肥胖对阿片类处方药物使用的影响
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肥胖对阿片类处方药物使用的影响
翻译：唐剑 编辑：冯玉蓉 审校：曹莹
背景：在过去的几十年里，肥胖患者迅速增长，伴随而来的是慢性疼痛和处方类阿片药物使用的急剧增加。肥胖通过其与疼痛的联系，可能是导致阿片类药物使用增加的一个重要因素。
方法和结果：这项横断面研究利用美国“国家健康和营养检查调查报告”(NHANES，2003-2016)的数据，调查了35至79岁的成年人中肥胖与处方阿片类药物使用之间的关系。相对于正常体重，超重(25≤ BMI< 30,OR 1.11 [CI 0.88~1.39)，肥胖I类(30≤BMI<35,OR 1.26[CI 1.01~1.57])，肥胖II类(35≤BMI< 40,OR 1.69[CI 1.34~2.12])和肥胖III类(40 ≤ BMI≤ 80,OR 2.33[CI 1.76~3.08])体重指数与阿片类处方药物使用的几率增加相关。慢性阿片类药物使用比持续时间小于90天的阿片类药物使用更多(p＜0.001)。我们估计，在人群水平上，14%(CI 9%~19%)的阿片类处方药物使用可归因于肥胖，这表明在假设肥胖者不肥胖的情况下，每年可能减少150万阿片类药物使用者(CI 0.9~2.0 百万使用者)。
结论：我们的研究结果表明，肥胖流行可能是美国阿片类处方药使用增加的部分原因。
文献来源： Stokes A, Berry KM, Collins JM,et al. The contribution of obesity to prescription opioid use in the United States.Pain 2019, 10;16010(10).
The contribution of obesity to prescription opioid use in the United States
Abstract
The prevalence of obesity has grown rapidly over the past several decades and has been accompanied by an increase in the prevalence of chronic pain and prescription opioid use. Obesity, through its association with pain, may represent an important contributor to opioid use. This cross-sectional study investigated the relationship between obesity and prescription opioid use among adults aged 35 to 79 years using data from the National Health and Nutrition Examination Survey (NHANES, 2003-2016). Relative to normal weight, body mass indices in the overweight {odds ratio (OR), 1.11 (confidence interval [CI], 0.88-1.39)}, obese I (OR, 1.26 [CI, 1.01-1.57]), obese II (OR, 1.69 [CI, 1.34-2.12]), and obese III (OR, 2.33 [CI, 1.76-3.08]) categories were associated with elevated odds of prescription opioid use. The association between excess weight and opioid use was stronger for chronic opioid use than for use with a duration of less than 90 days (P-value, <0.001). We estimated that 14% (CI, 9%-19%) of prescription opioid use at the population level was attributable to obesity, suggesting there might have been 1.5 million fewer opioid users per year under the hypothetical scenario where obese individuals were instead nonobese (CI, 0.9-2.0 million users). Back pain, joint pain, and muscle/nerve pain accounted for the largest differences in self-reported reasons for prescription opioid use across obesity status. Although interpretation is limited by the cross-sectional nature of the associations, our findings suggest that the obesity epidemic may be partially responsible for the high prevalence of prescription opioid use in the United States.
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