Adipose tissue quantification and primary graft dysfunction after lung transplantation: The Lung Transplant Body Composition study.
adipose tissue
inflammation
lung transplantation
obesity
primary graft dysfunction
Journal
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
ISSN: 1557-3117
Titre abrégé: J Heart Lung Transplant
Pays: United States
ID NLM: 9102703
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
07
02
2019
revised:
30
07
2019
accepted:
05
08
2019
pubmed:
3
9
2019
medline:
21
10
2020
entrez:
3
9
2019
Statut:
ppublish
Résumé
Obesity is associated with an increased risk of primary graft dysfunction (PGD) after lung transplantation. The contribution of specific adipose tissue depots is unknown. We performed a prospective cohort study of adult lung transplant recipients at 4 U.S. transplant centers. We measured cross-sectional areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) on chest and abdominal computed tomography (CT) scans and indexed each measurement to height. A total of 262 and 117 subjects had available chest CT scans and underwent protocol abdominal CT scans, respectively. In the adjusted models, a greater abdominal SAT index was associated with an increased risk of PGD (odds ratio 1.9, 95% CI 1.02-3.4, p = 0.04) but not with survival time. VAT indices were not associated with PGD risk or survival time. A greater abdominal SAT index correlated with greater pre- and post-transplant leptin (r = 0.61, p < 0.001, and r = 0.44, p < 0.001), pre-transplant IL-1RA (r = 0.25, p = 0.04), and post-transplant ICAM-1 (r = 0.25, p = 0.04). We identified 3 latent patterns of adiposity. The class defined by high thoracic and abdominal SAT had the greatest risk of PGD. Subcutaneous, but not visceral, adiposity is associated with an increased risk of PGD after lung transplantation.
Sections du résumé
BACKGROUND
Obesity is associated with an increased risk of primary graft dysfunction (PGD) after lung transplantation. The contribution of specific adipose tissue depots is unknown.
METHODS
We performed a prospective cohort study of adult lung transplant recipients at 4 U.S. transplant centers. We measured cross-sectional areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) on chest and abdominal computed tomography (CT) scans and indexed each measurement to height.
RESULTS
A total of 262 and 117 subjects had available chest CT scans and underwent protocol abdominal CT scans, respectively. In the adjusted models, a greater abdominal SAT index was associated with an increased risk of PGD (odds ratio 1.9, 95% CI 1.02-3.4, p = 0.04) but not with survival time. VAT indices were not associated with PGD risk or survival time. A greater abdominal SAT index correlated with greater pre- and post-transplant leptin (r = 0.61, p < 0.001, and r = 0.44, p < 0.001), pre-transplant IL-1RA (r = 0.25, p = 0.04), and post-transplant ICAM-1 (r = 0.25, p = 0.04). We identified 3 latent patterns of adiposity. The class defined by high thoracic and abdominal SAT had the greatest risk of PGD.
CONCLUSIONS
Subcutaneous, but not visceral, adiposity is associated with an increased risk of PGD after lung transplantation.
Identifiants
pubmed: 31474492
pii: S1053-2498(19)31631-6
doi: 10.1016/j.healun.2019.08.013
pmc: PMC6883162
mid: NIHMS1537235
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1246-1256Subventions
Organisme : CSRD VA
ID : IK2 CX001034
Pays : United States
Organisme : NHLBI NIH HHS
ID : R03 HL135227
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL087115
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL105323
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL111115
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL115354
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL114626
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK066525
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL116656
Pays : United States
Organisme : NIDDK NIH HHS
ID : T32 DK007328
Pays : United States
Organisme : NHLBI NIH HHS
ID : L30 HL143645
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL131937
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL134851
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL121406
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
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