High prevalence of metabolic syndrome after allogeneic hematopoietic cell transplantation
High prevalence of metabolic syndrome after allogeneic hematopoietic cell transplantation
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DOI：
10.1038/bmt.2008.263
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发表时间：
2009-01-01
影响因子：
4.8
通讯作者：
Burns, L. J.
中科院分区：
文献类型：
--
作者：
Majhail, N. S.;Flowers, M. E.;Burns, L. J.
我们进行了一项横断面研究，以估计代谢综合征的患病率，与心血管疾病相关的危险因素的聚集，在86名接受异基因造血细胞移植（HCT）的成年人中，与258名年龄和性别匹配的美国人群对照组相比，这些对照组选自2005-2006年国家健康和营养调查数据库。研究入组时的中位年龄为50岁（范围，21-71岁），患者距离HCT的中位年龄为3年（范围，1-21岁）。HCT受者中代谢综合征的患病率为49%（95%置信区间（CI），38-60%），与对照组相比增加了2.2倍（95% CI，1.3-3.6，P = 0.002）。HCT组高血压和高血脂的患病率显著高于对照组，而腹型肥胖、血糖升高和低高密度脂蛋白胆固醇的患病率则无显著差异。代谢综合征的HCT幸存者更可能有微量白蛋白尿（43 vs 10%）和肌酐升高（31 vs 11%）。没有患者、供体或移植特征与代谢综合征的诊断相关。我们的结论是代谢综合征经常发生在移植医生看到的同种异体HCT幸存者中。应该为HCT接受者开发代谢综合征的筛查、预防和管理方法。
We conducted a cross-sectional study to estimate the prevalence of metabolic syndrome, a clustering of risk factors associated with cardiovascular disease, among 86 adults who had allogeneic hematopoietic-cell transplant (HCT) as compared with 258 age- and gender-matched US population controls selected from the 2005-2006 National Health and Nutrition Examination Survey database. The median age at study enrollment was 50 years (range, 21-71), and patients were at a median of 3 years (range, 1-21) from HCT. The prevalence of metabolic syndrome was 49% (95% confidence intervals (CI), 38-60%) among HCT recipients, a 2.2-fold (95% CI, 1.3-3.6, P = 0.002) increase compared with controls. The prevalence rates of elevated blood pressure and hypertriglyceridemia were significantly higher among HCT recipients than among controls, but the prevalence rates of abdominal obesity, elevated blood glucose and low high-density lipoprotein cholesterol were not. HCT survivors with metabolic syndrome were more likely to have microalbuminuria (43 vs 10%) and elevated creatinine (31 vs 11%). No patient, donor or transplant characteristics were associated with the diagnosis of metabolic syndrome. We conclude that metabolic syndrome occurs frequently among allogeneic HCT survivors who are seen by transplant physicians. Approaches to screening, prevention and management of metabolic syndrome should be developed for HCT recipients.