Medical costs of obese Japanese: A 10-year follow-up study of national health insurance in Shiga, Japan
Medical costs of obese Japanese: A 10-year follow-up study of national health insurance in Shiga, Japan
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DOI：
10.1093/eurpub/ckl271
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发表时间：
2007-10-01
影响因子：
4.4
通讯作者：
Ueshima, Hirotsugu
中科院分区：
文献类型：
--
作者：
Nakamura, Koshi;Okamura, Tomonori;Ueshima, Hirotsugu
背景：对于日本人来说，身体质量指数(BMI)为25.029.9被归类为肥胖，是高血压等心血管疾病的危险因素。方法：利用基线BMI和10年随访期间的医疗费用进行了一项队列研究，以澄清日本人肥胖的成本。参与者是4502名社区居住区的日本国民健康保险(NHI)受益人，年龄为4069岁。根据他们的基线BMI值(KGM(2))，参与者被分为以下三类：BMI18.5，18.5BMI25.0和25.0BMI。比较了三类人群每人每月的医疗费用。结果：在被研究的日本人中，大约有20人的BMI为25.0或以上。观察到BMI和个人总医疗费用之间存在J型关系。每个类别的个人每月总医疗费用分别为189欧元(BMI18.5)、134欧元(18.5BMI25.0)和155欧元(25.0BMI)。在调整了年龄、性别、吸烟和饮酒习惯并排除了早逝的参与者后，观察到了J型模式。此外，吸烟习惯并没有改变医疗总费用的J型模式。体重指数为25.0或以上的日本国民健康保险受益者的医疗费用高于体重指数为18.524.9的受助者，其超额医疗费用占整个研究人群总医疗费用的3.1%。
Background: For the Japanese population, a body mass index (BMI) of 25.029.9 is classified as obesity and is a risk factor for cardiovascular disorders such as hypertension.Methods: A cohort study to clarify obesity costs for a Japanese population was conducted utilizing baseline BMI and medical costs over a 10-year follow-up period. The participants were 4502 community dwelling Japanese National Health Insurance (NHI) beneficiaries aged 4069 years. According to their baseline BMI values (kgm(2)), participants were classified into the following three categories: BMI18.5, 18.5BMI25.0 and 25.0BMI. Medical costs per person per month were compared among the three categories. Excess medical costs attributable to the 25.0BMI category compared to the 18.5BMI25.0 category were estimated.Results: Approximately 20 of the Japanese population studied had a BMI of 25.0 or over. A J-shaped relationship between BMI and personal total medical costs was observed. Personal total medical costs per month determined from the 10-year follow-up in each category were 189 Euros (BMI18.5), 134 Euros (18.5BMI25.0) and 155 Euros (25.0BMI). A J-shaped pattern was observed after adjusting for age, sex, smoking and drinking habits, and excluding early deceased participants. Furthermore, smoking habit did not modify the J-shaped pattern of total medical costs. The estimated excess medical costs for the 25.0BMI category represented 3.1 of the total medical costs for the entire study population (634105 Euros).Conclusion: The Japanese NHI beneficiaries with a BMI of 25.0 or over showed increased medical costs compared to those with a BMI of 18.524.9.