Aged ; Calcifediol/blood ; Case-Control Studies ; Comorbidity ; Female ; Humans ; Lung Diseases/blood ; Lung Diseases/epidemiology* ; Male ; Middle Aged ; Multivariate Analysis ; Mycobacterium Infections, Nontuberculous/blood ; Mycobacterium Infections, Nontuberculous/epidemiology* ; Prevalence ; Republic of Korea ; Severity of Illness Index* ; Vitamin D Deficiency/blood ; Vitamin D Deficiency/epidemiology*
Keywords
Korea ; Mycobacterium avium complex ; case-control study ; non-tuberculous mycobacteria ; vitamin D
Abstract
BACKGROUND AND OBJECTIVE:
Previous studies have found evidence of an association between tuberculosis and vitamin D deficiency (VDD). However, the association between VDD and infection caused by non-tuberculous mycobacteria (NTM) has never been studied. This study evaluated the prevalence and severity of VDD in NTM lung disease and attempted to identify predictive factors.
METHODS:
Age- and sex-matched case-control study was conducted to assess the prevalence and severity of VDD in patients with NTM lung disease.
RESULTS:
After adjusting for potential confounding factors, the adjusted mean serum level of 25-hydroxyvitamin D (25(OH)D) levels was lower in 104 patients with NTM lung disease (10.7 ng/mL, 95% confidence interval (CI) 4.5-16.8 ng/mL) than that of 312 controls (13.7 ng/mL, 95% CI 7.4-19.5 ng/mL) (P = 0.012). Although the prevalence of VDD defined as serum 25(OH)D level <20 ng/mL was not different, severe VDD defined as serum 25(OH)D level <10 ng/mL was more prevalent in patients (P < 0.001). In multivariate analysis, severe (but not mild) VDD was independently associated with NTM lung disease (adjusted odds ratio 3.9, 95% CI 1.9-8.5, P < 0.001).
CONCLUSIONS:
Patients with NTM lung disease have a high prevalence of severe VDD and VDD was independently associated with NTM lung disease. Further studies are needed to examine causality.