From weight to wellness: New database transforms obesity research

A new medical database automatically compiles the medical records of obese patients and those suffering from obesity-related diseases in a uniquely comprehensive and reliable manner. The initiative, led by Kobe University, offers valuable insights for health promotion and drug development.

“Obesity is at the root of many diseases,” says OGAWA Wataru, an endocrinologist at Kobe University. Obesity has been linked to the development of diabetes, hypertension, gout, coronary heart disease, stroke and many other diseases. Monitoring, treating and preventing obesity and the diseases it can cause is therefore not only good for the individual, but also important for the efficient use of public health resources.

But understanding the interplay between the various conditions is far from clear. Ogawa says, “Witnessing the complex health challenges faced by obese patients in daily clinical practice inspired me to seek a solution that more accurately reflects their true condition.” The most basic requirement is a source of reliable epidemiological data. But available data sources are either incomplete or written for insurance reimbursement purposes, which doesn’t accurately reflect patients’ conditions. Ogawa therefore took the initiative to create a new data collection template based on Japanese digital medical records that links sample analysis data, drug prescriptions, patient examination records, and disease incidence, and automatically updates an anonymized file in a database each time a patient visits a doctor at one of the currently seven participating healthcare facilities across Japan. “This database system now enables the efficient collection and analysis of comprehensive clinical information related to obesity management - something that was not possible before,” comments Ogawa on the project, which is managed by the Japan Society for the Study of Obesity (JASSO).

In the Journal of Diabetes Investigation, Ogawa and his team present the first results from 1,169 of the approximately 3,000 patients currently enrolled in the J-ORBIT database. The data not only show that most obese people have three other diabetes-related diseases, but also confirm or refute previous assumptions about how strongly obesity and various diseases are related. In addition, it showed that some treatment options, such as behavioral therapy, are underused. And because the dataset is so comprehensive, its analysis also revealed a high prevalence of conditions not traditionally associated with obesity, such as menstrual abnormalities and female infertility.

J-ORBIT shares its architecture and some of its data with another medical database, the Japan Diabetes Society’s J-DREAMS that collects data from diabetes patients. Ogawa explains, “I was involved in the management of J-DREAMS and wanted to develop a similar database specifically for obesity management.” The systems are set up so that, at institutions contributing to both databases, relevant patient data is automatically extracted and shared to both J-ORBIT and J-DREAMS. While this integration allows both diabetes and obesity researchers to rely on well-contextualized and accurate data, it comes with the disadvantage that diabetes is likely overrepresented in J-ORBIT data.

One of the biggest benefits of the system is that it can identify patients whose health would benefit most from weight loss and suggest appropriate treatment options. The pharmaceutical industry is also paying close attention. Ogawa explains: “Several companies developing anti-obesity drugs have provided funding for the system, and some of them have already started research using the data. So as obesity treatment undergoes a major transformation, a database like J-ORBIT will be of great importance.”

This research was funded by Japan Agency for Medical Research and Development (grant 16816396), Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd. and Boehringer Ingelheim Co. Ltd. It was conducted in collaboration with researchers from the National Center for Global Health and Medicine, Gifu University, Kyoto University, Tokushima University, Okayama University, Shiga University of Medical Science, the University of Tokyo and Chiba University.

Kobe University is a national university with roots dating back to the Kobe Higher Commercial School founded in 1902. It is now one of Japan’s leading comprehensive research universities with nearly 16,000 students and nearly 1,700 faculty in 10 faculties and schools and 15 graduate schools. Combining the social and natural sciences to cultivate leaders with an interdisciplinary perspective, Kobe University creates knowledge and fosters innovation to address society’s challenges.