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Associations of obesity with antidiabetic medication use after living kidney donation: An analysis of linked national registry and pharmacy fill records
Author(s) -
Lentine Krista L.,
Koraishy Farrukh M.,
Sarabu Nagaraju,
Naik Abhijit S.,
Lam Ngan N.,
Garg Amit X.,
Axelrod David,
Zhang Zidong,
Hess Gregory P.,
Kasiske Bertram L.,
Segev Dorry L.,
Henderson Macey L.,
Massie Allan B.,
Holscher Courtenay M.,
Schnitzler Mark A.
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13696
Subject(s) - medicine , underweight , overweight , body mass index , obesity , hazard ratio , pharmacy , incidence (geometry) , metformin , diabetes mellitus , insulin , endocrinology , confidence interval , family medicine , physics , optics
We examined a novel linkage of national US donor registry data with records from a pharmacy claims warehouse (2007‐2016) to examine associations (adjusted hazard ratio, LCL aHR UCL ) of post‐donation fills of antidiabetic medications (ADM, insulin or non‐insulin agents) with body mass index (BMI) at donation and other demographic and clinical factors. In 28 515 living kidney donors (LKDs), incidence of ADM use at 9 years rose in a graded manner with higher baseline BMI: underweight, 0.9%; normal weight, 2.1%; overweight, 3.5%; obese, 8.5%. Obesity was associated with higher risk of ADM use compared with normal BMI (aHR, 3.36 4.59 6.27 ). Metformin was the most commonly used ADM and was filled more often by obese than by normal weight donors (9‐year incidence, 6.87% vs 1.85%, aHR, 3.55 5.00 7.04 ). Insulin use was uncommon and did not differ significantly by BMI. Among a subgroup with BMI data at the 1‐year post‐donation anniversary (n = 19 528), compared with stable BMI, BMI increase >0.5 kg/m 2 by year 1 was associated with increased risk of subsequent ADM use (aHR, 1.03 1.48 2.14, P = .04). While this study did not assess the impact of donation on the development of obesity, these data support that among LKD, obesity is a strong correlate of ADM use.