Association Between Body Composition and Development of Glucose Intolerance after Allogeneic Hematopoietic Cell Transplantation

Autor:	Rusha Bhandari, Jennifer Berano Teh, Tianhui He, Kelly Peng, Aleksi Iukuridze, Liezl Atencio, Ryotaro Nakamura, Sogol Mostoufi-Moab, Shana McCormack, Kyuwan Lee, F. Lennie Wong, Saro H. Armenian
Rok vydání:	2022
Předmět:	Adult Male Epidemiology Hematopoietic Stem Cell Transplantation Middle Aged Overweight Article Adipose Tissue Oncology Glucose Intolerance Body Composition Humans Transplantation Homologous Female Obesity Tomography X-Ray Computed Retrospective Studies
Zdroj:	Cancer Epidemiol Biomarkers Prev
ISSN:	1538-7755 1055-9965
Popis:	Background: Allogeneic hematopoietic cell transplantation (HCT) recipients have increased risk of developing glucose intolerance and diabetes mellitus (DM). The strongest risk factor for glucose intolerance is being overweight/obese, as determined by body mass index (BMI), which does not account for differences in body composition. We examined the association between body composition measures from pre-HCT CT and early-onset (≤30 days) de novo glucose intolerance after HCT, and determined its impact on nonrelapse mortality (NRM). Methods: This study included 749 patients without pre-HCT DM. Skeletal muscle loss [abnormal skeletal muscle gauge (SMG)] and abnormal visceral adiposity (VA) were defined by sex-specific tertiles. Fine–Gray proportional subdistribution HR estimates and 95% confidence intervals (CI) were obtained to determine the association between muscle loss and VA and development of glucose intolerance. 1 year NRM was calculated for patients alive at day 30. Results: Median age at HCT was 50.2 years. By day 30, 8.1% of patients developed glucose intolerance and 731 remained alive. In multivariable analysis, abnormal SMG was associated with increased risk of glucose intolerance in nonoverweight (BMI < 25 kg/m2) patients (HR = 3.00; 95% CI, 1.15–7.81; P = 0.024); abnormal VA was associated with increased risk of glucose intolerance in overweight/obese patients (HR = 2.26; 95% CI, 1.24–4.12; P = 0.008). Glucose intolerance was independently associated with NRM (HR = 1.88; 95% CI, 1.05–3.39; P = 0.035). Conclusions: Abnormal SMG and VA were associated with glucose intolerance in nonoverweight and overweight/obese patients, respectively, which contributed to increased risk of 1 year NRM. Impact: This information may guide personalized interventions to decrease the risk of adverse outcomes after HCT. See related commentary by Giri and Williams, p. 2002
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::82205674437364c92395da614b8c8974 https://doi.org/10.1158/1055-9965.epi-21-1449 Zobrazit plný text záznamu