Han-Sang Baek, Jong Hyuk Lee, Joonyub Lee, Seung-Hwan Lee, Gi June Min, Sung-Soo Park, Silvia Park, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Hee-Je Kim, Chang-Ki Min, Seok-Goo Cho, Jong Wook Lee, Jae-Ho Yoon
{"title":"造血干细胞移植后体重指数与生存的关系。","authors":"Han-Sang Baek, Jong Hyuk Lee, Joonyub Lee, Seung-Hwan Lee, Gi June Min, Sung-Soo Park, Silvia Park, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Hee-Je Kim, Chang-Ki Min, Seok-Goo Cho, Jong Wook Lee, Jae-Ho Yoon","doi":"10.3904/kjim.2024.246","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>The unclear relationship between body mass index (BMI) and post-hematopoietic stem cell transplantation (HSCT) mortality was investigated, including the impact of metabolic diseases.</p><p><strong>Methods: </strong>This retrospective study conducted at a Korean tertiary hospital (2009-2021) included patients who underwent HSCT. Patients were categorized as underweight (BMI < 18.5 kg/m2, n = 106), normal (BMI 18.5-22.9 kg/m2, n = 1,345), overweight (BMI 23.0-24.9 kg/m2, n = 980), or obese (BMI ≥ 25.0 kg/m2, n = 1,471). Diabetes mellitus (DM), hypertension, and dyslipidemia were identified by disease codes or medication prescriptions. A Cox proportional hazards model was used to analyze mortality risks.</p><p><strong>Results: </strong>Over 108 months, 29.8% (1,164/3,902) of the participants died. Patients with underweight had significantly higher mortality (adjusted HR 1.76, 95% CI 1.29-2.40, p < 0.001) than in those with normal BMI. Patients with overweight and obesity did not show increased mortality. Post-HSCT, DM significantly raised mortality risk (HR 3.36, 95% CI 2.86-3.94, p < 0.001), whereas newly diagnosed dyslipidemia was associated with lower mortality (HR 0.27, 95% CI 0.23-0.33, p < 0.001). Post-transplant hypertension had no significant impact on mortality (HR 1.10, 95% CI 0.95-1.28, p = 0.184).</p><p><strong>Conclusion: </strong>Post-HSCT, obesity is not a prognostic factor for poor survival; however, certain metabolic diseases have diverse effects on mortality.</p>","PeriodicalId":48785,"journal":{"name":"Korean Journal of Internal Medicine","volume":"40 4","pages":"645-656"},"PeriodicalIF":2.4000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257010/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between body mass index and survival after hematopoietic stem cell transplantation.\",\"authors\":\"Han-Sang Baek, Jong Hyuk Lee, Joonyub Lee, Seung-Hwan Lee, Gi June Min, Sung-Soo Park, Silvia Park, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Hee-Je Kim, Chang-Ki Min, Seok-Goo Cho, Jong Wook Lee, Jae-Ho Yoon\",\"doi\":\"10.3904/kjim.2024.246\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aims: </strong>The unclear relationship between body mass index (BMI) and post-hematopoietic stem cell transplantation (HSCT) mortality was investigated, including the impact of metabolic diseases.</p><p><strong>Methods: </strong>This retrospective study conducted at a Korean tertiary hospital (2009-2021) included patients who underwent HSCT. Patients were categorized as underweight (BMI < 18.5 kg/m2, n = 106), normal (BMI 18.5-22.9 kg/m2, n = 1,345), overweight (BMI 23.0-24.9 kg/m2, n = 980), or obese (BMI ≥ 25.0 kg/m2, n = 1,471). Diabetes mellitus (DM), hypertension, and dyslipidemia were identified by disease codes or medication prescriptions. A Cox proportional hazards model was used to analyze mortality risks.</p><p><strong>Results: </strong>Over 108 months, 29.8% (1,164/3,902) of the participants died. Patients with underweight had significantly higher mortality (adjusted HR 1.76, 95% CI 1.29-2.40, p < 0.001) than in those with normal BMI. Patients with overweight and obesity did not show increased mortality. Post-HSCT, DM significantly raised mortality risk (HR 3.36, 95% CI 2.86-3.94, p < 0.001), whereas newly diagnosed dyslipidemia was associated with lower mortality (HR 0.27, 95% CI 0.23-0.33, p < 0.001). Post-transplant hypertension had no significant impact on mortality (HR 1.10, 95% CI 0.95-1.28, p = 0.184).</p><p><strong>Conclusion: </strong>Post-HSCT, obesity is not a prognostic factor for poor survival; however, certain metabolic diseases have diverse effects on mortality.</p>\",\"PeriodicalId\":48785,\"journal\":{\"name\":\"Korean Journal of Internal Medicine\",\"volume\":\"40 4\",\"pages\":\"645-656\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257010/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Korean Journal of Internal Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3904/kjim.2024.246\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3904/kjim.2024.246","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景/目的：研究了身体质量指数（BMI）与造血干细胞移植（HSCT）后死亡率之间的不明确关系，包括代谢性疾病的影响。方法：本回顾性研究于2009-2021年在韩国一家三级医院进行，纳入了接受HSCT的患者。患者分为体重过轻（BMI < 18.5 kg/m2, n = 106）、正常（BMI 18.5-22.9 kg/m2, n = 1345）、超重（BMI 23.0-24.9 kg/m2, n = 980）、肥胖（BMI≥25.0 kg/m2, n = 1471）。糖尿病（DM）、高血压和血脂异常是通过疾病代码或药物处方确定的。采用Cox比例风险模型分析死亡风险。结果：108个月后，29.8%（1164 / 3902）的参与者死亡。体重过轻的患者死亡率明显高于BMI正常的患者（校正后危险度1.76,95% CI 1.29-2.40, p < 0.001）。超重和肥胖患者的死亡率没有增加。hsct后，糖尿病显著增加死亡风险（HR 3.36, 95% CI 2.86-3.94, p < 0.001），而新诊断的血脂异常与较低的死亡率相关（HR 0.27, 95% CI 0.23-0.33, p < 0.001）。移植后高血压对死亡率无显著影响（HR 1.10, 95% CI 0.95-1.28, p = 0.184）。结论：hsct后，肥胖不是预后不良的因素；然而，某些代谢性疾病对死亡率有不同的影响。
Association between body mass index and survival after hematopoietic stem cell transplantation.
Background/aims: The unclear relationship between body mass index (BMI) and post-hematopoietic stem cell transplantation (HSCT) mortality was investigated, including the impact of metabolic diseases.
Methods: This retrospective study conducted at a Korean tertiary hospital (2009-2021) included patients who underwent HSCT. Patients were categorized as underweight (BMI < 18.5 kg/m2, n = 106), normal (BMI 18.5-22.9 kg/m2, n = 1,345), overweight (BMI 23.0-24.9 kg/m2, n = 980), or obese (BMI ≥ 25.0 kg/m2, n = 1,471). Diabetes mellitus (DM), hypertension, and dyslipidemia were identified by disease codes or medication prescriptions. A Cox proportional hazards model was used to analyze mortality risks.
Results: Over 108 months, 29.8% (1,164/3,902) of the participants died. Patients with underweight had significantly higher mortality (adjusted HR 1.76, 95% CI 1.29-2.40, p < 0.001) than in those with normal BMI. Patients with overweight and obesity did not show increased mortality. Post-HSCT, DM significantly raised mortality risk (HR 3.36, 95% CI 2.86-3.94, p < 0.001), whereas newly diagnosed dyslipidemia was associated with lower mortality (HR 0.27, 95% CI 0.23-0.33, p < 0.001). Post-transplant hypertension had no significant impact on mortality (HR 1.10, 95% CI 0.95-1.28, p = 0.184).
Conclusion: Post-HSCT, obesity is not a prognostic factor for poor survival; however, certain metabolic diseases have diverse effects on mortality.
期刊介绍：
The Korean Journal of Internal Medicine is an international medical journal published in English by the Korean Association of Internal Medicine. The Journal publishes peer-reviewed original articles, reviews, and editorials on all aspects of medicine, including clinical investigations and basic research. Both human and experimental animal studies are welcome, as are new findings on the epidemiology, pathogenesis, diagnosis, and treatment of diseases. Case reports will be published only in exceptional circumstances, when they illustrate a rare occurrence of clinical importance. Letters to the editor are encouraged for specific comments on published articles and general viewpoints.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
