Zaydfudim Victor, Feurer Irene D, Moore Derek E, Wisawatapnimit Panarut, Wright J Kelly, Wright Pinson C
Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, TN 37232-2730, USA.
Surgery. 2009 Aug;146(2):174-80. doi: 10.1016/j.surg.2009.04.027.
Recent studies suggest that obesity does not affect survival after liver transplantation. Overweight and obesity, however, impair health-related quality of life (HRQOL) in patients with chronic illnesses. We tested the effect of pretransplant body weight on HRQOL in liver transplant recipients.
Prospective, longitudinal HRQOL data were collected using the SF-36 health survey. Pretransplant body weight was stratified based on body mass index (BMI), as follows: normal (18.5-24.9), overweight (25.0-29.9), and obese (> or =30.0). Linear mixed-effects models were used to test the effects pretransplant BMI category on the trajectory of HRQOL after liver transplantation.
The sample included 154 adults who underwent liver transplantation. Thirty-one percent had normal BMI, 41% were overweight, and 28% were obese pretransplant. The mean pretransplant physical HRQOL did not differ by BMI group (P > or = .697). Physical and mental HRQOL improved (P < .001) in all groups after transplantation, but the rate of improvement in physical HRQOL was significantly greater during the first year posttransplant in the normal BMI compared with the overweight and obese patients (P < or = .032). There was no effect of BMI on the rate of improvement in mental HRQOL.
Excess pretransplant body weight hinders the rate of improvement in physical quality of life during the first year after liver transplantation.
近期研究表明，肥胖并不影响肝移植后的生存率。然而，超重和肥胖会损害慢性病患者的健康相关生活质量（HRQOL）。我们测试了移植前体重对肝移植受者HRQOL的影响。
使用SF-36健康调查收集前瞻性纵向HRQOL数据。根据体重指数（BMI）对移植前体重进行分层，如下：正常（18.5-24.9）、超重（25.0-29.9）和肥胖（≥30.0）。使用线性混合效应模型测试移植前BMI类别对肝移植后HRQOL轨迹的影响。
样本包括154名接受肝移植的成年人。31%的人BMI正常，41%超重，28%移植前肥胖。移植前身体HRQOL的平均值在各BMI组之间无差异（P≥0.697）。移植后所有组的身体和心理HRQOL均有所改善（P<0.001），但与超重和肥胖患者相比，正常BMI患者在移植后第一年身体HRQOL的改善率显著更高（P≤0.032）。BMI对心理HRQOL的改善率没有影响。
移植前体重超标会阻碍肝移植后第一年身体生活质量的改善速度。
