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Body composition changes successfully classify prognosis in patients with mycobacterium avium complex lung disease
Daisuke Akahori1, Yuzo Suzuki1, Koushi Yokomura2
1Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan.
The Journal of Infection
|August 4, 2019
Summary
Body composition changes, particularly decreased erector spinae muscle mean attenuation (ESMMA), impact prognosis in Mycobacterium avium complex lung disease (MAC-LD). Combined assessment of ESMMA and BMI predicts patient outcomes.
Area of Science:
- Pulmonology
- Medical Imaging
- Body Composition Analysis
Background:
- Weight loss (cachexia) is common in Mycobacterium avium complex lung disease (MAC-LD) and affects prognosis.
- The role of specific body composition changes in MAC-LD prognosis is not well understood.
Purpose of the Study:
- To investigate the prognostic significance of erector spinae muscle cross-sectional area (ESM_CSA) and mean attenuation (ESM_MA) in MAC-LD patients.
- To determine if body composition metrics can predict survival outcomes in MAC-LD.
Main Methods:
- Computed tomography (CT) imaging was used to measure ESM_CSA and ESM_MA in two independent cohorts of MAC-LD patients.
- Measurements were compared between patients and controls, and associations with survival were analyzed.
Main Results:
- MAC-LD patients exhibited smaller ESM_CSA and lower BMI compared to controls, with no difference in ESM_MA.
- Reduced ESM_CSA, declining BMI, and decreased ESM_MA were linked to poorer survival.
- Decreased ESM_MA emerged as a significant independent prognostic factor in multivariate analysis.
Conclusions:
- Body composition changes, especially diminished ESM_MA, hold prognostic value in MAC-LD.
- Combining ESM_MA and BMI assessments provides an accurate prediction of MAC-LD prognosis, aiding disease management.
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