title: Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: a report from the bone marrow transplantation survivor study.
abstract: We ascertained the prevalence of self-reported late occurrence of diabetes, hypertension, and cardiovascular (CV) disease in 1089 hematopoietic cell transplantation (HCT) survivors who underwent HCT between 1974 and 1998, survived at least 2 years, and were not currently taking immunosuppressant agents and compared them with 383 sibling controls. All subjects completed a 255-item health questionnaire. The mean age at survey completion was 39.3 years for survivors and 38.6 years for siblings; mean follow-up was 8.6 years. Adjusting for age, sex, race, and body mass index (BMI), survivors of allogeneic HCT were 3.65 times (95% confidence interval [CI], 1.82-7.32) more likely to report diabetes than siblings and 2.06 times (95% CI, 1.39-3.04) more likely to report hypertension compared with siblings but did not report other CV outcomes with any greater frequency. Recipients of autologous HCTs were no more likely than siblings to report any of the outcomes studied. Allogeneic HCT survivors were also more likely to develop hypertension (odds ratio [OR]=2.31; 95% CI, 1.45-3.67) than autologous recipients. Total body irradiation (TBI) exposure was associated with an increased risk of diabetes (OR=3.42; 95% CI, 1.55-7.52). Thus, HCT survivors have a higher age- and BMI-adjusted risk of diabetes and hypertension, potentially leading to a higher than expected risk of CV events with age.
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis 55455, USA. baker084@umn.edu
authors.forename: K Scott
authors.initials: KS
authors.lastname: Baker
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Julia
authors.initials: J
authors.lastname: Steinberger
authors.forename: Andrea
authors.initials: A
authors.lastname: Carter
authors.forename: Liton
authors.initials: L
authors.lastname: Francisco
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Burns
authors.forename: Charles
authors.initials: C
authors.lastname: Sklar
authors.forename: Stephen
authors.initials: S
authors.lastname: Forman
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisdorf
authors.forename: James G
authors.initials: JG
authors.lastname: Gurney
authors.forename: Smita
authors.initials: S
authors.lastname: Bhatia
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D003625:Data Collection; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D035781:Siblings; D017741:Survivors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation / Q000009:adverse effects