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心脏移植受者的移植后体重指数:决定因素及后果

Post-transplantation body mass index in heart transplant recipients: determinants and consequences.

作者信息

Milaniak I, Przybyłowski P, Wierzbicki K, Sadowski J

机构信息

Cardiovascular Surgery and Transplantology Department, John Paul II Hospital; Krakow, Poland; Andrzej Frycz Modrzewski Krakow University, Faculty of Health and Medical Science; Krakow, Poland.

Cardiovascular Surgery and Transplantology Department, John Paul II Hospital; Krakow, Poland; Collegium Medicum UJ, Krakow, Poland.

出版信息

Transplant Proc. 2014 Oct;46(8):2844-7. doi: 10.1016/j.transproceed.2014.09.025.

Abstract

BACKGROUND

Heart transplantation (HTx) is an important treatment for end-stage chronic heart failure. After HTx, recipients frequently become obese. Gaining weight measured by body mass index (BMI) has been reported as a common phenomenon for patients before and after solid organ transplantation, becoming specifically significant for the long-term follow up after organ transplantation. In the long term following HTx, overweight and obesity may lead to increased risk of cardiovascular complications, developing metabolic syndrome-a topic well documented in previous studies.

AIM

The aims of this study were to calculate the BMI in patients after HTx with follow up in our center and to assess potential predictors for overweight and obesity as well as their consequences.

METHODS

A complete assessment of the BMI among all available heart transplant (HT) recipients (n = 169) was performed. Data were retrieved from patients' charts. Data were statistically analyzed.

RESULTS

The sample mean age was 55.12 ± 13.34 years, mean years since transplantation being 10.70 ± 5.26 years and the majority of study subjects were males (76.33%). Overall BMI was mean 26.33 ± 3.79. Based on the World Health Organization (WHO) classification, 32.54% were normal, 46.74% were overweight, and 18.34% were obese. We did not observe a statistical difference between BMI before and after transplantation, between immunosuppressive protocol, and receipt of steroids. We observed an association between BMI and level of fasting glucose (r = 0.35; P < .05) and difference between BMI and gender as well as the presence of cardiovascular diseases.

CONCLUSIONS

Overweight and obesity after HTx are common and reflect a risk factor for cardiac allograft vasculopathy and other cardiovascular diseases as well as metabolic syndrome among HT recipients.

摘要

背景

心脏移植(HTx)是终末期慢性心力衰竭的重要治疗方法。心脏移植后,受者经常会出现肥胖。据报道,通过体重指数(BMI)衡量体重增加是实体器官移植患者移植前后的常见现象,在器官移植后的长期随访中尤为显著。在心脏移植后的长期随访中,超重和肥胖可能会导致心血管并发症风险增加,进而发展为代谢综合征——这是先前研究中已有充分记录的一个话题。

目的

本研究的目的是计算在我们中心接受随访的心脏移植术后患者的BMI,并评估超重和肥胖的潜在预测因素及其后果。

方法

对所有可获得的心脏移植(HT)受者(n = 169)的BMI进行了全面评估。数据从患者病历中获取。对数据进行了统计分析。

结果

样本的平均年龄为55.12 ± 13.34岁,移植后的平均年限为10.70 ± 5.26年,大多数研究对象为男性(76.33%)。总体BMI平均为= 26.33 ± 3.79。根据世界卫生组织(WHO)的分类,32.54%为正常,46.74%为超重,18.34%为肥胖。我们未观察到移植前后BMI之间、免疫抑制方案之间以及是否接受类固醇之间存在统计学差异。我们观察到BMI与空腹血糖水平之间存在关联(r = 0.35;P <.05),以及BMI与性别和心血管疾病的存在之间存在差异。

结论

心脏移植后超重和肥胖很常见,并且反映了心脏移植受者发生心脏移植血管病变和其他心血管疾病以及代谢综合征的危险因素。

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