Body mass index changes after fecal microbiota transplantation for recurrent Clostridioides difficile infection.

IF 3.9 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Therapeutic Advances in Gastroenterology Pub Date : 2025-02-23 eCollection Date: 2025-01-01 DOI:10.1177/17562848251321121

Kanika Sehgal, Parul Berry, Janice Cho, George Saffouri, Ross A Dierkhising, Eric Battaglioli, Purna C Kashyap, Darrell Pardi, Sahil Khanna

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引用次数: 0

Abstract

Background: Fecal microbiota transplantation (FMT) is a successful therapy for Clostridioides difficile infection (CDI). FMT from overweight donors is speculated to influence the recipient's body mass index (BMI) after administration for CDI.

Objectives: We investigated changes in the recipient's BMI after FMT in relation to the donor's BMI.

Design: We conducted a retrospective cohort study involving patients who underwent FMT for recurrent CDI at Mayo Clinic between 2012 and 2019.

Methods: We analyzed demographic and donor data for patients undergoing FMT at Mayo Clinic (2012-2019). Recipient BMI (pre- and post-FMT) and donor BMI were extracted from medical records. Mixed-effects linear regression was used to evaluate the impact of donor BMI, donor BMI category, recipient baseline BMI, time before and after FMT, and interactions between these variables on overall BMI change and BMI change per month. Kaplan-Meier curves were used to assess BMI changes (⩾5 units) based on the last recorded post-FMT BMI.

Results: We analyzed data from 401 patients with recorded BMI measurements before and after FMT. The median age of the recipients at the time of FMT was 59.1 years (interquartile range (IQR): 40.5-70.1 years), with 61.6% being female. The median BMI for recipients prior to FMT was 26.7 kg/m² (IQR: 22.7-31.6 kg/m²), while the median BMI of the donors was 24.5 kg/m² (IQR: 23.9-27.5 kg/m²). Stool from donors with a normal BMI was used for 58.2% of recipients, while 41.8% received stool from pre-obese donors. Donor BMI data were missing for 3.2% of recipients. Donor BMI was not significantly associated with changes in recipient BMI; for each 1-unit increase in donor BMI, a 0.01-unit monthly increase was observed (95% confidence interval: -0.0003, 0.02; p = 0.11). The log-rank test for BMI increases (⩾+5) and decreases (⩽-5) revealed no significant differences among the donor BMI groups (Chi-squared = 4.4, p = 0.1 for increases, Chi-squared = 2, p = 0.4 for decreases).

Conclusion: The lack of impact of donor BMI on BMI changes post-FMT suggests that these changes are more dependent on the recipient's metabolic profile. Prospective, controlled trials are required to analyze these results more comprehensively.

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粪便微生物群移植治疗复发性艰难梭菌感染后体重指数的变化。

背景：粪便菌群移植（FMT）是治疗艰难梭菌感染（CDI）的成功方法。据推测，来自超重供体的FMT在接受CDI治疗后会影响受体的体重指数（BMI）。目的：我们调查了FMT后受体BMI相对于供体BMI的变化。设计：我们进行了一项回顾性队列研究，涉及2012年至2019年在梅奥诊所接受FMT治疗复发性CDI的患者。方法：我们分析了2012-2019年在梅奥诊所接受FMT的患者的人口统计学和供体数据。从医疗记录中提取受者BMI （fmt前后）和供者BMI。采用混合效应线性回归评估供体BMI、供体BMI类别、受体基线BMI、FMT前后时间以及这些变量之间的相互作用对总体BMI变化和每月BMI变化的影响。Kaplan-Meier曲线用于基于fmt后最后记录的BMI评估BMI变化（大于或等于5个单位）。结果：我们分析了401例患者在FMT前后记录的BMI测量数据。接受FMT治疗的患者年龄中位数为59.1岁（四分位间距为40.5-70.1岁），其中61.6%为女性。FMT前受者的BMI中位数为26.7 kg/m2 (IQR: 22.7-31.6 kg/m2)，而供者的BMI中位数为24.5 kg/m2 （IQR: 23.9-27.5 kg/m2）。58.2%的接受者使用了BMI正常的捐赠者的粪便，而41.8%的接受者使用了肥胖前捐赠者的粪便。3.2%的受者缺少供者BMI数据。供体BMI与受体BMI变化无显著相关；供体BMI每增加1个单位，每月增加0.01个单位(95%可信区间：-0.0003,0.02；p = 0.11)。BMI增加（大于或等于+5）和减少（大于或等于-5）的对数秩检验显示供体BMI组之间没有显著差异（卡方= 4.4，增加p = 0.1，卡方= 2，减少p = 0.4）。结论：供体BMI对fmt后BMI变化的影响不足，表明这些变化更多地依赖于受体的代谢特征。需要前瞻性对照试验来更全面地分析这些结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.70

自引率

2.40%

发文量

103

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.