Background: Little is known about the association between abnormal metabolic obesity states and the outcomes of chronic myeloid leukemia (CML), especially in patients with obesity with different metabolic status. Here, we used the Nationwide Readmissions Database to assess the effects of metabolically defined obesity on adverse outcomes of CML.
Methods: Of the 35 460 557 (weighted) patients, we included 7931 adults with discharge diagnoses of CML from January 1, 2018 to June 30, 2018. The study population was observed until December 31, 2018 and divided into four groups based on body mass index and metabolic status. The primary outcome was the adverse outcomes of CML, including nonremission (NR)/relapse and severe mortality risk. Multivariate logistic regression analysis was performed to analyze data.
Results: Metabolically unhealthy normal weight and metabolically unhealthy obesity were all risk factors for adverse outcomes of CML compared with metabolically healthy normal weight (all p < 0.01), and a significant difference was not found in the metabolically healthy obese. Female patients with metabolically unhealthy normal weight and metabolically unhealthy obesity had 1.23-fold and 1.40-fold increased NR/relapse risk, while male patients did not have this risk. Moreover, patients with a higher number of metabolic risk factors or with dyslipidemia were at higher risk of adverse outcomes, regardless of obesity status.
Conclusions: Metabolic abnormalities were associated with adverse outcomes in patients with CML, irrespective of obesity status. Future treatment of patients with CML should consider the effects of obesity on their adverse outcomes under different metabolic status, especially in female patients.
目的:目前对异常代谢性肥胖状态与慢性粒细胞白血病(CML)预后的关系知之甚少, 尤其是不同代谢状态的肥胖患者。在本研究中, 我们利用全国再入院数据库评估了代谢定义的肥胖对CML不良结局的影响。 方法:纳入2018年1月1日至2018年6月30日出院诊断为CML的成人患者7931例。研究人群观察至2018年12月31日, 根据体重指数和代谢状态分为4组。主要结局指标为CML的不良结局, 包括未缓解(NR)/复发和严重死亡风险。采用多因素logistic回归分析数据。 结果:与代谢健康的正常体重患者相比, 代谢不健康的正常体重和代谢不健康的肥胖均是CML不良结局的危险因素(均p < 0.01), 而代谢健康的肥胖与CML不良结局差异无统计学意义。代谢不健康的正常体重女性患者和代谢不健康的肥胖患者的NR/复发风险分别增加1.23倍和1.40倍, 而男性患者则无明显变化。此外, 无论肥胖状态如何, 合并代谢危险因素数量越多或血脂异常的患者发生不良结局的风险越高。 结论:无论肥胖是否处于健康还是不健康状态, 代谢异常与CML患者不良预后相关。未来CML患者的治疗应考虑不同代谢状态下肥胖对其不良结局的影响, 尤其是女性患者。.
Keywords: adverse outcomes; chronic myeloid leukemia; metabolic abnormalities; obesity; 不良结局; 代谢异常; 慢性粒细胞白血病; 肥胖.
© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.