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Incidence and Risk Factors of Obesity in Childhood Solid-Organ Transplant Recipients
- Source :
- Transplantation. 104:1644-1653
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- 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.
- Subjects :
- Male
Pediatric Obesity
medicine.medical_specialty
Adolescent
030230 surgery
Overweight
Body Mass Index
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Interquartile range
Internal medicine
medicine
Humans
Mass Screening
Cumulative incidence
Registries
Child
Glucocorticoids
Retrospective Studies
Ontario
Transplantation
business.industry
Incidence
Incidence (epidemiology)
Hazard ratio
Age Factors
Infant
Organ Transplantation
medicine.disease
Obesity
Transplant Recipients
Child, Preschool
Female
030211 gastroenterology & hepatology
medicine.symptom
business
Body mass index
Follow-Up Studies
Subjects
Details
- ISSN :
- 00411337
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- Transplantation
- Accession number :
- edsair.doi.dedup.....d6d239a62a4ca8c9764cefa480e23c3d