The Association between Body Mass Index Groups and Metabolic Comorbidities with Healthcare and Medication Costs: A Nationwide Biobank and Registry Study in Finland

ABSTRACT Background: The increasing prevalence of obesity imposes a significant cost burden on individuals and societies worldwide. Objective: In this nationally representative study, the association between body mass index (BMI) groups and the number of metabolic comorbidities (MetC) with total direct costs was investigated in the Finnish population. Study design, setting, and participants: The study cohort included 5,587 adults with BMI ≥ 18.5 kg/m2 who participated in the cross-sectional FinHealth 2017 health examination survey conducted by the Finnish Institute for Health and Welfare. Data on healthcare resource utilization (HCRU) and drug purchases were collected from national healthcare and drug registers. Main outcome measure: The primary outcome was total direct costs (costs of primary and secondary HCRU and prescription medications). Results: Class I (BMI 30.0–34.9 kg/m2) and class II–III (BMI ≥ 35.0 kg/m2) obesity were associated with 43% and 40% higher age- and sex-adjusted direct costs, respectively, compared with normal weight, mainly driven by a steeply increased comorbidity in the higher BMI groups. In all BMI groups combined, individuals with ≥2 MetCs comprised 39% of the total study population and 60% of the total costs. Conclusion: To manage the cost burden of obesity, treatment should be given equal consideration as other chronic diseases, and BMIs ≥ 30.0 kg/m2 should be considered in treatment decisions

The association between body mass index groups and metabolic comorbidities with healthcare and medication costs: a nationwide biobank and registry study in Finland

ABSTRACTBackground: The increasing prevalence of obesity imposes a significant cost burden on individuals and societies worldwide.Objective: In this nationally representative study, the association between body mass index (BMI) groups and the number of metabolic comorbidities (MetC) with total direct costs was investigated in the Finnish population.Study design, setting, and participants: The study cohort included 5,587 adults with BMI ≥18.5 kg/m2 who participated in the cross-sectional FinHealth 2017 health examination survey conducted by the Finnish Institute for Health and Welfare. Data on healthcare resource utilization (HCRU) and drug purchases were collected from national healthcare and drug registers.Main outcome measure: The primary outcome was total direct costs (costs of primary and secondary HCRU and prescription medications).Results: Class I (BMI 30.0–34.9 kg/m2) and class II – III (BMI ≥35.0 kg/m2) obesity were associated with 43% and 40% higher age- and sex-adjusted direct costs, respectively, compared with normal weight, mainly driven by a steeply increased comorbidity in the higher BMI groups. In all BMI groups combined, individuals with ≥2 MetCs comprised 39% of the total study population and 60% of the total costs.Conclusion: To manage the cost burden of obesity, treatment should be given equal consideration as other chronic diseases, and BMIs ≥30.0 kg/m2 should be considered in treatment decisions

Lihavuuden yhteys elämänlaatuun ja työkykyyn suomalaisessa aikuisväestössä

Vertaisarvioitu. English summary.Lähtökohdat : Tämän poikkileikkaustutkimuksen tavoitteena oli selvittää lihavuuden yhteyksiä elämänlaatuun ja työkykyyn suomalaisessa aikuisväestössä. Menetelmät : Aineistoon kuului 4 956 FinTerveys 2017 -tutkimuksen terveystarkastukseen satunnaisesti valittua täysi-ikäistä henkilöä. Elämänlaatua eri painoindeksiryhmissä selvitettiin EUROHIS-QOL 8 -¬elämänlaatumittarilla. Koettua psyykkistä ja fyysistä työkykyä sekä työstä poissaolojen määrää kartoitettiin kyselylomakkeella. Tulokset : Ylipainoisten ja lihavien elämänlaatu oli merkitsevästi heikompi kuin normaalipainoisten. Lihavat kokivat fyysisen ja psyykkisen työkykynsä heikommaksi kuin normaalipainoiset ja heillä oli enemmän itse raportoituja poissaoloja työstä. Päätelmät : Lihavuus on yhteydessä yksilön kokemukseen terveydestä sekä hyvinvoinnista ja heikentää työkykyä. Lihavuuden tehokkaalla hoidolla voidaan liitännäissairauksien ehkäisyn lisäksi parantaa väestön työ- ja toimintakykyä sekä elämänlaatua.Peer reviewe

The effects of a HTR2B stop codon and testosterone on energy metabolism and beta cell function among antisocial Finnish males

Herein, we examined insulin resistance (IR), insulin sensitivity (IS), beta cell activity, and glucose metabolism in subjects with antisocial personality disorder (ASPD), and whether the serotonin 2B (5-HT2B) receptor and testosterone have a role in energy metabolism. A cohort of subjects belonging to a founder population that included 98 ASPD males, aged 25-30, was divided into groups based on the presence of a heterozygous 5-HT2B receptor loss-of-function gene mutation (HTR2B Q20*; n = 9) or not (n = 89). Serum glucose and insulin levels were measured in a 5 h oral glucose tolerance test (75 g) and indices describing IR, IS, and beta cell activity were calculated. Body mass index (BMI) was also determined. Concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid were measured in cerebrospinal fluid, and testosterone levels from serum. An IR-like state comprising high IR, low IS, and high beta cell activity indices was observed among ASPD subjects without the HTR2B Q20* allele. By contrast, being an ASPD HTR2B Q20* carrier appeared to be preventive of these pathophysiologies. The HTR2B Q20* allele and testosterone predicted lower BMI independently, but an interaction between HTR2B Q20* and testosterone lead to increased insulin sensitivity among HTR2B Q20* carriers with low testosterone levels. The HTR2B Q20* allele also predicted reduced beta cell activity and enhanced glucose metabolism. Reduced 5-HT2B receptor function at low or normal testosterone levels may be protective of obesity. Results were observed among Finnish males having an antisocial personality disorder, which limits the generality. (C) 2016 Elsevier Ltd. All rights reserved.Peer reviewe

The association of body mass index with quality of life and working ability:a Finnish population-based study

Abstract Purpose: The impact of obesity on quality of life (QoL) and working ability vary in different dimensions. This study investigated the association of obesity with QoL and working ability in Finnish adults. Comorbidities as associative factors were also characterised. Methods: This cross-sectional study included 4956 randomly selected adults. QoL (EUROHIS-QOL 8 total score and individual components), perceived physical and psychological working ability, and sick leave days were analysed in different body mass index (BMI) groups. Regression models were used to study the role of comorbidities as associative factors. Results: EUROHIS-QOL 8 total score was significantly lower in BMI group 25.0–29.9 kg/m² (4.01; 95% confidence interval 3.97–4.05), BMI 30.0–34.9 kg/m² (3.85; 3.79–3.91), BMI 35.0–39.9 kg/m² (3.75; 3.66–3.85), and BMI ≥ 40.0 kg/m² (3.73; 3.46–4.00) compared to individuals with normal (18.5–24.9 kg/m²) BMI (4.08; 4.04–4.12). Individuals with obesity (BMI ≥ 30.0 kg/m²) rated their QoL lower than individuals with normal BMI in seven of the eight EUROHIS-QOL 8 components. A lesser proportion of individuals (53–73%) with obesity rated their physical working ability as very or fairly good compared to individuals with normal BMI (90%, p values < 0.001). The psychological working ability was rated as very or fairly good by 71–75% of individuals with obesity compared to 85% of individuals with normal BMI (p = 0.008 and p = 0.001 in individuals with BMI 30.0–34.9 and BMI 35.0–39.9 kg/m², respectively). Conclusions: Obesity was negatively associated with both physical and psychological components of QoL, even after accounting for obesity-related comorbidities. Obesity treatment can benefit from a holistic approach that considers these multifaceted associations

Lihavuuden yhteys elämänlaatuun ja työkykyyn suomalaisessa aikuisväestössä

Vertaisarvioitu. English summary.Lähtökohdat : Tämän poikkileikkaustutkimuksen tavoitteena oli selvittää lihavuuden yhteyksiä elämänlaatuun ja työkykyyn suomalaisessa aikuisväestössä. Menetelmät : Aineistoon kuului 4 956 FinTerveys 2017 -tutkimuksen terveystarkastukseen satunnaisesti valittua täysi-ikäistä henkilöä. Elämänlaatua eri painoindeksiryhmissä selvitettiin EUROHIS-QOL 8 -¬elämänlaatumittarilla. Koettua psyykkistä ja fyysistä työkykyä sekä työstä poissaolojen määrää kartoitettiin kyselylomakkeella. Tulokset : Ylipainoisten ja lihavien elämänlaatu oli merkitsevästi heikompi kuin normaalipainoisten. Lihavat kokivat fyysisen ja psyykkisen työkykynsä heikommaksi kuin normaalipainoiset ja heillä oli enemmän itse raportoituja poissaoloja työstä. Päätelmät : Lihavuus on yhteydessä yksilön kokemukseen terveydestä sekä hyvinvoinnista ja heikentää työkykyä. Lihavuuden tehokkaalla hoidolla voidaan liitännäissairauksien ehkäisyn lisäksi parantaa väestön työ- ja toimintakykyä sekä elämänlaatua.Peer reviewe