RESUMEN
BACKGROUND: The comorbidity between obesity and smoking and its association with cardiometabolic risk factors has been little explored. OBJECTIVES: Describe the prevalence of such comorbidity and to explore its association with cardiometabolic risk factors. METHODS: The study was based on the 2016-2017 Chilean National Health Survey and included 6,233 participants. The independent variables were general obesity according to Body Mass Index (BMI), central obesity measured by Waist-to-Height Ratio (WTHR) and Waist Circumference (WC), and daily tobacco consumption (DTC). The dependent variables were blood lipids, fasting glucose and blood pressure. The association analysis was performed by multivariate logistic regression and excluded subjects with a medical record of hypertension, diabetes mellitus and dyslipidemia to avoid reverse causality. RESULTS: The prevalence of General obesity-DTC comorbidity was 7.7%, WTHR risk-DTC was 10.8% and elevated WC-DTC was 13.2%. A total of 3,132 participants were included in logistic regressions. General obesity alone, and DTC-general obesity comorbidity had statistically significant association with elevated triglycerides, decreased HDL, elevated non-HDL and total cholesterol, elevated fasting glucose, and elevated blood pressure. The comorbidities DTC-risk WTHR and DTC-increased WC were associated with increased triglycerides and non-HDL cholesterol. DTC alone was associated with elevated systolic blood pressure. CONCLUSION: DTC-general obesity comorbidity is more frequently associated with the cardiometabolic risk factors explored than DTC-central obesity comorbidity. Smoking cessation can be a cost-effective intervention in this risk comorbidity.
Asunto(s)
Factores de Riesgo Cardiometabólico , Comorbilidad , Encuestas Epidemiológicas , Obesidad , Fumar , Humanos , Masculino , Femenino , Chile/epidemiología , Persona de Mediana Edad , Adulto , Obesidad/epidemiología , Fumar/epidemiología , Prevalencia , Adulto Joven , Índice de Masa Corporal , Circunferencia de la Cintura , Anciano , Adolescente , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Estudios Transversales , Factores de Riesgo , Modelos LogísticosRESUMEN
OBJECTIVES: This study aimed to quantify the association between the loss of health state utilities (LHSU) and obesity, considering different obesity categories. This is relevant to interventions economic evaluations and for public policy decision planning. METHODS: Using data from the Chilean National Health Survey, this study uses linear regression models and counterfactual scenarios to calculate the prevalent burden, population averages, and total sum of LHSU attributable to obesity for the Chilean national level on people older than 15 years, year 2017. Adjustments for socioeconomic status and associated noncommunicable diseases (NCDs) are considered. Calculating the LHSU using these methods enables the approximation of loss of prevalent quality-adjusted life-years (QALYs). RESULTS: The raw obesity LHSU burden was 9.1% (95% uncertainty interval [UI] 5.1-13). When adjustment is considered, the LHSU attributable to obesity reaches 4.6% (95% UI 0.6-8.5) being responsible for 121 045 prevalent QALYs. Socioeconomic status adjusted analysis of higher body mass index (BMI, in kg/m2) categories of obesity shows a dose-response effect for LHSU, being the BMI ≥ 40 category with the highest population average of attributable LHSU (10.1; 95% UI 5.5-14.5, scale 0 [full health] to 100 [dead]). Burden for BMI ≥ 35 categories showed the biggest change after NCD adjustment. CONCLUSIONS: Obesity carries a significant burden of QALY loss. Policy decision-making addressing obesity should focus specially on the BMI ≥ 40 group. NCD comorbidity should be considered for policies addressing the BMI ≥ 35 group.