title: Negative effects of pretransplant body mass index on physical health-related quality of life after lung transplant.
abstract: BACKGROUND
  Although current national data show improved graft and patient survival following lung transplant, the effects of several modifiable preexisting comorbid conditions on health-related quality of life after transplant have not been evaluated. This study examines the effects of 3 comorbid conditions present before lung transplant (reduced bone density, diabetes mellitus, and elevated body mass index) on health-related quality of life after lung transplant.
  
  
  METHODS
  The Short Form 36 Health Survey was completed by 92 adult recipients at various times after lung transplant (mean, 41 months; range, 1-127 months). Multiple linear regression models that controlled for underlying disease, chronic rejection, and time after transplant tested the independent effects of the 3 pretransplant conditions on posttransplant health-related quality of life.
  
  
  RESULTS
  The effects of pretransplant reduced bone density and diabetes mellitus were not statistically significant in these models. However, pretransplant body mass index had a significant negative effect (β = -.29, P = .007) on posttransplant physical health-related quality of life. Additionally, overweight status and obesity exerted comparable independent negative effects (P = .01 and P = .03, respectively) on the physical function scale of the Short-Form 36 Health Survey compared with persons who were underweight or normal weight before transplant.
  
  
  CONCLUSIONS
  Reevaluation of elevated body mass index before transplant as a risk for reduced physical quality of life after lung transplant should be considered.
authors.affiliation: Vanderbilt Transplant Center, Nashville, TN, USA. haley.hoy@vanderbilt.edu
authors.forename: Haley M
authors.initials: HM
authors.lastname: Hoy
authors.forename: Irene D
authors.initials: ID
authors.lastname: Feurer
authors.forename: Susan
authors.initials: S
authors.lastname: Alexander
authors.forename: Jim
authors.initials: J
authors.lastname: Loyd
authors.forename: Nancy
authors.initials: N
authors.lastname: Wells
authors.forename: C Wright
authors.initials: CW
authors.lastname: Pinson
mesh_terms: D015992:Body Mass Index; D015519:Bone Density; D015897:Comorbidity; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires