Incidence and Risk Factors of Obesity in Childhood Solid-Organ Transplant Recipients

被引：8
|
作者：
Bondi, Bianca C. [1 ]
Banh, Tonny M. [1 ]
Vasilevska-Ristovska, Jovanka [1 ]
Szpindel, Aliya [1 ]
Chanchlani, Rahul [2 ,3 ]
Hebert, Diane [4 ,5 ,6 ]
Solomon, Melinda [4 ,6 ,7 ,8 ]
Dipchand, Anne I. [4 ,6 ,9 ]
Kim, S. Joseph [6 ,10 ,11 ]
Ng, Vicky L. [4 ,6 ,12 ]
Parekh, Rulan S. [1 ,5 ,6 ,10 ,11 ,13 ]
机构：
[1] Hosp Sick Children, Res Inst, Child Hlth Evaluat Sci, Toronto, ON, Canada
[2] McMaster Univ, McMaster Childrens Hosp, Dept Pediat, Div Nephrol, Hamilton, ON, Canada
[3] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
[4] Hosp Sick Children, Transplant & Regenerat Med Ctr, Toronto, ON, Canada
[5] Hosp Sick Children, Div Pediat Nephrol, Toronto, ON, Canada
[6] Univ Toronto, Fac Med, Toronto, ON, Canada
[7] Hosp Sick Children, Div Pediat Resp Med, Toronto, ON, Canada
[8] Hosp Sick Children, Labatt Family Heart Ctr, Toronto, ON, Canada
[9] Hosp Sick Children, Labatt Family Heart Ctr, Toronto, ON, Canada
[10] Univ Hlth Network, Dept Med, Toronto, ON, Canada
[11] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[12] Hosp Sick Children, Div Pediat Gastroenterol Hepatol & Nutr, Toronto, ON, Canada
[13] Univ Toronto, Canadian Inst Hlth Res, Canada Res Chair Tier Chron Kidney Dis Epidemiol, Toronto, ON, Canada
来源：
TRANSPLANTATION | 2020年 / 104卷 / 08期
关键词：
BODY-MASS INDEX; RENAL-TRANSPLANTATION; LIVER-TRANSPLANTATION; HEALTH CONSEQUENCES; METABOLIC SYNDROME; PREVALENCE; OVERWEIGHT; CHILDREN; GRAFT; HYPERTENSION;
D O I：
10.1097/TP.0000000000003025
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Background. Obesity is a significant public health concern; however, the incidence post solid-organ transplantation is not well reported. Methods. This study determined the incidence and risk factors of obesity among pediatric solid-organ transplant recipients (heart, lung, liver, kidney, multiorgan) at The Hospital for Sick Children (2002-2011), excluding prevalent obesity. Follow-up occurred from transplantation until development of obesity, last follow-up, or end of study. Incidence of obesity was determined overall, by baseline body mass index, and organ group. Risk factors were assessed using Cox proportional-hazards regression. Results. Among 410 (55% male) children, median transplant age was 8.9 (interquartile range [IQR]: 1.0-14.5) years. Median follow-up time was 3.6 (IQR: 1.5-6.4) years. Incidence of obesity was 65.2 (95% confidence interval [CI]: 52.7-80.4) per 1000 person-years. Overweight recipients had a higher incidence, 190.4 (95% CI: 114.8-315.8) per 1000 person-years, than nonoverweight recipients, 56.1 (95% CI: 44.3-71.1). Cumulative incidence of obesity 5-years posttransplant was 24.1%. Kidney relative to heart recipients had the highest risk (3.13 adjusted hazard ratio [aHR]; 95% CI: 1.53-6.40) for obesity. Lung and liver recipients had similar rates to heart recipients. Those with higher baseline body mass index (z-score; 1.72 aHR; 95% CI: 1.39-2.14), overweight status (2.63 HR; 95% CI: 1.71-4.04), and younger transplant age (y; 1.18 aHR; 95% CI: 1.12-1.25) were at highest risk of obesity. Higher cumulative steroid dosage (per 10 mg/kg) was associated with increased risk of obesity after adjustment. Conclusions. Among all transplanted children at The Hospital for Sick Children, 25% developed obesity within 5-years posttransplant. Kidney recipients, younger children, those overweight at transplant, and those with higher cumulative steroid use (per 10 mg/kg) were at greatest risk. Early screening and intervention for obesity are important preventative strategies.
引用
收藏
页码：1644 / 1653
页数：10
相关论文
共 50 条
  • [21] Tolerance in Solid-Organ Transplant
    Fine, Richard N.
    EXPERIMENTAL AND CLINICAL TRANSPLANTATION, 2016, 14 : 1 - 5
  • [22] Vaccination Status in Pediatric Solid-Organ Transplant Recipients and Their Household Members
    Cortina, Gerard
    Ojinaga, Violeta
    Zlamy, Manuela
    Giner, Thomas
    Riedl, Magdalena
    Rauchenzauner, Markus
    Entenmann, Andreas
    Mueller, Thomas
    EXPERIMENTAL AND CLINICAL TRANSPLANTATION, 2019, 17 (04) : 429 - 434
  • [23] Clinical Experience with Immune Monitoring for Cytomegalovirus in Solid-Organ Transplant Recipients
    Manuel, Oriol
    CURRENT INFECTIOUS DISEASE REPORTS, 2013, 15 (06) : 491 - 496
  • [24] Management of Skin Cancer in Solid-organ Transplant Recipients: A Multidisciplinary Approach
    Greenberg, Judah N.
    Zwald, Fiona O.
    DERMATOLOGIC CLINICS, 2011, 29 (02) : 231 - +
  • [25] Epidemiology and risk factors for late infection in solid organ transplant recipients
    Cervera, C.
    Fernandez-Ruiz, M.
    Valledor, A.
    Linares, L.
    Anton, A.
    Angeles Marcos, M.
    Sanclemente, G.
    Hoyo, I.
    Cofan, F.
    Ricart, M. J.
    Perez-Villa, F.
    Navasa, M.
    Pumarola, T.
    Moreno, A.
    TRANSPLANT INFECTIOUS DISEASE, 2011, 13 (06) : 598 - 607
  • [26] Risk Factors Profile and Cardiovascular Events in Solid Organ Transplant Recipients
    Ghods, Ahad J.
    IRANIAN JOURNAL OF KIDNEY DISEASES, 2012, 6 (01) : 9 - 13
  • [27] Patients with psychotic disorders in solid-organ transplant
    Zimbrean, Paula
    Emre, Sukru
    PROGRESS IN TRANSPLANTATION, 2015, 25 (04) : 289 - 296
  • [28] Herpes zoster incidence in a multicenter cohort of solid organ transplant recipients
    Pergam, S. A.
    Forsberg, C. W.
    Boeckh, M. J.
    Maynard, C.
    Limaye, A. P.
    Wald, A.
    Smith, N. L.
    Young, B. A.
    TRANSPLANT INFECTIOUS DISEASE, 2011, 13 (01) : 15 - 23
  • [29] Neuroendocrine Carcinomas Arising in Solid-Organ Transplant Recipients: Rare but Aggressive Malignancies
    Fiebiger, Wolfgang
    Kaserer, Klaus
    Roedler, Suzanne
    Oberbauer, Rainer
    Bauer, Claudia
    Raderer, Markus
    ONCOLOGY, 2009, 77 (05) : 314 - 317
  • [30] Nonmelanoma Skin Cancers in Solid-Organ Transplant Recipients: A Single Center Experience
    Albayati, Abbas
    Ozkan, Burak
    Eyuboglu, Atilla Adnan
    Uysal, Ahmet Cagri
    Ertas, Nilgun Markal
    Haberal, Mehmet
    EXPERIMENTAL AND CLINICAL TRANSPLANTATION, 2018, 16 : 95 - 100
12345