prevalence of coronary heart disease. Understanding sex-specific variations in co-morbidities across ages can support early screening and diagnosis of risk clusters for optimal obesity management.
全面检查诊断为肥胖的男性和女性的合并症范围。
这项横断面回顾性研究使用了 Merative MarketScan 研究数据库的美国商业和医疗保险索赔数据，从 2018 年至 2020 年，确定了连续保险覆盖范围内患有肥胖症的成年人（年龄≥18 岁）。根据编码诊断列出合并症，并计算各年龄段男性和女性的患病率。年龄调整后的优势比（OR）确定了性别之间合并症的差异。
在符合条件的 690 万样本中，我们确定了至少有一个与肥胖相关的国际疾病分类，第 10 次修订版临床修正码的 2028273 个人。男性和女性中肥胖的比例分别为 43.0%和 57.0%。男性和女性中最常见的合并症是高血压（62.8%对 52.2%）、血脂异常（63.3%对 50.3%）和抑郁和/或焦虑（D/A；29.7%对 48.5%）。在年轻人群中，D/A 的患病率较高，但在两性中随着年龄的增长而稳步下降；然而，高血压和血脂异常随着年龄的增长而持续增加。男性诊断出高血压和血脂异常的时间比女性早 6-8 年。女性患骨关节炎（OR 1.33）、抑郁症（OR 2.22）或骨质疏松症（OR 7.10）的几率高于男性；所有 P<0.0001。
与女性相比，肥胖男性接受心血管危险因素诊断的年龄更早，这可能导致冠心病的患病率更高。了解不同年龄段合并症的性别特异性差异可以支持早期筛查和诊断风险聚类，以实现最佳肥胖管理。
