Association of BMI with mortality in drug-induced liver injury

医学 体重不足 超重 内科学 体质指数 比例危险模型 肝移植 死因 肥胖 死亡率 胃肠病学 移植 疾病
作者
Zikun Ma,Min Li,Yan Wang,Cailun Zou,Yu Wang,Tiantian Guo,Yu Su,Mengmeng Zhang,Meng Yao,Jidong Jia,Jing Zhang,Zhengsheng Zou,Xinyan Zhao
出处
期刊:European Journal of Gastroenterology & Hepatology [Ovid Technologies (Wolters Kluwer)]
卷期号:36 (2): 220-228 被引量:2
标识
DOI:10.1097/meg.0000000000002689
摘要

Background To clarify the associations between BMI and the incidences of all-cause death or liver-related death (LRD)/liver transplantation (LT) in drug-induced liver injury (DILI). Methods DILI patients from three hospitals were retrospectively retrieved and follow-up from 2009 to 2021. They were categorized into underweight (BMI < 18.5 kg/m 2 ), normal weight (BMI of 18.5–23.9 kg/m 2 ), overweight (BMI of 24–27.9 kg/m 2 ) and obese (BMI ≥ 28 kg/m 2 ) groups. Cox regression models were conducted to reveal the effect of BMI on all-cause death or LRD/LT. Results A total of 1469 eligible DILI patients were included: underweight 73 (4.97%), normal weight 811 (55.21%), overweight 473 (32.20%) and obese 112 (7.62%). Eighty-nine patients (6.06%) had all-cause death, of which 66 patients (4.49%) had LRD/LT. The median age was 52 years old, and females were 1039 (70.73%). The associations between BMI and all-cause mortality ( nonlinear test P < 0.01) or liver-related mortality/LT ( nonlinear test P = 0.01) were J-shaped. Multivariate Cox regression analysis showed that underweight (HR: 3.02, 95% CI: 1.51–6.02) was significantly associated with all-cause mortality after adjusting for age and sex. Furthermore, obese males were significantly associated with liver-related mortality/LT (HR: 3.49, 95% CI: 1.13–10.72) after additional adjustment for serological indices and comorbidities. Conclusion Association between BMI and mortality is a J-shape. The overall mortality was significantly higher in underweight and obese group. Male obesity is independently associated with LRD/LT. These findings indicate that DILI patients with extreme BMI would have a high risk of dismal outcomes, which warrants extra medical care.
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