肥胖的并发症—培训课件.ppt

* Relationship between weight gain in adulthood and risk of type 2 diabetes mellitus An increase in weight since young adulthood (18–20 years of age) in men and women is associated with increased risk of developing type 2 diabetes. A weight gain of 10 kg, which is the average amount of weight gained by US adults from 20 to 50 years of age, is associated with a two- to threefold increase in the risk of diabetes. Weight gain during adulthood is also associated with an increased risk of coronary heart disease, hypertension, and cholelithiasis compared with those who maintain their weight after 18 to 20 years of age. Willet WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med 1999;341:427-434. * Direct cost of chronic diseases in the United States It is estimated that obesity accounts for 6% of the nation’s total healthcare expenses, with $51.6 billion/year in direct costs and over $100 billion/year in both direct and indirect costs. Direct costs include the costs of personal health care, hospital care, physician services, allied health services, and medications. Indirect costs include the value of lost productivity from illness or premature mortality. The estimated direct cost of obesity is comparable to that of other prevalent, chronic diseases, such as type 2 diabetes and coronary heart disease, and is more costly than both hypertension and stroke. Moreover, obesity contributes to the development of other chronic diseases; it is estimated that 61% of the direct cost of type 2 diabetes, 17% of the direct cost of coronary heart disease, and 17% of the direct cost of hypertension are attributable to obesity. Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes Res. 1998;6:97-106. Hodgson TA, Cohen AJ. Medical care expenditures for selected circulatory diseases: opportunities for reducing national health expenditures. Med Care. 1999;37:994-1012. * Effect of obesity on expected lifetime medical care costs