Incidence and Risk Factors of Obesity in Childhood Solid-Organ Transplant Recipients

被引：8
|
作者：
Bondi, Bianca C. [1 ]
Banh, Tonny M. [1 ]
Vasilevska-Ristovska, Jovanka [1 ]
Szpindel, Aliya [1 ]
Chanchlani, Rahul [2 ,3 ]
Hebert, Diane [4 ,5 ,6 ]
Solomon, Melinda [4 ,6 ,7 ,8 ]
Dipchand, Anne I. [4 ,6 ,9 ]
Kim, S. Joseph [6 ,10 ,11 ]
Ng, Vicky L. [4 ,6 ,12 ]
Parekh, Rulan S. [1 ,5 ,6 ,10 ,11 ,13 ]
机构：
[1] Hosp Sick Children, Res Inst, Child Hlth Evaluat Sci, Toronto, ON, Canada
[2] McMaster Univ, McMaster Childrens Hosp, Dept Pediat, Div Nephrol, Hamilton, ON, Canada
[3] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
[4] Hosp Sick Children, Transplant & Regenerat Med Ctr, Toronto, ON, Canada
[5] Hosp Sick Children, Div Pediat Nephrol, Toronto, ON, Canada
[6] Univ Toronto, Fac Med, Toronto, ON, Canada
[7] Hosp Sick Children, Div Pediat Resp Med, Toronto, ON, Canada
[8] Hosp Sick Children, Labatt Family Heart Ctr, Toronto, ON, Canada
[9] Hosp Sick Children, Labatt Family Heart Ctr, Toronto, ON, Canada
[10] Univ Hlth Network, Dept Med, Toronto, ON, Canada
[11] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[12] Hosp Sick Children, Div Pediat Gastroenterol Hepatol & Nutr, Toronto, ON, Canada
[13] Univ Toronto, Canadian Inst Hlth Res, Canada Res Chair Tier Chron Kidney Dis Epidemiol, Toronto, ON, Canada
来源：
TRANSPLANTATION | 2020年 / 104卷 / 08期
关键词：
BODY-MASS INDEX; RENAL-TRANSPLANTATION; LIVER-TRANSPLANTATION; HEALTH CONSEQUENCES; METABOLIC SYNDROME; PREVALENCE; OVERWEIGHT; CHILDREN; GRAFT; HYPERTENSION;
D O I：
10.1097/TP.0000000000003025
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Background. Obesity is a significant public health concern; however, the incidence post solid-organ transplantation is not well reported. Methods. This study determined the incidence and risk factors of obesity among pediatric solid-organ transplant recipients (heart, lung, liver, kidney, multiorgan) at The Hospital for Sick Children (2002-2011), excluding prevalent obesity. Follow-up occurred from transplantation until development of obesity, last follow-up, or end of study. Incidence of obesity was determined overall, by baseline body mass index, and organ group. Risk factors were assessed using Cox proportional-hazards regression. Results. Among 410 (55% male) children, median transplant age was 8.9 (interquartile range [IQR]: 1.0-14.5) years. Median follow-up time was 3.6 (IQR: 1.5-6.4) years. Incidence of obesity was 65.2 (95% confidence interval [CI]: 52.7-80.4) per 1000 person-years. Overweight recipients had a higher incidence, 190.4 (95% CI: 114.8-315.8) per 1000 person-years, than nonoverweight recipients, 56.1 (95% CI: 44.3-71.1). Cumulative incidence of obesity 5-years posttransplant was 24.1%. Kidney relative to heart recipients had the highest risk (3.13 adjusted hazard ratio [aHR]; 95% CI: 1.53-6.40) for obesity. Lung and liver recipients had similar rates to heart recipients. Those with higher baseline body mass index (z-score; 1.72 aHR; 95% CI: 1.39-2.14), overweight status (2.63 HR; 95% CI: 1.71-4.04), and younger transplant age (y; 1.18 aHR; 95% CI: 1.12-1.25) were at highest risk of obesity. Higher cumulative steroid dosage (per 10 mg/kg) was associated with increased risk of obesity after adjustment. Conclusions. Among all transplanted children at The Hospital for Sick Children, 25% developed obesity within 5-years posttransplant. Kidney recipients, younger children, those overweight at transplant, and those with higher cumulative steroid use (per 10 mg/kg) were at greatest risk. Early screening and intervention for obesity are important preventative strategies.
引用
收藏
页码：1644 / 1653
页数：10
相关论文
共 50 条
  • [31] Herpes Zoster Infections in Solid-Organ Transplant Recipients
    Sari, Nuran
    Erol, Cigdem
    Yalcin, Tugba Yanik
    Azap, Ozlem Kurt
    Arslan, Hande
    Karakaya, Emre
    Altinel, Cemile Tugba
    Sezgin, Atilla
    Incekas, Caner
    Haberal, Mehmet
    EXPERIMENTAL AND CLINICAL TRANSPLANTATION, 2023, 21 (09) : 764 - 771
  • [32] Management of Infectious Complications in Solid-Organ Transplant Recipients
    Grim, S. A.
    Clark, N. M.
    CLINICAL PHARMACOLOGY & THERAPEUTICS, 2011, 90 (02) : 333 - 342
  • [33] Medical progress: Infection in solid-organ transplant recipients
    Fishman, Jay A.
    NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (25): : 2601 - 2614
  • [34] Management of medication noncompliance in solid-organ transplant recipients
    Kaul, V
    Khurana, S
    Munoz, S
    BIODRUGS, 2000, 13 (05) : 313 - 326
  • [35] Pharmacokinetics of Intravenous Isavuconazole in Solid-Organ Transplant Recipients
    Wu, Xuemei
    Clancy, Cornelius J.
    Rivosecchi, Ryan M.
    Zhao, Wenchen
    Shields, Ryan K.
    Marini, Rachel V.
    Venkataramanan, Raman
    Nguyen, M. Hong
    ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2018, 62 (12)
  • [36] RECURRENT CYTOMEGALOVIRUS DISEASE IN SOLID-ORGAN TRANSPLANT RECIPIENTS
    FALAGAS, ME
    SNYDMAN, DR
    TRANSPLANTATION PROCEEDINGS, 1995, 27 (05) : 34 - 37
  • [37] Colorectal cancer among solid-organ transplant recipients
    Johnson, E
    Pirsch, J
    Heise, C
    GASTROENTEROLOGY, 2005, 128 (04) : A798 - A799
  • [38] Management of cytomegalovirus infection in solid-organ transplant recipients
    Murray, BM
    IMMUNOLOGICAL INVESTIGATIONS, 1997, 26 (1-2) : 243 - 255
  • [39] Long-Term Risk of Pulmonary Embolism in Solid-Organ Transplant Recipients
    Kupeli, Elif
    Ulubay, Gaye
    Dogrul, Ilgaz
    Birben, Ozlem
    Seyfettin, Pinar
    Ugurlu, Aylin Ozsancak
    Eyuboglu, Fusun Oner
    Haberal, Mehmet
    EXPERIMENTAL AND CLINICAL TRANSPLANTATION, 2015, 13 : 223 - 227
  • [40] Cardiac operations in solid-organ transplant recipients - Discussion
    Bolman, RM
    Mitruka
    ANNALS OF THORACIC SURGERY, 1997, 64 (05): : 1278 - 1278
12345