Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans.
Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans.
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DOI：
10.7326/0003-4819-154-4-201102150-00001
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发表时间：
2011-02-15
影响因子：
39.2
通讯作者：
Katz JN
中科院分区：
文献类型：
--
作者：
Losina E;Walensky RP;Reichmann WM;Holt HL;Gerlovin H;Solomon DH;Jordan JM;Hunter DJ;Suter LG;Weinstein AM;Paltiel AD;Katz JN
肥胖和膝骨性关节炎是影响50岁至84岁美国人的最常见的慢性疾病之一。估计因肥胖和膝骨性关节炎造成的经质量调整的寿命损失年，以及将肥胖率降低到十年前观察到的水平对健康的好处。来自国家数据源的美国人口普查和肥胖数据与有症状的膝骨性关节炎的估计患病率相结合，将50至84岁的人分为4个亚组：非肥胖者无膝骨性关节炎(参照组)、非肥胖者无膝骨性关节炎、肥胖者无膝骨性关节炎、肥胖者有膝骨性关节炎。骨关节炎政策模型是膝关节骨关节炎和肥胖的计算机模拟模型，与参照组相比，该模型被用来估计因膝关节骨关节炎和肥胖而造成的经质量调整的寿命年损失。美国。年龄在50岁到84岁之间的美国人口。经质量调整的寿命年--因膝骨性关节炎和肥胖而损失。估计人均质量调整寿命年的损失从患有膝骨性关节炎的非肥胖者的1.857到患有这两种疾病的人的3.501不等，导致因肥胖、膝骨性关节炎或两者兼而有之而损失的质量调整寿命年总数为8,600万年。因膝骨性关节炎和/或肥胖而损失的质量调整寿命年占50至84岁人群剩余质量调整寿命的10%至25%。西班牙裔和黑人女性的损失高得不成比例。模型结果表明，将肥胖率逆转到10年前的水平，将避免178 071例冠心病、889 872例糖尿病和111 206例全膝关节置换。肥胖症的减少将使美国50岁至84岁成年人的寿命增加6 318 030岁，预期寿命增加7812 120岁。共病发生率是根据一般人口预期寿命的患病率估计得出的，这可能会导致保守的低估。进行了校准分析，以确保基于模型的预测和来自外部来源的数据具有可比性。由于膝骨性关节炎和肥胖而损失的经质量调整的寿命年数似乎很大，黑人和西班牙裔妇女遭受的损失不成比例。将这一人群的平均体重指数降低到十年前的水平，将产生巨大的健康益处。美国国立卫生研究院和关节炎基金会。
Obesity and knee osteoarthritis are among the most frequent chronic conditions affecting Americans aged 50 to 84 years. To estimate quality-adjusted life-years lost due to obesity and knee osteoarthritis and health benefits of reducing obesity prevalence to levels observed a decade ago. The U.S. Census and obesity data from national data sources were combined with estimated prevalence of symptomatic knee osteoarthritis to assign persons aged 50 to 84 years to 4 subpopulations: nonobese without knee osteoarthritis (reference group), nonobese with knee osteoarthritis, obese without knee osteoarthritis, and obese with knee osteoarthritis. The Osteoarthritis Policy Model, a computer simulation model of knee osteoarthritis and obesity, was used to estimate quality-adjusted life-year losses due to knee osteoarthritis and obesity in comparison with the reference group. United States. U.S. population aged 50 to 84 years. Quality-adjusted life-years lost owing to knee osteoarthritis and obesity. Estimated total losses of per-person quality-adjusted life-years ranged from 1.857 in nonobese persons with knee osteoarthritis to 3.501 for persons affected by both conditions, resulting in a total of 86.0 million quality-adjusted life-years lost due to obesity, knee osteoarthritis, or both. Quality-adjusted life-years lost due to knee osteoarthritis and/or obesity represent 10% to 25% of the remaining quality-adjusted survival of persons aged 50 to 84 years. Hispanic and black women had disproportionately high losses. Model findings suggested that reversing obesity prevalence to levels seen 10 years ago would avert 178 071 cases of coronary heart disease, 889 872 cases of diabetes, and 111 206 total knee replacements. Such a reduction in obesity would increase the quantity of life by 6 318 030 years and improve life expectancy by 7 812 120 quality-adjusted years in U.S. adults aged 50 to 84 years. Comorbidity incidences were derived from prevalence estimates on the basis of life expectancy of the general population, potentially resulting in conservative underestimates. Calibration analyses were conducted to ensure comparability of model-based projections and data from external sources. The number of quality-adjusted life-years lost owing to knee osteoarthritis and obesity seems to be substantial, with black and Hispanic women experiencing disproportionate losses. Reducing mean body mass index to the levels observed a decade ago in this population would yield substantial health benefits. The National Institutes of Health and the Arthritis Foundation.
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