Baek Han-Sang, Lee Jong Hyuk, Lee Joonyub, Lee Seung-Hwan, Min Gi June, Park Sung-Soo, Park Silvia, Lee Sung-Eun, Cho Byung-Sik, Eom Ki-Seong, Kim Yoo-Jin, Lee Seok, Kim Hee-Je, Min Chang-Ki, Cho Seok-Goo, Lee Jong Wook, Yoon Jae-Ho
Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Hematology, Catholic Hematology Hospital, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
Korean J Intern Med. 2025 Jul;40(4):645-656. doi: 10.3904/kjim.2024.246. Epub 2025 Jul 1.
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.
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.
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).
Post-HSCT, obesity is not a prognostic factor for poor survival; however, certain metabolic diseases have diverse effects on mortality.
背景/目的：研究了体重指数（BMI）与造血干细胞移植（HSCT）后死亡率之间尚不明确的关系，包括代谢性疾病的影响。
这项在韩国一家三级医院进行的回顾性研究（2009 - 2021年）纳入了接受HSCT的患者。患者被分为体重过轻（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）或肥胖（BMI≥25.0 kg/m²，n = 1471）。通过疾病编码或药物处方确定糖尿病（DM）、高血压和血脂异常。使用Cox比例风险模型分析死亡风险。
在超过108个月的时间里，29.8%（1164/3902）的参与者死亡。体重过轻的患者死亡率显著高于BMI正常的患者（调整后HR 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，DM显著提高死亡风险（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没有显著影响（HR 1.10，95% CI 0.95 - 1.28，p = 0.184）。
HSCT后，肥胖不是生存不良的预后因素；然而，某些代谢性疾病对死亡率有不同影响。
