title: The impact of low subcutaneous fat in patients with nontuberculous mycobacterial lung disease.
abstract: BACKGROUND
  Nontuberculous mycobacteria (NTM) are pathogens that cause chronic respiratory disease, even in immunocompetent patients. We hypothesized that low subcutaneous fat is a predisposing factor for NTM lung disease.
  
  
  METHODS
  Following a retrospective review of medical records from between 2005 and 2012, a total of 148 patients with NTM lung disease and 142 age- and sex-matched controls were enrolled. We evaluated subcutaneous fat using chest computed tomography (CT) scans at the midpole level of the left kidney.
  
  
  RESULTS
  The median age of the patients was 62 years and 60.8 % were female. Approximately 71 % were classified into a nodular bronchiectatic group. The patient group had significantly less subcutaneous fat than the control group (39.3 vs. 53.0 cm(2), p = 0.001). Patients with both localized disease (43.5 vs. 53.0 cm(2), p = 0.042) and extensive disease (35.9 vs. 53.0 cm(2), p < 0.0001) had less subcutaneous fat compared with the control group. No difference in subcutaneous fat was observed with respect to the increasing bacterial load in sputum (p = 0.246). In 20 patients with prominent disease progression during the follow-up period, no significant difference was observed between subcutaneous fat at the initial diagnosis and that at the follow-up CT (36.2 vs. 42.0 cm(2), p = 0.47).
  
  
  CONCLUSIONS
  Our results suggest that lower subcutaneous fat may contribute to host susceptibility to NTM lung disease.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Center and Ewha Medical Research Institute, Mokdong Hospital, Ewha Womans University School of Medicine, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, Republic of Korea.
authors.forename: Seok Jeong
authors.initials: SJ
authors.lastname: Lee
authors.forename: Yon Ju
authors.initials: YJ
authors.lastname: Ryu
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Lee
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Chang
authors.forename: Sung Shine
authors.initials: SS
authors.lastname: Shim
mesh_terms: D050154:Adiposity; D000368:Aged; D004198:Disease Susceptibility; D005260:Female; D054884:Host-Pathogen Interactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification / Q000472:pathogenicity; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed