The Korean journal of internal medicine · 2025
Association between body mass index and survival after hematopoietic stem cell transplantation.
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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
Аннотация
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.
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.