Body habitus in patients with and without bronchiectasis and non-tuberculous mycobacteria

Abstract

BackgroundFemale gender, tall stature, presence of bronchiectasis are associated with pulmonary nontuberculous mycobacterial (NTM) infections. The biologic relationship between the body habitus and NTM infection is not well defined and the body habitus profile of the patients with NTM and concurrent bronchiectasis is completely unknown.MethodsWe conducted a case control study at the Miami VA Healthcare System and the University of Illinois Medical Center on patients with pulmonary NTM infections between 2010 and 2015. We compared pulmonary NTM subjects with and without bronchiectasis. NTM infection was confirmed by using the American Thoracic Society/ Infectious Disease Society of America criteria. Standard radiological criteria were used to define bronchiectasis in chest CT-scan.ResultsTwo hundred twenty subjects with pulmonary NTM were enrolled in the study. Sixty six subjects (30%) had bronchiectasis on CT scan of the chest. Subjects in the bronchiectasis group included more women (p = 0.002) and were significantly older (p = 0.005). Those patients who had bronchiectasis tended to have a significantly lower weight (less than 50kg) and height ≤155 cm (p <0.0001 and p = 0.018, respectively). Kaplan–Meier analysis confirmed that subjects who had bronchiectasis were shorter and weighed less, after adjusting for gender.ConclusionsThis study defines a new sub-phenotype of NTM subjects with bronchiectasis who tend to be short with lower body weight. Further studies are needed to better understand and define the body habitus profiles of this new sub-phenotype and their clinical implications.

Association of low fat mass with nontuberculous mycobacterial infection in patients with bronchiectasis

“…[ 8 ] Several studies have also consistently shown that in otherwise healthy subjects, low BMI and the female sex were risk factors of NTM-LD. [ 7 , 8 ] While BMI is the most commonly used parameter to characterize body morphotype, BMI can neither distinguish nor quantify muscle mass and fat mass. [ 15 ] To overcome this limitation, the BIA method was used in the current study, which can estimate the exact component of body compositions.…”

“…[ 5 , 6 ] Particularly, female patients, tall statured patients, and patients with low body weights are more susceptible to NTM-LD. [ 7 ] Recent studies demonstrated that the susceptibility of a patient with a thin body to NTM-LD is related to dysregulation of hormones produced by fat tissue. [ 8 , 9 ] Notably, alterations in adipokine levels, implicated in the regulation of immune responses, have been noted to influence the susceptibility to NTM-LD.…”

Different source of sample strains corresponds to different characteristics of patients with non-tuberculous mycobacterium

“…Nodular-related bronchiectasis is of signi cance in the diagnosis and treatment of pulmonary NTM infection. Although bronchiectasis has been observed in 20%-30% of patients with NTM, NTM infection seems not common in patients with bronchiectasis [10,27]. Indeed, 34%-50% of patients with multiple small nodules (and sometimes cavity or cavities) combined with their diffusion (or widespread) indicate the presence of active pulmonary NTM infection [28].…”

Increasing Non-tuberculous Mycobacteria Infections in Veterans With COPD and Association With Increased Risk of Mortality

“…However, previous studies have indicated that using ICD codes to determine infections from NTM can also miss from 25 to 75% of cases ( 21 ). Recently, authors looked at the accuracy of ICD codes for pulmonary NTM in the VA system, and calculated an accuracy rate as low as 65% ( 36 ). This may indicate an underestimation of true NTM cases, but the change over time may still represent an increase in NTM prevalence.…”