Background
Methods
Participants
Study design
Mycobacterial culture and Species identification of NTM
Statistical analysis
Results
Baseline patient characteristics
Total patients (N = 150) | Progressed (N = 47) | Not progressed (N = 103) |
p-value | |
---|---|---|---|---|
Age, years | 64 [55–72] | 62 [54–68] | 66 [56–74] | 0.030 |
Sex, female | 92 (61.3) | 32 (68.1) | 60 (58.3) | 0.251 |
Smoking | 0.160 | |||
Ever-smoker | 40 (26.6) | 9 (19.2) | 31 (30.1) | |
Never-smoker | 110 (73.3) | 38 (80.9) | 72 (69.9) | |
Past medical history | ||||
Tuberculosis | 55 (36.9) | 20 (43.5) | 35 (34.0) | 0.267 |
Measles | 29 (19.3) | 7 (14.9) | 22 (21.4) | 0.352 |
Pertussis | 7 (4.7) | 3 (6.4) | 4 (3.9) | 0.678 |
Comorbidity | ||||
COPD | 27 (18.8) | 6 (12.8) | 21 (21.6) | 0.200 |
Asthma | 4 (2.8) | 0 (0) | 4 (4.1) | 0.304 |
Diabetes | 14 (9.3) | 5 (10.6) | 9 (8.7) | 0.765 |
Malignancy | 20 (13.3) | 4 (8.5) | 16 (15.5) | 0.241 |
Symptom at initial visit | ||||
Cough | 61 (40.7) | 23 (48.9) | 38 (36.9) | 0.164 |
Sputum | 108 (72.0) | 35 (74.5) | 73 (70.9) | 0.649 |
Dyspneaa
| 15 (10.0) | 3 (6.4) | 12 (11.3) | 0.392 |
Hemoptysis | 29 (19.3) | 13 (27.7) | 16 (15.5) | 0.081 |
Fever | 19 (12.7) | 5 (10.6) | 14 (13.6) | 0.614 |
Weight loss | 17 (11.3) | 8 (17.0) | 9 (8.7) | 0.138 |
Abnormal breath sounds | 20 (13.3) | 9 (19.1) | 11 (10.7) | 0.157 |
Crackles | 11 (7.3) | 4 (8.5) | 7 (6.8) | 0.741 |
Wheezing | 13 (8.7) | 7 (14.9) | 6 (5.8) | 0.113 |
Anxietyb
| 29 (19.3) | 11 (23.4) | 18 (17.5) | 0.394 |
Depressionb
| 41 (27.3) | 16 (34.0) | 25 (24.3) | 0.213 |
SGRQ | 21.2 [11.3–35.2] | 24.4 [12.7–44.1] | 19.8 [10.3–30.6] | 0.011 |
Radiologic features | 0.599 | |||
Nodular bronchiectatic disease | 135 (90) | 41 (30.4) | 94 (69.6) | |
Fibrocavitatary disease | 14 (9.3) | 6 (42.9) | 8 (57.1) | |
Unclassifiable | 1 (0.7) | 0 (0) | 1 (1.0) | |
Chest CT scorec
| 10 [7–13] | 13 [8–15] | 9 [7–12] | <0.001 |
Radiologic deteriorationd
| 58/130 (44.6) | 21/27 (77.8) | 37/103 (35.9) | <0.001 |
Presence of cavity | 37 (24.7) | 24 (51.1) | 13 (12.6) | <0.001 |
Pulmonary function | ||||
FVC, L | 2.83 [2.32–3.42] | 2.54 [2.23–3.16] | 2.97 [2.36–3.48] | 0.032 |
FVC, % | 93 [81–101] | 88 [79–95] | 94 [82–106] | 0.005 |
FEV1, L | 2.09 [1.76–2.48] | 2.11 [1.77–2.38] | 2.08 [1.73–2.51] | 0.532 |
FEV1, % | 97 [82–110] | 93 [82–105] | 99 [81–113] | 0.205 |
DLCO, % | 93 [80–106] | 93 [80–104] | 93 [81–107] | 0.998 |
Cholesterol, mg/dL | 182 [161–204] | 178 [146–202] | 183 [167–205] | 0.229 |
Albumin, g/dL | 4.3 [4.0–4.4] | 4.2 [4.0–4.4] | 4.3 [4.1–4.5] | 0.031 |
Total patients (N = 150) | Progressed (N = 47) | Not progressed (N = 103) |
p-value | |
---|---|---|---|---|
Height, cm | 160.4 [155.0–167.2] | 159.0 [154.0–167.1] | 162.0 [156.4–167.3] | 0.227 |
Weight, kg | 54.1 [49.1–60.0] | 51.0 [45.0–57.0] | 55.5 [50.0–61.8] | 0.002 |
BMI, kg/m2
| 21.1 [19.3–22.8] | 19.9 [18.5–21.7] | 21.6 [19.8–23.2] | 0.003 |
Waist, cm | 76.0 [70.0–83.0] | 72.0 [67.0–82.0] | 77.0 [72.0–85.0] | 0.008 |
Hip, cm | 92.0 [89.0–97.0] | 90.0 [88.0–92.0] | 93.0 [90.0–97.0] | 0.004 |
Skeletal muscle mass, kg | 21.3 [19.0–24.4] | 19.9 [17.3–22.5] | 21.9 [19.6–24.7] | 0.015 |
Body fat, kg | 13.5 [10.1–17.4] | 12.0 [9.1–13.8] | 14.9 [11.0–18.5] | 0.003 |
Body fat percentage, % | 25.2 [20.2–30.4] | 23.8 [18.6–26.0] | 27.1 [20.4–31.0] | 0.044 |
Abdominal fat ratio | 0.86 [0.83–0.91] | 0.85 [0.81–0.87] | 0.87 [0.83–0.92] | 0.004 |
Nontuberculous mycobacterial species isolated from participants
Species | Total patients (N = 150) | Progressed (N = 47) | Not progressed (N = 103) |
p-value |
---|---|---|---|---|
Mycobacterium avium complex (MAC) | ||||
M. avium
| 54 (36.0) | 15 (31.9) | 39 (37.9) | 0.481 |
M. intracellulare
| 40 (26.7) | 17 (36.2) | 23 (22.3) | 0.075 |
M. chimaera
| 1 (0.7) | 0 (0) | 1 (1.0) | 1.000 |
M. yongonense
| 1 (0.7) | 0 (0) | 1 (1.0) | 1.000 |
M. avium and M. intracellulare
| 10 (6.7) | 3 (6.4) | 7 (6.8) | 1.000 |
M. avium and M. chimaera
| 1 (0.7) | 1 (2.1) | 0 (0) | 0.313 |
MAC and othersa
| 2 (1.3) | 1 (2.1) | 1 (1.0) | 0.530 |
M. abscessus complex (MABC) | ||||
M. abscessus subsp. abscessus
| 14 (9.3) | 4 (8.5) | 10 (9.7) | 1.000 |
M. abscessus subsp. massiliense
| 12 (8.0) | 3 (6.4) | 9 (8.7) | 0.754 |
M. abscessus subsp. abscessus and massiliense
| 4 (2.7) | 1 (2.1) | 3 (2.9) | 1.000 |
MABC and othersb
| 1 (0.7) | 0 (0) | 1 (1.0) | 1.000 |
MAC and MABC | 7 (4.7) | 2 (4.3) | 5 (4.9) | 1.000 |
M. fortuitum
| 2 (1.3) | 0 (0) | 2 (1.9) | 1.000 |
M. kyorinense
| 1 (0.7) | 0 (0) | 1 (1.0) | 1.000 |
Progression of nontuberculous mycobacterial lung disease
Predictors of disease progression
Unadjusted HR | 95% CI |
p-value | |
---|---|---|---|
Age, years | |||
Q1 [<55, n = 31] | Ref. | ||
Q2 [55– 64, n = 40] | 0.990 | 0.463–2.160 | 0.979 |
Q3 [65–72, n = 36] | 1.052 | 0.480–2.309 | 0.899 |
Q4 [>72, n = 43] | 0.429 | 0.169–1.089 | 0.075 |
Sex | |||
Male | Ref. | ||
Female | 1.351 | 0.731–2.496 | 0.337 |
SGRQ | |||
< 25 | Ref. | ||
≥ 25 | 1.562 | 0.875–2.789 | 0.132 |
Radiologic feature | |||
Nodular bronchiectatic disease | 1 | ||
Fibrocavitary disease | 1.740 | 0.737–4.108 | 0.206 |
Chest CT score | |||
X | Ref. | ||
X + 1 | 1.211 | 1.123–1.306 | <0.001 |
Presence of cavity | |||
Absent | Ref. | ||
Present | 3.750 | 2.086–6.739 | <0.001 |
Cholesterol, mg/dL | |||
≥ 200 | Ref. | ||
< 200 | 1.263 | 0.673–2.371 | 0.467 |
Albumin, g/dL | |||
≥ 3.5 | Ref. | ||
< 3.5 | 8.942 | 3.097–25.818 | <0.001 |
FVC, % | |||
≥ 80 | Ref. | ||
< 80 | 1.974 | 1.049–3.715 | 0.035 |
FEV1
| |||
≥ 80 | Ref. | ||
< 80 | 1.102 | 0.546–2.226 | 0.786 |
Height, cm | |||
High [>165, n = 48] | Ref. | ||
Middle [157–165, n = 55] | 1.126 | 0.547–2.319 | 0.748 |
Low [<157, n = 47] | 1.243 | 0.604–2.562 | 0.555 |
Weight, kg | |||
High [>59, n = 49] | Ref. | ||
Middle [50–59, n = 55] | 1.935 | 0.861–4.347 | 0.110 |
Low [<50, n = 46] | 3.146 | 1.437–6.885 | 0.004 |
BMI, kg/m2
| |||
High [>22, n = 52] | Ref. | ||
Middle [20–22, n = 44] | 1.619 | 0.669–3.752 | 0.261 |
Low [<20, n = 54] | 3.211 | 1.538–6.705 | 0.002 |
Waist, cm | |||
High [>80, n = 50] | Ref. | ||
Middle [72–80, n = 41] | 1.082 | 0.467–2.507 | 0.853 |
Low [<72, n = 37] | 2.183 | 1.041–4.575 | 0.039 |
Hip, cm | |||
High [>95, n = 45] | Ref. | ||
Middle [90–95, n = 48] | 2.062 | 0.890–4.780 | 0.092 |
Low [<90, n = 35] | 2.485 | 1.041–5.929 | 0.040 |
Skeletal muscle mass, kg | |||
High [>23, n = 41] | Ref. | ||
Middle [20–23, n = 43] | 1.068 | 0.434–2.629 | 0.886 |
Low [<20, n = 44] | 2.382 | 1.083–5.242 | 0.031 |
Body fat, kg | |||
High [>16, n = 43] | Ref. | ||
Middle [11.5–16, n = 42] | 2.565 | 1.045–6.300 | 0.040 |
Low [<11.5, n = 43] | 3.068 | 1.270–7.409 | 0.013 |
Body fat percentage, % | |||
High [>29, n = 42] | Ref. | ||
Middle [22.5–29, n = 40] | 2.545 | 1.037–6.246 | 0.041 |
Low [<22.5, n = 46] | 2.609 | 1.081–6.296 | 0.033 |
Abdominal fat ratio | |||
High [>0.88, n = 51] | Ref. | ||
Middle [0.84–0.88, n = 39] | 2.342 | 1.024–5.356 | 0.044 |
Low [<0.84, n = 38] | 2.987 | 1.302–6.851 | 0.010 |
Adjusted HR | 95% CI |
p-value | |
---|---|---|---|
Abdominal fat ratio | |||
High [>0.88, n = 51] | Ref. | ||
Middle [0.84–0.88, n = 39] | 2.758 | 1.112–6.843 | 0.029 |
Low [<0.84, n = 38] | 3.084 | 1.241–7.668 | 0.015 |
Albumin, g/dL | |||
≥ 3.5 | Ref. | ||
< 3.5 | 12.943 | 2.588–64.718 | 0.002 |
Presence of cavity | |||
Absent | Ref. | ||
Present | 4.577 | 2.364–8.861 | <0.001 |
Serum adipokine levels
Total patients (N = 147) | Progressed (N = 47) | Not progressed (N = 100) |
p-value | |
---|---|---|---|---|
Leptin, ng/mL | 6.60 [4.20–11.70] | 6.40 [3.60–10.70] | 6.85 [4.33–12.33] | 0.160 |
Adiponectin, μg/mL | 9.58 [6.65–11.88] | 10.10 [7.18–13.67] | 9.27 [6.52–11.75] | 0.337 |
Leptin/adiponectin ratio, ng/μg | 0.76 [0.39–1.44] | 0.58 [0.39–1.24] | 0.94 [0.42–1.60] | 0.089 |
Leptin/total body fat, ng/mL/kg | 0.56 [0.40–0.75] | 0.60 [0.43–0.82] | 0.53 [0.37–0.72] | 0.086 |
Adiponectin/total body fat, μg/mL/kg | 0.72 [0.44–1.15] | 0.82 [0.63–1.26] | 0.60 [0.38–1.11] | 0.020 |