Characteristics associated with progression in patients with of nontuberculous mycobacterial lung disease : a prospective cohort study

BMC Pulm Med. 2017 Jan 5;17(1):5. doi: 10.1186/s12890-016-0349-3.

Abstract

Background: Patients with distinctive morphotype were more susceptible to nontuberculous mycobacterial lung disease (NTM-LD). However, little is known about the association between body morphotype and progression of NTM-LD. The aim of this study was to elucidate predictors of NTM-LD progression, focusing on body morphotype and composition.

Methods: Data from patients with NTM-LD who participated in NTM cohort which started in 1 July 2011 were analyzed. Patients with more than 6 months of follow up were included for analysis. NTM-LD progression was defined as clinician-initiated anti-NTM treatment, based on symptomatic and radiologic aggravation. Body morphotype and composition was measured at entry to the cohort using bioelectrical impedance analysis.

Results: NTM-LD progressed in 47 out of 150 patients with more than 6 months of follow up. Patients with middle (adjusted hazard ratio [aHR], 2.758; 95% confidence interval [CI], 1.112-6.843) or lowest tertile (aHR, 3.084; 95% CI, 1.241-7.668) of abdominal fat ratio had a higher risk of disease progression compared with the highest tertile. Other predictors for disease progression were presence of cavity on chest computed tomography (aHR, 4.577; 95% CI, 2.364-8.861), and serum albumin level <3.5 g/dL (aHR, 12.943; 95% CI, 2.588-64.718).

Conclusions: Progression of NTM-LD is associated with body composition. Lower abdominal fat ratio is an independent predictor of NTM-LD progression.

Trial registration: ClinicalTrials.gov, NCT01616745 Registered 25 March 2012.

Keywords: Abdominal fat; Anthropometry; Body composition; Nontuberculous mycobacteria.

Publication types

  • Observational Study

MeSH terms

  • Abdominal Fat
  • Adiposity*
  • Aged
  • Anthropometry
  • Disease Progression*
  • Female
  • Humans
  • Leptin / blood
  • Logistic Models
  • Lung / diagnostic imaging
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / diagnosis*
  • Nontuberculous Mycobacteria / isolation & purification
  • Proportional Hazards Models
  • Prospective Studies
  • Republic of Korea
  • Sputum / microbiology
  • Tomography, X-Ray Computed
  • Tuberculosis, Pulmonary / diagnosis*

Substances

  • Leptin

Associated data

  • ClinicalTrials.gov/NCT01616745