| Affiliation: | 1. Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsugagun-Mibu, Japan;2. Ibaraki Health Plaza, Mito, Japan;3. Ibaraki Health Service Association, Mito, Japan;4. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan;5. Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan;6. Department of Health and Welfare, Ibaraki Prefectural Office, Mito, Japan |
| Abstract: | BackgroundThe aim of this study was to examine the attribution of each cardiovascular risk factor in combination with abdominal obesity (AO) on Japanese health expenditures.MethodsThe health insurance claims of 43,469 National Health Insurance beneficiaries aged 40–75 years in Ibaraki, Japan, from the second cohort of the Ibaraki Prefectural Health Study were followed-up from 2009 through 2013. Multivariable health expenditure ratios (HERs) of diabetes mellitus (DM), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), and hypertension with and without AO were calculated with reference to no risk factors using a Tweedie regression model.ResultsWithout AO, HERs were 1.58 for DM, 1.06 for high LDL-C, 1.27 for low HDL-C, and 1.31 for hypertension (all P < 0.05). With AO, HERs were 1.15 for AO, 1.42 for DM, 1.03 for high LDL-C, 1.11 for low HDL-C, and 1.26 for hypertension (all P < 0.05, except high LDL-C). Without AO, population attributable fractions (PAFs) were 2.8% for DM, 0.8% for high LDL-C, 0.7% for low HDL-C, and 6.5% for hypertension. With AO, PAFs were 1.0% for AO, 2.3% for DM, 0.4% for low HDL-C, and 5.0% for hypertension.ConclusionsOf the obesity-related cardiovascular risk factors, hypertension, independent of AO, appears to impose the greatest burden on Japanese health expenditures. |
