Zhongguo quanke yixue (Oct 2022)
Body Composition Analysis during Allogeneic Hematopoietic Stem Cell Transplantation in Overweight/Obese Patients with Hematologic Diseases
Abstract
Background With the rise of overweight/obese people around the world, the prevalence of allogeneic hematopoietic stem cell transplantation (HSCT) for treating hematologic diseases in this population is also increasing. Obesity has been reported to be associated with poor prognosis after transplantation. More research should be conducted to improve the poor outcome in these patients. Objective To analyze the characteristics of body composition changes in overweight/obese patients with hematologic diseases during allogeneic HSCT, providing evidence and ideas for the delivery of nutritional intervention in the transplantation for these patients. Methods Two hundred and twelve hematologic disease patients with allogeneic HSCT were selected from the First Affiliated Hospital of Soochow University from November 2018 to March 2021. Baseline data, including personal demographics and clinical information, were collected. SPSS 26.0 software was used to compare the changes in body composition and abnormal glucolipid metabolism parameters between patients with normal BMI (normal group, n=137) and those with overweight/obesity (overweight/obese group, n=75) on the day before and after pretreatment, as well as 14 days after transplantation. Results The normal and overweight/obese groups had no significant differences in sex ratio, mean age, diagnosis, preconditioning regimen and HLA typing (P>0.05) . Fourteen days after the allogeneic HSCT, overweight/obese patients had obviously decreased body weight (t=14.271, P<0.001) , fat-free body weight (t=12.344, P<0.001) , skeletal muscle mass (t=14.119, P<0.001) , BMI (t=14.119, P<0.001) and fat-free mass index (FFMI) (t=12.344, P<0.001) , insignificantly changed body fat (P>0.05) , and significantly increased body fat percentage and visceral fat area (t=-3.258, -2.478, P<0.05) . Compared with normal BMI group, overweight/obese group had a more significant decrease in muscle-related indicators such as fat-free body weight, skeletal muscle mass and FFMI (t=3.525, 3.728, 3.545, P<0.05) at 14 days after the allogeneic HSCT. Moreover, the incidence of abnormal fasting glucose and hypercholesterolemia in overweight/obesity group was significantly higher (χ2=7.250, 4.665, P<0.05) . Conclusion We found that overweight/obese patients had a more significant decrease in skeletal muscle mass, a tendency of visceral fat accumulation, and a higher risk of abnormal glycolipid metabolism after the allogeneic HSCT. In view of this, more attention should be given to body weight and body composition in the overweight/obese patients, and corresponding nutrition intervention should be provided to them during the peri-transplant period.
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