文摘
Hypertriglyceridemia is a lipid abnormality prevalent in 1/3 of the United States adult population. Our objective was to describe the independent contribution of hypertriglyceridemia to medical care costs. Using an observational cohort of 108,324 members of Kaiser Permanente Northwest, we analyzed the electronic medical records of those patients aged ≥18 years who had triglyceride (TG) measurements in 2008 and had been members of Kaiser Permanente Northwest for the entire year. After assigning patients to TG categories of <150, 150 to 199, 200 to 499, and ≥500 mg/dl, we compared the annual direct medical costs. To isolate the independent contribution of the TG levels, we adjusted the costs for age, gender, body mass index, blood pressure, smoking history, low-density lipoprotein and high-density lipoprotein cholesterol, and health conditions such as cardiovascular disease, diabetes, and renal disease. Of the 108,324 study subjects, 64.1 % had normal TG levels (<150 mg/dl), 16.4 % had borderline high levels (150 to 199 mg/dl), 18.0 % had high TG levels (200 to 499 mg/dl), and 1.5 % had very high TG levels (≥500 mg/dl). After adjustment, the patients with TG levels ≥500 mg/dl (severe hypertriglyceridemia) had significantly greater mean total costs ($8,567, 99 % confidence interval $7,034 to $10,100) than those with levels <150 mg/dl ($6,186, 99 % confidence interval $6,058 to $6,314), 150 to 199 mg/dl ($6,449, 99 % confidence interval $6,196 to $6,702), or 200 to 499 mg/dl ($6,376, 99 % confidence interval $6,118 to $6,634). The differences were driven by both outpatient and pharmaceutical costs. The inpatient costs were also greater for those with TG levels ≥500 mg/dl, but the difference did not reach statistical significance. In conclusion, severe hypertriglyceridemia was associated with 33 % to 38 % greater medical costs per annum, independent of resource-intensive conditions such as cardiovascular disease, heart failure, hypertension, and diabetes.
