title: The impact of obesity on diabetes, hyperlipidemia and hypertension in the United States.
abstract: OBJECTIVE
  The prevalence of obesity and associated cardiometabolic risk factors such as diabetes, hyperlipidemia and hypertension is increasing significantly for all demographic groups.
  
  
  METHODS
  The 2000 and 2002 Medical Expenditure Panel Survey (MEPS), a nationally representative survey of the U.S. population, was used to estimate the marginal impact of obesity on health function, perception, and preferences for individuals with diabetes, hyperlipidemia, and hypertension using multivariate regression methods controlling for age, sex, race, ethnicity, education, income, insurance, smoking status, comorbidity, and proxy response. Three different instruments were used: SF-12 physical component scale (PCS-12) and mental component scale (MCS-12); EQ-5D index and visual analogue scale (VAS). Censored least absolute deviation was used for the EQ-5D and VAS (due to censoring) and ordinary least squares (OLS) was used for the PCS-12 and MCS-12.
  
  
  RESULTS
  After controlling for sociodemographic characteristics, diabetes, hyperlipidemia, and hypertension were associated with significantly lower scores compared to normal weight individuals without the condition for all four instruments. Obesity significantly exacerbated this association. Controlling for comorbidity attenuated the negative association of obesity and cardiometabolic risk factors on instrument scores. In addition, scores decreased for increasing weight and number of risk factors.
  
  
  CONCLUSIONS
  Obesity significantly exacerbates the deleterious association between diabetes, hyperlipidemia, and hypertension, and health function, health perception, and preference-based scores in the United States.
authors.affiliation: Pharmaceutical Outcomes Research Program, School of Pharmacy, University of at Denver Colorado and Health Sciences Center, 4200 East Ninth Avenue, C238, Denver, CO, 80262, USA. patrick.sullivan@uchsc.edu
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Sullivan
authors.forename: Vahram H
authors.initials: VH
authors.lastname: Ghushchyan
authors.forename: Rami
authors.initials: R
authors.lastname: Ben-Joseph
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000503:physiopathology / Q000523:psychology*; D006973:Hypertension / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D010147:Pain Measurement; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
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