Kim Soo Jung, Yoon Soon Ho, Choi Sun Mi, Lee Jinwoo, Lee Chang-Hoon, Han Sung Koo, Yim Jae-Joon
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
BMC Pulm Med. 2017 Jan 5;17(1):5. doi: 10.1186/s12890-016-0349-3.
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.
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.
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).
Progression of NTM-LD is associated with body composition. Lower abdominal fat ratio is an independent predictor of NTM-LD progression.
ClinicalTrials.gov, NCT01616745 Registered 25 March 2012.
具有独特体型的患者更容易患非结核分枝杆菌肺病（NTM-LD）。然而，关于体型与NTM-LD进展之间的关联知之甚少。本研究的目的是阐明NTM-LD进展的预测因素，重点关注体型和身体成分。
分析了2011年7月1日开始的NTM队列研究中NTM-LD患者的数据。纳入随访超过6个月的患者进行分析。NTM-LD进展定义为基于症状和影像学加重由临床医生启动的抗NTM治疗。在队列入组时使用生物电阻抗分析测量体型和身体成分。
150例随访超过6个月的患者中有47例NTM-LD病情进展。腹部脂肪比例处于中等三分位数（调整后风险比[aHR]，2.758；95%置信区间[CI]，1.112 - 6.843）或最低三分位数（aHR，3.084；95%CI，1.241 - 7.668）的患者与最高三分位数相比，疾病进展风险更高。疾病进展的其他预测因素包括胸部计算机断层扫描显示有空洞（aHR，4.577；95%CI，2.364 - 8.861）以及血清白蛋白水平<3.5 g/dL（aHR，12.943；95%CI，2.588 - 64.718）。
NTM-LD的进展与身体成分有关。较低的腹部脂肪比例是NTM-LD进展的独立预测因素。
ClinicalTrials.gov，NCT01616745，2012年3月25日注册。
