Respiratory Care: Chest Infections |

The Changes of Cholesterol Concentration Is Correlated With Disease Course in Patients With Pulmonary Nontuberculous Mycobacterial Disease FREE TO VIEW

Myung-Goo Lee, MD
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Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea (the Republic of)

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1245A. doi:10.1016/j.chest.2016.08.1357
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SESSION TITLE: Chest Infections

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To evaluate the sequential changes of nutritional markers including cholesterol and visceral fat area according to NTM pulmonary disease course

METHODS: An age-, sex- and number of comorbid disease- matched case control analysis of 71 patients with NTM pulmonary disease and 284 Korean national survey participants was performed. After retrospective analysis of medical records of 114 patients with NTM pulmonary disease admitted to our hospitals between October 2007 and June 2014, 71 patients with NTM pulmonary disease were included in this study. The control group was randomly recruited from subjects who participated in the Korea National Health and Nutrition Examination Surveys (KAHANES) V study from 2011 to 2012. KAHANES is a nationwide survey to evaluate the health and nutritional status of Korean population (https://knhanes.cdc.go.kr/knhanes).

RESULTS: The median BMI and cholesterol levels in patients with NTM pulmonary disease group (BMI: 19.6, IQR 17.5-21.0, Cholesterol: 156, IQR 133-181) were lower than those of controls (BMI: 23.1, IQR 21.5-25.1, Cholesterol: 192, IQR 168-214, both P <0.001). On multivariate analysis, BMI <19.5 kg/m2 (OR: 7.17, 95% CI 1.61-32.03, P value 0.01) and cavitary lesions (OR: 4.29, 95% CI 1.18-15.58, P value 0.027) were independently associated with the extensive pulmonary lesions involving more than four lobes. The total cholesterol level and visceral fat area showed a tendency to decrease in NTM patients with disease progression (both, P value <0.05), but did not showed it in NTM patients with stable disease. The decrease of cholesterol concentration more than 20 mg/dL was a predicting factor of disease progression (OR: 12.43, 95% CI 2.69-59.49, P value 0.001)

CONCLUSIONS: These finding suggests that the changes of cholesterol level may reveal the disease progression in patients with NTM pulmonary disease.

CLINICAL IMPLICATIONS: 1) The therapeutic effects of cholesterol-rich diet in patients with NTM pulmonary disease need to be evaluated. 2) The changes of total cholesterol level and visceral fat area may be a useful prognostic factor for disease progression.

DISCLOSURE: The following authors have nothing to disclose: Myung-Goo Lee

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