Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan.
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan.
J Infect. 2019 Oct;79(4):341-348. doi: 10.1016/j.jinf.2019.07.014. Epub 2019 Jul 31.
Loss of body weight, a manifestation of cachexia, is frequently found in patients with Mycobacterium avium complex lung disease (MAC-LD) and known as a prognostic determinant. However, the involvement of body composition changes in the prognosis of patients with MAC-LD remains unclear.
The cross-sectional-area of the erector spinea muscle (ESM) and mean attenuation of the erector spinae muscles (ESM) in patients with MAC-LD, as determined by computed tomography imaging, were measured in two independent cohorts (137 and 111 patients, respectively).
Patients with MAC-LD showed significantly smaller ESM together with lower body mass index (BMI), but no difference in ESM in both cohorts compared with controls. Smaller ESM, body mass index decline, and decreased ESM were associated with worse survival in the patients. Among them, decreased ESM showed prognostic significance in the multivariate analyses. Importantly, assessment by ESM together with BMI successfully divided the patients into three groups with distinct prognoses.
Changes in body composition, especially decreased ESM, had prognostic significance in patients with MAC-LD. Additionally, combined assessment of ESM and BMI accurately predicted the prognosis of MAC-LD, which may be a helpful tool for disease management.
体重减轻是鸟分枝杆菌复合群肺病（MAC-LD）患者中常见的恶病质表现，被认为是预后的决定因素。然而，MAC-LD 患者的身体成分变化对预后的影响尚不清楚。
通过 CT 影像学测量 MAC-LD 患者竖脊肌的横截面积（ESM）和平均衰减值（ESM），在两个独立队列（分别为 137 例和 111 例患者）中进行测量。
MAC-LD 患者的 ESM 明显较小，体重指数（BMI）较低，但与对照组相比，两个队列的 ESM 均无差异。较小的 ESM、BMI 下降和 ESM 减少与患者的生存预后较差相关。其中，ESM 减少在多变量分析中具有预后意义。重要的是，ESM 与 BMI 的联合评估成功地将患者分为预后明显不同的三组。
身体成分的变化，特别是 ESM 的减少，对 MAC-LD 患者具有预后意义。此外，ESM 和 BMI 的联合评估准确预测了 MAC-LD 的预后，这可能是疾病管理的有用工具。
