Nutritional indicators are correlated with the radiological severity score in patients with Mycobacterium avium complex pulmonary disease: a cross-sectional study

Intern Med. 2014;53(5):397-401. doi: 10.2169/internalmedicine.53.1277.

Abstract

Objective: Body weight loss in patients with Mycobacterium avium complex (MAC) pulmonary disease can be fatal. The administration of nutritional supplements should be an important component in the treatment of this disease. Objective data regarding the association between the nutritional status and disease severity have not been reported. This cross-sectional study aimed to compare the nutritional status and radiological severity scores in MAC pulmonary disease patients.

Methods: We retrospectively reviewed the records of 40 patients who were admitted to our institution for the treatment of MAC pulmonary disease between July 2008 and July 2010. Nutritional indices, including the ideal body weight ratio, triceps skinfold, mid-upper arm muscle circumference, and percentage of predicted resting energy expenditure, were compared with the radiological severity scores. Quantitative values of the extent of nodules, infiltration shadows, cavities, and bronchiectasis on the computed tomography scans were used to evaluate the radiological severity scores.

Results: The patients suffered from a significantly decreased percentage of ideal body weight, body fat and muscle mass. The average radiological score was 17.6±8.4 points. The percentage of ideal body weight (p<0.001), percentage of triceps skinfold (p<0.001) and percentage of mid-upper arm muscle circumference (p<0.002) were negatively correlated with the radiological scores, while the percentage of the predicted resting energy expenditure (p<0.001) was positively correlated with the scores.

Conclusion: A poor nutritional status is common in patients with progressive MAC pulmonary disease, which supports the hypothesis that aggressive nutritional interventions are indicated in the treatment of this disease.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Female
  • Humans
  • Incidence
  • Japan / epidemiology
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / epidemiology
  • Lung Diseases / microbiology
  • Male
  • Middle Aged
  • Mycobacterium avium Complex / isolation & purification*
  • Mycobacterium avium-intracellulare Infection / diagnostic imaging*
  • Mycobacterium avium-intracellulare Infection / epidemiology
  • Mycobacterium avium-intracellulare Infection / microbiology
  • Nutritional Status*
  • Retrospective Studies
  • Severity of Illness Index
  • Skinfold Thickness
  • Tomography, X-Ray Computed / methods*