Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: a report from the bone marrow transplantation survivor study
Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: a report from the bone marrow transplantation survivor study
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DOI：
10.1182/blood-2006-05-022335
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发表时间：
2007-02-15
期刊：
影响因子：
20.3
通讯作者：
Bhatia, Smita
中科院分区：
文献类型：
--
作者：
Baker, K. Scott;Ness, Kirsten K.;Bhatia, Smita
我们确定了1089例造血细胞移植（HCT）幸存者中自我报告的晚期糖尿病、高血压和心血管（CV）疾病的患病率，这些患者在1974年至1998年间接受了HCT手术，存活至少2年，目前未服用免疫抑制剂，并将他们与383例同胞对照进行了比较。所有受试者都完成了一份包含255个项目的健康问卷。调查完成时，幸存者的平均年龄为39.3岁，兄弟姐妹的平均年龄为38.6岁；平均随访8.6年。调整年龄、性别、种族和体重指数（BMI）后，异基因HCT幸存者报告糖尿病的可能性是其兄弟姐妹的3.65倍（95%可信区间[CI]， 1.82-7.32），报告高血压的可能性是其兄弟姐妹的2.06倍（95% CI, 1.39-3.04），但报告其他CV结果的频率没有增加。自体hct接受者报告任何研究结果的可能性并不比兄弟姐妹高。同种异体HCT幸存者也比自体受体更容易发生高血压（优势比[OR] = 2.31; 95% CI, 1.45-3.67）。全身照射（TBI）暴露与糖尿病风险增加相关（OR = 3.42; 95% CI, 1.55-7.52）。因此，HCT幸存者有更高的年龄和bmi调整后的糖尿病和高血压风险，这可能导致CV事件随年龄增长的风险高于预期。[j] .中华医学杂志。2007;109:1765-1772。(c) 2007年由美国血液学会出版。
We ascertained the prevalence of self-reported late occurrence of diabetes, hypertension, and cardiovascular (CV) disease in 1089 hematopoietic cell transplantation (HCT) survivors who underwent HCT between 1974 and 1998, survived at least 2 years, and were not currently taking immunosuppressant agents and compared them with 383 sibling controls. All subjects completed a 255-item health questionnaire. The mean age at survey completion was 39.3 years for survivors and 38.6 years for siblings; mean follow-up was 8.6 years. Adjusting for age, sex, race, and body mass index (BMI), survivors of allogeneic HCT were 3.65 times (95% confidence interval [CI], 1.82-7.32) more likely to report diabetes than siblings and 2.06 times (95% CI, 1.39-3.04) more likely to report hypertension compared with siblings but did not report other CV outcomes with any greater frequency. Recipients of autologous HCTs were no more likely than siblings to report any of the outcomes studied. Allogeneic HCT survivors were also more likely to develop hypertension (odds ratio [OR] = 2.31; 95% CI, 1.45-3.67) than autologous recipients. Total body irradiation (TBI) exposure was associated with an increased risk of diabetes (OR = 3.42; 95% CI, 1.55-7.52). Thus, HCT survivors have a higher age- and BMI-adjusted risk of diabetes and hypertension, potentially leading to a higher than expected risk of CV events with age. (Blood. 2007;109: 1765-1772). (c) 2007 by The American Society of Hematology.