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The impact of obesity and overweight on medical expenditures and disease incidence in Korea from 2002 to 2013.

ABSTRACT: Few studies have assessed the long-term medical costs and incidence of obesity and overweight in Asia. We evaluated the impact of body mass index (BMI) on medical expenditures and disease incidence and prevalence over more than 10 years in South Korea.Using 2002-2013 data from the Korean National Claims Database, we analysed two population sets (initial BMI in 2002-2003; consistent BMI in 2002-2003 and 2012-2013). Obesity was defined by Asian BMI criteria. Incremental medical expenditures or Charlson Comorbidity Index (CCI) ratios for obese compared to normal weight individuals were calculated. Medical expenditure over 11 years was estimated by BMI using a generalised linear model. Individual obesity-related disease incidence was determined and adjusted hazard ratios were calculated.Data for 496,469 and 214,477 individuals were included in the entire and consistent BMI level populations, respectively. Average CCI score change in normal weight and the obesity III (BMI 35-59.99 kg/m2) group over 11 years were 0.94 and 1.56, respectively in the entire population, and incremental ratio in the obesity III group was 66.0% compared to the normal weight group. In consistent BMI level population, incremental ratio (92.1%) for obesity III was higher than entire population. Medical costs in the obesity III groups versus the normal weight group in the entire and consistent BMI level populations increased by 38.4% and 77.1%, respectively. Over 11 years, individuals with BMI ≥30 kg/m2 in the entire and consistent BMI level populations had post-adjustment medical expenditures of 1.13-1.20 and 1.21-1.40 times the normal weight group, respectively. Incidence rate and adjusted hazard ratio of obesity-related disease increased in the obesity groups compared to the normal weight group.Our findings emphasize the importance of the effective and sustainable obesity management strategies, considering the dramatic increase in obesity (BMI ≥30 kg/m2) in South Korea.

SUBMITTER: Song HJ

PROVIDER: S-EPMC5944944 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundSince the early 1980s, papillary thyroid cancer (PTC) incidence rates and the prevalence of obesity, a risk factor for PTC, have increased substantially in the United States. We estimated the proportion of PTC incidence in the United States attributable to overweight and obesity during 1995-2015.MethodsNational Institutes of Health-AARP Diet and Health Study cohort data (n = 457 331 participants, 50-71 years and cancer-free at baseline) were used to estimate multivariable-adjusted hazard ratios (HRs) for PTC across body mass index categories. Population attributable fractions (PAFs) were calculated using estimated hazard ratios and annual overweight and obesity prevalence estimates from the National Health Interview Survey. PAF estimates were combined with Surveillance, Epidemiology, and End Results-13 data to calculate annual percent changes in PTC incidence rates attributable (and unrelated) to overweight and obesity.ResultsOverweight (25.0-29.0 kg/m2) and obesity (≥30.0 kg/m2) were associated with 1.26-fold (95% confidence interval [CI] = 1.05- to 1.52-fold) and 1.30-fold (95% CI = 1.05- to 1.62-fold) increased risks of PTC, respectively, and nearly threefold (HR = 2.93, 95% CI = 1.25 to 6.87) and greater than fivefold (HR = 5.42, 95% CI = 2.24 to 13.1) increased risks of large (>4 cm) PTCs compared with normal weight (18.5-24.9 kg/m2). During 1995-2015, PAF estimates for overweight and obesity increased from 11.4% to 16.2% for all PTCs and from 51.4% to 63.2% for large PTCs. Overweight or obesity accounted for 13.6% and 57.8% of the annual percent changes in total (5.9%/y) and large (4.5%/y) PTC incidence rates, respectively, during 1995-2015.ConclusionsOverweight and obesity may have contributed importantly to the rapid rise in PTC incidence during 1995-2015. By 2015, we estimate that one of every six PTCs diagnosed among adults 60 years or older, including nearly two-thirds of large PTCs, were attributable to overweight and obesity.

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The impact of obesity and overweight on medical expenditures and disease incidence in Korea from 2002 to 2013.

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