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一项前瞻性队列研究中的多重疾病:重度肥胖患者的患病率及其与体重减轻和健康状况的关联

Multimorbidity in a prospective cohort: prevalence and associations with weight loss and health status in severely obese patients.

作者信息

Agborsangaya Calypse B, Majumdar Sumit R, Sharma Arya M, Gregg Edward W, Padwal Raj S

机构信息

Department of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Alberta Diabetes Institute, Edmonton, Alberta, Canada.

出版信息

Obesity (Silver Spring). 2015 Mar;23(3):707-12. doi: 10.1002/oby.21008. Epub 2015 Feb 13.

Abstract

OBJECTIVE

To examine the prevalence of multimorbidity (≥2 chronic conditions) in severely obese patients and its associations with weight loss and health status over 2 years.

METHODS

In a prospective cohort including 500 severely obese adults, self-reported prevalence of 20 chronic conditions was calculated at baseline and 2 years. Multivariable logistic regression models were fitted to test the covariate-adjusted associations between ≥5% weight reduction and reduction in multimorbidity and the association between health status (visual analogue scale [VAS]) and reduction in multimorbidity over 2 years.

RESULTS

After 2 years, mean weight change was -12.9 ±18.7 kg, 53% had ≥5% weight reduction, mean change in VAS was 11.5 ± 21.2, and 53.5% had ≥10% increase in VAS. Multimorbidity was reported in 95.4% and 92.8% patients at baseline and 2 years, respectively. Weight loss (≥5%) over 2 years was associated with reduction in multimorbidity (adjusted OR = 1.7, 95% CI 1.1-2.7). Reduction in multimorbidity was associated with clinically important improvements (≥10% increase in VAS) in health status (adjusted OR = 2.5, 95% CI 1.6, 4.0).

CONCLUSIONS

Multimorbidity is common in severely obese patients. Having ≥5% weight reduction over 2 years was associated with a reduction in multimorbidity, which was also associated with improvements in health status.

摘要

目的

研究重度肥胖患者中多种疾病并存(≥2种慢性病)的患病率及其与2年内体重减轻和健康状况的关联。

方法

在一个包含500名重度肥胖成年人的前瞻性队列中,在基线和2年时计算20种慢性病的自我报告患病率。采用多变量逻辑回归模型来检验体重减轻≥5%与多种疾病并存减少之间的协变量调整关联,以及健康状况(视觉模拟评分法[VAS])与2年内多种疾病并存减少之间的关联。

结果

2年后,平均体重变化为-12.9±18.7千克,53%的人体重减轻≥5%,VAS平均变化为11.5±21.2,53.5%的人VAS增加≥10%。基线和2年时分别有95.4%和92.8%的患者报告存在多种疾病并存。2年内体重减轻(≥5%)与多种疾病并存减少相关(调整后的比值比=1.7,95%置信区间1.1-2.7)。多种疾病并存减少与健康状况的临床显著改善(VAS增加≥10%)相关(调整后的比值比=2.5,95%置信区间1.6,4.0)。

结论

多种疾病并存在重度肥胖患者中很常见。2年内体重减轻≥5%与多种疾病并存减少相关,而多种疾病并存减少又与健康状况改善相关。

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