Metabolic syndrome prevalence and impact on outcomes in patients with chronic graft-versus-host disease

• Published in: Bone marrow transplantation (Basingstoke) Vol. 58; no. 12; pp. 1377 - 1383
• Main Authors: Zhao, Aaron T., Pirsl, Filip, Steinberg, Seth M., Holtzman, Noa G., Schulz, Eduard, Mina, Alain, Mays, Jacqueline W., Cowen, Edward W., Comis, Leora E., Joe, Galen O., Yanovski, Jack A., Pavletic, Steven Z.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2023; Nature Publishing Group
• Subjects: 692/308/2779/109; 692/499; Adult; Body mass; Body mass index; Body size; Bone marrow; Bronchiolitis Obliterans Syndrome; C-reactive protein; Cell Biology; Chronic Disease; Comorbidity; Creatinine; Cross-Sectional Studies; Erythrocyte sedimentation rate; Glomerular filtration rate; Graft versus host disease; Graft vs Host Disease - etiology; Graft-versus-host reaction; Hematology; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Internal Medicine; Medicine; Medicine & Public Health; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - etiology; Prevalence; Public Health; Stem cell transplantation; Stem Cells
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/s41409-023-02097-y

Patients with chronic graft-versus-host disease (cGVHD) are at heightened risk for components of metabolic syndrome (MetS), yet the prevalence and impact of MetS in the cGVHD patient population remain unknown. Adult patients ( n  = 229) with cGVHD enrolled in the cross-sectional NIH cGVHD Natural History Study (NCT00092235) were evaluated for MetS at enrollment and for variables associated with MetS. A majority (54.1%, 124/229) of the cohort met the diagnostic criteria for MetS. Patients with higher body mass index and lower performance status scores were more likely to have MetS ( P  < 0.0001; P  = 0.026; respectively). Higher circulating erythrocyte sedimentation rate, C-reactive protein, and creatinine concentrations, along with lower estimated glomerular filtration rate, were associated with MetS ( P  < 0.001; P  < 0.004; P  = 0.02; P  = 0.002; respectively). Patients with MetS compared to patients without MetS had no statistical differences in survival or NRM (5-year OS: 64% [95% CI: 54.8–71.8%] vs. 75.1% [95% CI: 65.6–82.3%]; respectively; overall P  = 0.20; 5-year NRM: 21.7% [95% CI: 13.6–30.9%] vs. 10.1% [95% CI: 4.4–18.7%]; respectively; overall P  = 0.12). Additionally, there was no difference in cGVHD severity between the two groups. Given the high prevalence of MetS in this cohort, clinicians should screen for its presence before it develops into comorbidities that complicate the course of cGVHD treatment.