Impact of body mass index on graft loss in normal and overweight patients: retrospective analysis of 206 renal transplants
Impact of body mass index on graft loss in normal and overweight patients: retrospective analysis of 206 renal transplants
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DOI：
10.1111/j.1399-0012.2010.01258.x
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发表时间：
2010-11-01
影响因子：
2.1
通讯作者：
Bonofiglio, Renzo
中科院分区：
文献类型：
--
作者：
Papalia, Teresa;Greco, Rosita;Bonofiglio, Renzo
背景：在移植受者中，体重超标越来越普遍。目前，大多数研究人员认为体重指数（BMI）是一个分类变量，假设所有风险因素和移植结果在同一类别的所有患者中相似。我们调查了正常体重（NW：BMI 18.5-24.9）和超重（OW：BMI 25-30）患者的分类和连续BMI增量对肾移植结果的影响。我们人群的平均BMI为24.3 +/- 2.83 kg/m2。各组患者在年龄、性别、透析时间、供体类型、冷缺血时间和HLA错配数量方面相似。使用考克斯多元回归分析确定BMI与生存率的独立相关性。在移植物失功的患者中，移植物功能延迟恢复、慢性移植物肾病、急性排斥反应和高血压的发生率较高。Kaplan-Meier分析显示，OW患者的移植物存活率显著低于NW患者（p = 0.008）。在多变量考克斯回归分析中，作为连续变量评估的初始BMI仍然是移植物丢失的独立预测因子（风险比1.21，95% CI 1.04-1.47）。然而，与患者分层到世界卫生组织的BMI类别，并进一步，到四分位数的初始BMI，BMI类别和移植loss.Conclusion之间没有显着的相关性：我们认为，增加BMI值，虽然没有分类的变化，可能是一个独立的风险因素移植物丢失。我们对小样本人群的回顾性分析需要进一步的研究来证实这些数据。
Background:Excess body mass is increasingly prevalent in transplant recipients. Currently, most investigators consider body mass index (BMI) a categorical variable, which assumes that all risk factors and transplant outcomes will be similar in all patients within the same category. We investigated the effect of categorical and continuous BMI increments on renal transplant outcome in normal weight (NW: BMI 18.5-24.9) and overweight (OW: BMI 25-30) patients.Methods:We retrospectively studied 206 patients. The mean BMI of our population was 24.3 +/- 2.83 kg/m2. Patients of each group were similar regarding age, gender, time on dialysis, donor type, cold ischemia time, and number of HLA mismatches. The independent association of BMI with survival was determined using Cox multivariate regression.Results:OW patients showed a higher prevalence of co-morbidities. In patients with graft loss, there was a higher incidence of delayed graft function, chronic allograft nephropathy, acute rejection, and hypertension. Graft survival was significantly lower in OW patients compared to NW patients upon Kaplan-Meier analysis (p = 0.008). In a multivariate Cox regression analysis, the initial BMI, evaluated as a continuous variable, remained an independent predictor of graft loss (hazard ratio 1.21, 95% CI 1.04-1.47). However, with patient stratification into World Health Organization BMI category and, further, into quartiles of initial BMI, no significant correlation between BMI category and graft loss was found.Conclusion:We suggest that increasing BMI value, although without categorical variation, may represent an independent risk factor for graft loss. Our retrospective analysis of a small sample population will require further studies to confirm these data.