Modifiable Co-Morbidities Trends During Hospital Admissions for Obesity in France (2009-2014)
Abstract
Obesity is a growing public health problem in France, but modifiable co-morbidities in obese patients during their hospital admissions excluding bariatric surgery are lacking. Data were extracted from the French national hospital discharge database. Data on patient admissions, age, gender, and length of stay were extracted by selecting any stay coded primary as obesity. Obesity was defined as body mass index (BMI) between 30-39 kg/m², and morbid obesity as BMI≥40 kg/m². Only modifiable co-morbidities frequently diagnosed during the 6-year period with a rate≥3% were chosen. The admission rate for obesity decreased by 27.2% (P<0.001) with more females than males (71.9% vs. 28.1 %; P<0.001). The main modifiable co-morbidities were hypertension (22.72%), sleep apnea (13.64%), diabetes (12.34%), vitamin D deficiency (7.09%), hyperlipidemia (6.9%), hypercholesterolemia (4.98%), and nonalcoholic steatohepatitis (4.94%). Significant decreases were observed for hypertension (14.5%), diabetes (20%), hypercholesterolemia (30%) with steeper increase for vitamin D deficiency (830.7%) and nonalcoholic steatohepatitis (165.2%). Considering obesity class, admission for obesity (BMI: 30-40 kg/m²) and morbid obesity (BMI≥40 kg/m²) increased (P<0.001) by 6% and 7% respectively. Taking into account severity in proportion, stay>3 days significantly increased by 29.2% (P<0.001). The increase in the proportion of morbid obesity, vitamin D deficiency, and nonalcoholic steatohepatitis adds further evidence on the likely adverse health consequences of modifiable obesity-related comorbidities. There is a need for Health Authorities to promoting healthy lifestyle.
NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014:a pooled analysis of 1698 population-based measurementstudies with 19·2 million participants. Lancet2016;387:1377-96.
Girdhar S, Sharma S, Chaudhary A, Bansal P, Satija M.An Epidemiological Study of Overweight and ObesityAmong Women in an Urban Area of North India. Indian JCommunity Med 2016;41:154-7.
Arnold M, Pandeya N, Byrnes G, Renehan AG, StevensGA, Ezzati M, et al. Global burden of cancer attributableto high body-mass index in 2012: a population-basedstudy. Lancet Oncol 2015;16:36-46.
Reeves GK, Balkwill A, Cairns BJ, Green J, Beral V;Million Women Study Collaborators. Hospital admissionsin relation to body mass index in UK women: aprospective cohort study. BMC Med 2014;12:45.
Rahmani A, Sayehmiri K, Asadollahi K, Sarokhani D,Islami F, Sarokhani M. Investigation of the Prevalence ofObesity in Iran: a Systematic Review and Meta-AnalysisStudy. Acta Med Iran 2015;53:596-607.
Kim CH, Kim HK, Kim EH, Bae SJ, Park JY. Associationbetween changes in body composition and risk ofdeveloping Type 2 diabetes in Koreans. Diabet Med2014;31:1393-8.
Nielsen JD, Laverty AA, Millett C, Mainous AG 3rd,Majeed A, Saxena S. Rising obesity-related hospitaladmissions among children and young people in England:national time trends study. PLoS One 2013;8:e65764.
Takahashi Y, Sugimoto K, Inui H, Fukusato T. Currentpharmacological therapies for nonalcoholic fatty liverdisease/nonalcoholic steatohepatitis. World J Gastroenterol2015;21:3777-85.
Korda RJ, Joshy G, Paige E, Butler JR, Jorm LR, Liu B, etal. The relationship between body mass index andhospitalisation rates, days in hospital and costs: findingsfrom a large prospective linked data study. PLoS One2015;10:e0118599.
Gupta S, Richard L, Forsythe A. The humanistic andeconomic burden associated with increasing body massindex in the EU5. Diabetes Metab Syndr Obes 2015;8:327-38.
ObEpi-Roche 2012: Enquête nationale sur l’obésité et le surpoids. (Accessed October 2015, 10, athttp://www.roche.fr/content/dam/roche_france/fr_FR/doc/ obepi_2012.pdf).
Emery C, Dinet J, Lafuma A, Sermet C, Khoshnood B,Fagnani F. Cost of obesity in France. Presse Med2007;36:832-40.
Lin YH, Chu LL, Kao CC, Chen TB, Lee I, Li HC. TheEffects of a Diet and Exercise Program for Older AdultsWith Metabolic Syndrome. J Nurs Res 2015;23:197-205.
Lehmann U, Gjessing HR, Hirche F, Mueller-Belecke A,Gudbrandsen OA, Ueland PM, et al. Efficacy of fish intakeon vitamin D status: a meta-analysis of randomizedcontrolled trials. Am J Clin Nutr 2015;102:837-47.
Tsunoda K, Kai Y, Kitano N, Uchida K, Kuchiki T,Nagamatsu T. Impact of physical activity on nonalcoholicsteatohepatitis in people with nonalcoholic simple fattyliver: A prospective cohort study. Prev Med 2016;88:237-240.
Herrick JE, Bliwise DL, Puri S, Rogers S, Richards KC.Strength training and light physical activity reduces theapnea-hypopnea index in institutionalized older adults. JAm Med Dir Assoc 2014;15:844-6.
Mc Donald A, Bradshaw RA, Fontes F, Mendoza EA,Motta JA, Cumbrera A, Cruz C. Prevalence of obesity inpanama: some risk factors and associated diseases. BMCPublic Health 2015;15:1075.
Pearl RL1, Dovidio JF, Puhl RM, Brownell KD. Exposureto Weight-Stigmatizing Media: Effects on ExerciseIntentions, Motivation, and Behavior. J Health Commun2015;20:1004-13.
Cohen E, Boetsch G, Palstra FP, Pasquet P. Socialvalorisation of stoutness as a determinant of obesity in thecontext of nutritional transition in Cameroon: the Bamilékécase. Soc Sci Med. 2013;96:24-32
Vidal P, Ramón JM, Goday A, Parri A, Crous X, Trillo L,et al. Lack of adherence to follow-up visits after bariatricsurgery: reasons and outcome. Obes Surg 2014;24:179-83.
Bocquier A, Paraponaris A, Gourheux JC, Lussault PY,Basdevant A, Verger P. Obesity management knowledge,attitudes and practices of general practitioners insoutheastern France; results of a telephone survey. PresseMed 2005;34:769-75.
Wilmot EG, Edwardson CL, Biddle SJ, Gorely T, HensonJ, Khunti K, et al. Prevalence of diabetes and impairedglucose metabolism in younger 'at risk' UK adults: insightsfrom the STAND programme of research. Diabet Med2013;30:671-5.
Jennings A, Hughes CA, Kumaravel B, Bachmann MO,Steel N, Capehorn M, et al. Evaluation of amultidisciplinary Tier 3 weight management service foradults with morbid obesity, or obesity and co-morbidities,based in primary care. Clin Obes 2014;4:254-66.
Zeller MH, Inge TH, Modi AC, Jenkins TM, MichalskyMP, Helmrath M, et al. Teen Longitudinal Assessment ofBariatric Surgery (TeenLABS) Consortium. Severeobesity and co-morbidcondition impact on the weightrelatedquality of life of the adolescent patient. J Pediatr2015;166:651-9.e4.
Fredheim JM, Rollheim J, Omland T, Hofsø D, Røislien J,Vegsgaard K, et al. Type 2 diabetes and pre-diabetes areassociated with obstructive sleep apnea in extremely obesesubjects: a cross-sectional study. Cardiovasc Diabetol2011;10:84.
Ducloux R, Nobécourt E, Chevallier JM, Ducloux H, ElianN, Altman JJ. Vitamin D deficiency before bariatricsurgery: should supplement intake be routinely prescribed?Obes Surg 2011;21:556-60.
Xanthakos SA, Jenkins TM, Kleiner DE, Boyce TW,Mourya R, Karns R, et al. Teen-LABS Consortium. HighPrevalence of Nonalcoholic Fatty Liver Disease inAdolescents Undergoing Bariatric Surgery.Gastroenterology 2015;149:623-34.
Santomauro M, Paoli-Valeri M, Fernández M, CamachoN, Molina Z, Cicchetti R, et al. Non-alcoholic fatty liverdisease and its association with clinical and biochemicalvariables in obese children and adolescents: effect of aone-year intervention on lifestyle. Endocrinol Nutr2012;59:346-53.
Ekstedt M, Franzén LE, Mathiesen UL, Thorelius L,Holmqvist M, Bodemar G, et al. Long-term follow-up ofpatients with NAFLD and elevated liver enzymes.Hepatology 2006;44:865-73
Dasarathy J, Periyalwar P, Allampati S, Bhinder V,Hawkins C, Brandt P, et al. Hypovitaminosis D isassociated with increased whole body fat mass and greaterseverity of non-alcoholic fatty liver disease. Liver Int2014;34:e118-27.
| Files | ||
| Issue | Vol 55, No 7 (2017) | |
| Section | Original Articles | |
| Keywords | ||
| Arterial hypertension Diabetes Hypercholesterolaemia Hyperlipidaemia Nonalcoholic steatohepatitis Vitamin D deficiency | ||
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