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      Severity of underweight affects the development of nontuberculous mycobacterial pulmonary disease; a nationwide longitudinal study

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      Author(s): 1 , 2 , 3 ,
      Publication date (Electronic):
      Journal: Scientific Reports
      Publisher: Nature Publishing Group UK
      Keywords: Medical research, Risk factors

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          Abstract

          Regarding to known association between underweight and non-tuberculous mycobacterial pulmonary disease (NTM-PD), the underweight was simply categorized as body mass index (BMI) less than 18.5 kg/m 2, mainly because of its low prevalence. We aimed to better define the impact of BMI severity on NTM-PD development. We analysed health data from 4,332,529 individuals examined in 2009 and followed up until December 2017 to determine the incidence of NTM-PD. Based on the BMI in kg/m 2, the population was categorized into mild (17.00–18.49), moderate (16.00–16.99), and severe underweight (< 16.00) groups. Using Cox proportional-hazards analyses, hazard ratios for NTM-PD were calculated according to the severity of underweight in reference to normal BMI (18.50–22.99). Over a median follow-up of 5.6 ± 1.2 years, 6223 participants developed NTM-PD. Risk of NTM-PD increased significantly with the severity of underweight: multivariate adjusted hazard ratios (95% confidence intervals) for mild, moderate, and severe underweight were 2.34 (2.17–2.52), 3.50 (3.07–3.99), and 4.35 (3.63–5.21), respectively. In subgroup analysis, being younger (< 65 years old) or male exacerbated the effect of severe underweight on the risk of NTM-PD. This study proved that as underweight categories became more severe, the risk of NTM-PD increased proportionally.

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          The prevalence of underweight, overweight and obesity in Bangladeshi adults: Data from a national survey

          Tuhin Biswas, Sarah Garnett, Sonia Pervin … (2017)
          Background Over the two last decades Bangladesh, a low-income country, has experienced a rapid demographic and epidemiological transition. The population has increased substantially with rapid urbanization and changing pattern of disease, which at least in part, can be explained by nutritional changes. However, the nutritional status of the adult population has not been previously described. Hence, the objective of this study was to estimate the prevalence and explore socio-demographic determinants of underweight, overweight and obesity among the Bangladeshi adult population. Methods This study is a secondary data analysis of the national 2011 Bangladesh Demographic and Health Survey. We determined the nutritional status of adults aged ≥35 years of age, who had a measured weight and height, using the Asian body mass index (BMI) cut-offs for underweight (BMI <18.5 kg/m2), overweight (BMI 23 to <27.5 kg/m2) and obesity (BMI ≥27.5 kg/m2). Logistic regression modeling was used to determine the association between socio-demographic factors and nutritional status. Result Of total sample (n = 5495), 30.4% were underweight, 18.9% were overweight and 4.6% were obese. Underweight was associated with age, education and wealth. The adjusted odd ratios for underweight were higher for older people (≥70 years) compared to younger, the least educated compared to the most educated and the poorest compared to the wealthiest were 2.51 (95%CI: 1.95–3.23, p<0.001), 3.59 (95%CI: 2.30–5.61, p<0.001) and 3.70 (95%CI: 2.76–4.96, p<0.001), respectively. Younger age (35–44 years), being female, higher education, wealthier and living in urban areas were associated with overweight/obesity with adjusted odds ratios of 1.73 (95%CI: 1.24–2.41, p<0.001), 2.48 (95%CI: 1.87–3.28, p<0.001), 3.98 (95%CI: 2.96–5.33, p<0.001), 7.14 (95%CI: 5.20–9.81, p<0.001) 1.27 (95%CI: 1.05–1.55, p-0.02), respectively. Conclusion Underweight and overweight/obesity are prevalent in Bangladeshi adults. Both conditions are associated with increased morbidity and mortality and increase the risk of developing non-communicable diseases. Effective public health intervention approaches are necessary to address both these conditions.
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            Prognostic factors associated with long-term mortality in 1445 patients with nontuberculous mycobacterial pulmonary disease: a 15-year follow-up study

            Byung Woo Jhun, Seong Moon, Kyeongman Jeon … (2020)
            Limited data are available regarding the prognostic factors for patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated the prognostic factors associated with long-term mortality in NTM-PD patients after adjusting for individual confounders, including aetiological organism and radiological form. A total of 1445 patients with treatment-naïve NTM-PD who were newly diagnosed between July 1997 and December 2013 were included. The aetiological organisms were as follows: Mycobacterium avium (n=655), M. intracellulare (n=487), M. abscessus (n=129) and M. massiliense (n=174). The factors associated with mortality in NTM-PD patients were analysed using a multivariable Cox model after adjusting for demographic, radiological and aetiological data. The overall 5-, 10- and 15-year cumulative mortality rates for the NTM-PD patients were 12.4%, 24.0% and 36.4%, respectively. On multivariable analysis, the following factors were significantly associated with mortality in NTM-PD patients: old age, male sex, low body mass index, chronic pulmonary aspergillosis, pulmonary or extrapulmonary malignancy, chronic heart or liver disease and erythrocyte sedimentation rate. The aetiological organism was also significantly associated with mortality: M. intracellulare had an adjusted hazard ratio (aHR) of 1.40, 95% CI 1.03–1.91; M. abscessus had an aHR of 2.19, 95% CI 1.36–3.51; and M. massiliense had an aHR of 0.99, 95% CI 0.61–1.64, compared to M. avium . Mortality was also significantly associated with the radiological form of NTM-PD for the cavitary nodular bronchiectatic form (aHR 1.70, 95% CI 1.12–2.59) and the fibrocavitary form (aHR 2.12, 95% CI 1.57–3.08), compared to the non-cavitary nodular bronchiectatic form. Long-term mortality in patients with NTM-PD was significantly associated with the aetiological NTM organism, cavitary disease and certain demographic characteristics.
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              Body mass index and risk of pneumonia: a systematic review and meta-analysis.

              Z. Wang, Page B C Chu, Mark S. Rutherford … (2013)
              The aims of our meta-analysis were to examine the pattern and gender's influence on body mass index (BMI) - pneumonia relationship. Published studies were searched from PubMed, Web of Science, Cochrane Library databases using keywords of pneumonia, BMI and epidemiologic studies. Random-effects analysis was applied to estimate pooled effect sizes from individual studies. The Cochrane Q-test and index of heterogeneity (I(2) ) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Random-effects meta-regression was applied to examine the pattern and gender's influence on BMI-pneumonia relationship. A total of 1,531 studies were initially identified, and 25 studies finally were included. The pooled relative risk (RR) and meta-regression model revealed a J-shaped relationship between BMI and risk of community-acquired pneumonia (underweight, RR 1.8, 95% confidence interval [CI], 1.4-2.2, P < 0.01; overweight, 0.89, 95%CI, 0.8-1.03, P, 0.1; obesity, 1.03, 95% CI, 0.8-1.3, p. 8) and U-shaped relationship between BMI and risk of influenza-related pneumonia (underweight, RR 1.9, 95% CI, 1.2-3, P < 0.01; overweight, 0.89, 95% CI, 0.79-0.99, P, 0.03; obesity, 1.3, 95% CI, 1.05-1.63, p. 2; morbidity obesity, 4.6, 95% CI, 2.2-9.8, P < 0.01); whereas, no difference in risk of nosocomial pneumonia was found across the BMI groups. Gender difference did not make significant contribution in modifying BMI-pneumonia risk relationship. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.
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                Author and article information

                Contributors
                Mee Kyoung Kim: makung@catholic.ac.kr
                Journal
                Journal ID (nlm-ta): Sci Rep
                Journal ID (iso-abbrev): Sci Rep
                Title: Scientific Reports
                Publisher: Nature Publishing Group UK (London )
                ISSN (Electronic): 2045-2322
                Publication date (Electronic): 13 October 2022
                Publication date PMC-release: 13 October 2022
                Publication date Collection: 2022
                Volume: 12
                Electronic Location Identifier: 17180
                Affiliations
                [1 ]GRID grid.413841.b, Division of Pulmonology, Department of Internal Medicine, , Cheju Halla General Hospital, ; Jeju, 63127 South Korea
                [2 ]GRID grid.263765.3, ISNI 0000 0004 0533 3568, Department of Statistics and Actuarial Science, , Soongsil University, ; Seoul, 06978 South Korea
                [3 ]GRID grid.411947.e, ISNI 0000 0004 0470 4224, Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, , The Catholic University of Korea, ; #10 63-ro, Yeongdeungpo-gu, Seoul, 07345 South Korea
                Article
                Publisher ID: 21511
                DOI: 10.1038/s41598-022-21511-x
                PMC ID: 9558037
                PubMed ID: 36229470
                SO-VID: 3b5738f5-0b0d-4a7a-b341-72b4071b5d1b
                Copyright © © The Author(s) 2022
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 11 February 2022
                Date accepted : 28 September 2022
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                Subject: Article
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                ScienceOpen disciplines: Uncategorized
                Keywords: medical research,risk factors
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                Keywords: medical research, risk factors

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