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荷兰全科医生记录体重指数、超重和肥胖情况的实践:一项观察性研究。

Recording practices of body mass index, overweight and obesity by Dutch general practitioners: an observational study.

作者信息

van den Hout Willemijn J, van Peet Petra G, Numans Mattijs E, Mook-Kanamori Dennis O

机构信息

Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.

Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

BMC Prim Care. 2025 Jan 2;26(1):1. doi: 10.1186/s12875-024-02696-8.

Abstract

BACKGROUND

Routine body mass index (BMI) recording in electronic health records (EHR) could support general practitioners (GPs) in managing patients with obesity. This study aimed to evaluate recording practices of BMI, overweight, and obesity in adults including subgroup analysis of age, sex, and comorbidities in primary care in the Netherlands.

METHODS

An observational study of individuals aged ≥ 18 years and registered between 2007 and 2023, using routine healthcare data from the Extramural LUMC Academic Network (ELAN) in the Netherlands. Outcomes were (i) incidence rates of a recorded BMIs per 1000 person-years for sex and ten-year age categories (ii) proportions of recorded BMIs for different comorbidities and (iii) proportions of diagnosis of overweight (BMI between 25 and 30 kg/m) and/or obesity (BMI ≥ 30 kg/m) for a corresponding recorded BMI.

RESULTS

Approximately 30% of 676,708 individuals had a recorded BMI. Highest incidence rate (186 per 1000 person-years) was at age 71 to 80 years. At least one BMI was recorded in 68.5% individuals with chronic obstructive pulmonary disease, 70.6% with hypertension, 86.3% with type II diabetes, 42.4% with eating disorders, 36% with depression and 64.2% with osteoarthritis. Diagnoses of overweight and/or obesity were found in 11.5% individuals with a BMI between 25 and 30 kg/m and in 36.4% with a BMI of ≥ 30 kg/m.

CONCLUSION

In the Netherlands, GPs recorded BMIs in nearly one third of all adults, mainly in adults with chronic diseases. Routinely recording BMI is not currently standard practice. With the increasing prevalence of obesity and its related comorbidities, it may be beneficial to start routinely recording BMI in primary care.

摘要

背景

在电子健康记录(EHR)中常规记录体重指数(BMI)有助于全科医生(GP)管理肥胖患者。本研究旨在评估荷兰初级保健机构中成人BMI、超重和肥胖的记录情况,并对年龄、性别和合并症进行亚组分析。

方法

一项针对年龄≥18岁且在2007年至2023年期间注册的个体的观察性研究,使用荷兰鹿特丹大学医学中心校外学术网络(ELAN)的常规医疗数据。研究结果包括:(i)按性别和十岁年龄组划分的每1000人年记录BMI的发病率;(ii)不同合并症记录BMI的比例;(iii)相应记录BMI的超重(BMI在25至30kg/m之间)和/或肥胖(BMI≥30kg/m)诊断比例。

结果

在676,708名个体中,约30%有记录的BMI。发病率最高(每1000人年186例)的年龄段为71至80岁。慢性阻塞性肺疾病患者中68.5%至少记录了一次BMI,高血压患者中70.6%,II型糖尿病患者中86.3%,饮食失调患者中42.4%,抑郁症患者中36%,骨关节炎患者中64.2%。BMI在25至30kg/m之间的个体中,11.5%被诊断为超重和/或肥胖;BMI≥30kg/m的个体中,36.4%被诊断为超重和/或肥胖。

结论

在荷兰,全科医生在近三分之一的成年人中记录了BMI,主要是患有慢性病的成年人。目前常规记录BMI并非标准做法。随着肥胖及其相关合并症患病率的增加,在初级保健中开始常规记录BMI可能有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f86/11697458/0a5fc47f806e/12875_2024_2696_Fig1_HTML.jpg

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