Kanika Sehgal, MBBS1, Janice Cho, MD1, George Saffouri, MD2, Ross Dierkhising, MS1, Eric Battaglioli, PhD3, Purna Kashyap, MBBS1, Darrell Pardi, MD, MS1, Sahil Khanna, MBBS, MS1 1Mayo Clinic, Rochester, MN; 2University of California Riverside School of Medicine, Riverside, CA; 3Kennesaw State University, Kennesaw, GA
Introduction: Fecal microbiota transplantation (FMT) is an effective treatment for Clostridioides difficile infection. There is evidence to suggest that the human metabolic profile may be influenced by FMT. Furthermore, recent data indicate that the body mass index (BMI) of donors can influence the BMI of recipients, where FMT from an obese donor may lead to obesity in the recipient. To better understand the role of FMT and its effect on weight, we sought to determine if there was a change in recipient BMI after FMT corresponding to donor BMI.
Methods: Patients who underwent FMT at Mayo Clinic from August 2012 to August 2019 were identified from a maintained database. Demographics of recipients and corresponding donors were recorded from this database. Recipient BMI 1 year before and after FMT, and donor pre-FMT BMI measurements were extracted from a query of electronic medical records. Body mass index between 18.5-24.9 kg/m2 was defined as normal and ≥25 kg/m2 was defined as overweight. Trends in BMI changes of recipients were analyzed using mixed linear regression models.
Results: We identified 403 patients with pre- and post-FMT BMI recordings. Median age of recipients was 59.1 years (interquartile range [IQR] 40.6 – 70.2) at the time of FMT; 61.8% were female and 38.2% were male. Median pre-FMT recipient BMI was 26.7 kg/m2 (IQR 22.7 – 31.6). Median donor BMI was 24.5 kg/m2 (IQR 23.9 – 27.5). Stool from a donor with a normal BMI was transplanted in 58.2% of recipients and 41.8% of recipients received stool from overweight donors. Donor BMI information was missing for 3.2% of recipients. Recipient BMI increased by 0.05/month after FMT within the 1-year follow-up period (95% CI 0.01-0.09, p=0.020). Donor BMI had no significant effect on recipient BMI change over time (p=0.24) or the BMI level (-0.18 per donor BMI point, 95% CI -0.48-0.12, p=0.233).
Discussion: Recipient BMI increases post-FMT. However, donor BMI did not correlate with recipient BMI changes post procedure. Recipient weight gain after FMT might be reflective of recovery towards baseline weight. In our study, data on pre-CDI weight loss are not available, but it is possible that increase in BMI after FMT represents the regain of weight that was lost during the period of diarrheal illness. Large, prospective, controlled trials examining weight in the context of FMT are needed before definitive conclusions can be drawn.
Disclosures: Kanika Sehgal indicated no relevant financial relationships. Janice Cho indicated no relevant financial relationships. George Saffouri indicated no relevant financial relationships. Ross Dierkhising indicated no relevant financial relationships. Eric Battaglioli indicated no relevant financial relationships. Purna Kashyap indicated no relevant financial relationships. Darrell Pardi indicated no relevant financial relationships. Sahil Khanna indicated no relevant financial relationships.
Kanika Sehgal, MBBS1, Janice Cho, MD1, George Saffouri, MD2, Ross Dierkhising, MS1, Eric Battaglioli, PhD3, Purna Kashyap, MBBS1, Darrell Pardi, MD, MS1, Sahil Khanna, MBBS, MS1. P0134 - Body Mass Index Changes After Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.