Relationships between prognosis and nutritional intake of Mycobacterium avium complex lung disease

Abstract

Abstract Objective Previous studies on prognostic factors in Mycobacterium avium complex (MAC) lung disease have consistently shown that nutritional status, specifically, low BMI, is a poor prognostic factor. However, there has been no study focusing on nutritional intake, and while several studies on prognosis have been published, none are prospective in design. This study aimed to prospectively examine relationships between prognosis and nutritional status and nutritional intake in patients with MAC lung disease.Patients and methods : This study included 174 outpatients and inpatients with MAC lung disease who were registered in our hospital between May 2010 and June 2016. At registration, sex, age, comorbidities, disease duration, bacterial strains, number of segments involved, disease type, treatment (with or without), nutritional status (body mass index [BMI]), waist circumference, lymphocyte count, serum albumin, serum cholinesterase, serum transferrin, total cholesterol, visceral fat area as assessed by abdominal CT, and nutritional intake were investigated, and their associations with all-cause mortality and disease-specific mortality risks were prospectively analyzed using Cox proportional hazard models.Results Older age, comorbidities, a large number of segments involved, fibrocavitary disease, low BMI, and low energy intake at registration were associated with all-cause mortality risk, whereas older age, a large number of segments involved, and low energy intake at registration were associated with disease-specific mortality risk.Conclusion Patients with MAC lung disease are characterized by low nutrient intake. It was suggested that low energy intake may be a risk factor for both all-cause and disease-specific deaths.Trial registration: This study was approved by the Ethics Committee of the National Hospital Organization Omuta Hospital (IRB approval number: 29 − 13). This study can be accessed via https://omuta.hosp.go.jp/profession/ethics_29.html