Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan.
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
BMC Pulm Med. 2020 Oct 9;20(1):262. doi: 10.1186/s12890-020-01304-6.
Nontuberculous mycobacterial (NTM) lung disease is one of a growing number of chronic health problems that is difficult to cure in aging societies. While it is important to be vigilant about associated comorbidities in order to provide better patient care, data on the prevalence of comorbidities stratified by country or region are scarce. We aimed to elucidate the comorbidities associated with NTM disease based on Japanese health insurance claims data.
Cross-sectional analyses were performed using the claims data for 2014 provided by the Japan Medical Data Center Co., Ltd. Patients aged 20-75 years with ≥3 claims associated with NTM disease were identified and matched to 10 sex-and-age-matched controls that had never made a claim for NTM disease. Thirty-one comorbidities previously suspected to be associated with NTM disease were selected, and the prevalence of these comorbidities compared between cases and controls.
Overall, 419 NTM patients (134 males and 285 females) and 4190 non-NTM controls were identified from the JMDC database. Aspergillosis, asthma, chronic heart failure, diffuse panbronchiolitis, gastroesophageal reflux, interstitial pneumonia, lung cancer, cancer other than breast, lung, ovary, or prostate cancer, and rheumatoid arthritis were associated with NTM disease in both males and females. Chronic obstructive pulmonary disease was associated with NTM in males while chronic kidney disease, osteoporosis, and Sjögren syndrome were associated with NTM in females.
NTM disease was associated with multiple comorbidities that should be considered when providing medical care to individuals with NTM disease.
非结核分枝杆菌（NTM）肺病是老龄化社会中越来越多的慢性健康问题之一，难以治愈。虽然警惕与该病相关的合并症对于提供更好的患者护理很重要，但按国家或地区划分的合并症患病率数据却很少。我们旨在根据日本健康保险索赔数据阐明与 NTM 疾病相关的合并症。
使用日本医疗数据中心有限公司提供的 2014 年的索赔数据进行横断面分析。确定年龄在 20-75 岁之间、有≥3 次与 NTM 疾病相关的索赔记录的患者，并与从未提出过 NTM 疾病索赔的 10 名性别和年龄匹配的对照者相匹配。选择了 31 种先前怀疑与 NTM 疾病相关的合并症，并比较了病例组和对照组中这些合并症的患病率。
总体而言，从 JMDC 数据库中确定了 419 名 NTM 患者（男性 134 名，女性 285 名）和 4190 名非 NTM 对照者。在男性和女性中，曲霉菌病、哮喘、慢性心力衰竭、弥漫性泛细支气管炎、胃食管反流、间质性肺炎、肺癌、乳腺癌、肺癌、卵巢癌或前列腺癌以外的癌症以及类风湿关节炎与 NTM 疾病相关。在男性中，慢性阻塞性肺疾病与 NTM 相关，而在女性中，慢性肾脏病、骨质疏松症和干燥综合征与 NTM 相关。
NTM 疾病与多种合并症相关，在为 NTM 疾病患者提供医疗护理时应考虑这些合并症。
