A Prospective Cohort Study of Bioavailable 25-Hydroxyvitamin D Levels as a Marker of Vitamin D Status in Nontuberculous Mycobacterial Pulmonary Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Study Protocol
2.3. Ultra Performance Liquid Chromatography (UPLC)-Mass Spectrometry (MS)/MS Analysis
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Vitamin D and Vitamin D Binding Protein
3.3. Association Factors and Clinical Outcome of NTM-PD
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total (n = 279) | Control (n = 226) | NTM (n = 53) | p-Value | |
---|---|---|---|---|
Age | 53.0 ± 11.7 | 51.0 ± 11.1 | 65.6 ± 10.5 | <0.001 |
Sex, male | 152 (54.5) | 136 (60.2) | 16 (30.2) | <0.001 |
BMI (kg/m2) | 23.6 ± 3.1 | 24.1 ± 3.0 | 21.5 ± 2.6 | <0.001 |
Causative organism | ||||
M. avium complex | 48 (90.6) | |||
M. abscessus complex | 4 (7.5) | |||
M. kansasii | 1 (1.9) | |||
Radiologic type | ||||
Fibrocavitary | 10 (18.9) | 10 (18.9) | ||
Nodular bronchiectatic | 43 (81.1) | 43 (81.1) | ||
Positive AFB smear | 17 (32.1) | 17 (32.1) | ||
Sampling season | <0.001 | |||
Spring (March–May) | 233 (83.5) | 226 (100) | 7 (13.2) | |
Summer (June–August) | 21 (7.5) | 0 (0.0) | 21 (39.6) | |
Autumn (September–November) | 21 (7.5) | 0 (0.0) | 21 (39.6) | |
Winter (December–February) | 4 (1.4) | 0 (0.0) | 4 (7.5) |
Total (n = 279) | Control (n = 226) | NTM (n = 53) | p-Value | |
---|---|---|---|---|
Diplotypes | 0.818 | |||
Gc1f/Gc2 | 83 (29.7) | 67 (29.6) | 16 (30.2) | |
Gc1s/Gc1f | 60 (21.5) | 48 (21.2) | 12 (22.6) | |
Gc1f/Gc1f | 59 (21.1) | 47 (20.8) | 12 (22.6) | |
Gc1s/Gc2 | 40 (14.3) | 36 (15.9) | 4 (7.5) | |
Gc2/Gc2 | 22 (7.9) | 18 (8.0) | 4 (7.5) | |
Gc1s/Gc1s | 15 (5.4) | 10 (4.4) | 5 (9.4) | |
Haplotypes | 0.441 | |||
Gc1f | 261 (46.8) | 209 (46.2) | 52 (49.1) | |
Gc1s | 130 (23.3) | 104 (23.0) | 26 (24.5) | |
Gc2 | 167 (29.9) | 139 (30.8) | 28 (26.4) | |
VDBP (μg/mL) | 224.0 ± 41.9 | 221.0 ± 31.0 | 235.5 ± 70.1 | 0.022 |
Control (n = 226) | NTM (n = 53) * | NTM (n = 53) | ||||
---|---|---|---|---|---|---|
Observation (n = 29) | Treatment (n = 24) | |||||
Baseline | 6-Month | Baseline | 6-Month † | |||
Total 25-(OH)D (nmol/L) | 52.2 ± 24.9 | 55.9 ± 25.7 | 56.3 ± 26.1 | 57.4 ± 26.8 | 55.5 ± 25.7 | 48.2 ± 25.5 † |
25-(OH)D2 | 1.0 ± 0.8 | 1.5 ± 2.0 | 1.6 ± 2.5 | 1.6 ± 1.8 | 1.3 ± 0.8 | 1.1 ± 0.9 † |
25-(OH)D3 | 51.2 ± 24.9 | 54.5 ± 25.7 | 54.7 ± 26.1 | 55.8 ± 27.2 | 54.2 ± 25.8 | 47.1 ± 25.7 † |
Genotype-specific | ||||||
Free 25-(OH)D (pmol/L) | 19.5 ± 11.9 | 19.5 ± 10.9 | 19.3 ± 10.9 | 19.0 ± 10.9 | 19.8 ± 11.1 | 17.3 ± 10.3 |
Bioavailable 25-(OH)D (nmol/L) | 7.6 ± 4.7 | 6.9 ± 3.9 | 6.9 ± 4.0 | 6.6 ± 3.5 | 6.8 ± 4.0 | 6.0 ± 3.5 |
24,25-(OH)2D3 (nmol/L) | 4.4 ± 2.9 | 3.9 ± 3.0 | 4.1 ± 3.0 | 3.8 ± 2.7 | 3.7 ± 3.0 | 2.3 ± 1.9 † |
Univariable Analysis | Multivariable Analysis | |||
---|---|---|---|---|
OR (95% CI) | p-Value | OR (95% CI) | p-Value | |
Age | 1.100 (1.063–1.139) | <0.001 | 1.134 (1.088–1.183) | <0.001 |
Sex, male | 0.286 (0.150–0.545) | <0.001 | 0.357(0.161–0.794) | 0.012 |
BMI | 0.707 (0.619–0.807) | <0.001 | 0.677 (0.578–0.793) | <0.001 |
Total 25-(OH)D * | 1.015 (0.985–1.045) | 0.331 | ||
Genotype-specific | ||||
Free 25-(OH)D | 1.001 (0.939–1.067) | 0.980 | ||
Bioavailable 25-(OH)D | 0.908 (0.763–1.081) | 0.280 | 0.736 (0.588–0.921) | 0.007 |
VDBP | 1.008 (1.000–1.015) | 0.062 | – | – |
24,25-(OH)2D3 | 0.864 (0.657–1.137) | 0.297 | – | – |
Treatment Outcomes | p-Value | ||
---|---|---|---|
Success (n = 14) | Failure (n = 10) | ||
Age | 61.0 (55.5–66.0) | 60.5 (49.5–65.3) | 0.703 |
Sex, male | 4 (28.6) | 3 (30.0) | >0.999 |
BMI | 21.4 (20.2–22.3) | 21.4 (18.8–23.6) | 0.884 |
AFB smear positivity | 5 (35.7) | 7 (70.0) | 0.214 |
Causative organism | 0.525 | ||
M. avium complex | 13 (90.9) | 10 (100.0) | |
M. Kansasii | 1 (9.1) | 0 (0.0) | |
Radiologic types | >0.999 | ||
Fibrocavitary | 5 (35.7) | 4 (40.0) | |
Nodular bronchiectatic | 9 (64.3) | 6 (60.0) | |
Total 25-(OH)D | 64.0 (40.1–82.4) | 39.5 (32.2–47.7) | 0.143 |
25-(OH)D2 | 1.0 (0.8–1.6) | 1.1 (0.9–1.3) | 0.429 |
25-(OH)D3 | 62.6 (38.5–81.6) | 38.4 (30.0–46.9) | 0.143 |
Genotype-specific | |||
Free 25-(OH)D | 21.1 (12.9–32.3) | 16.7 (7.4–23.6) | 0.242 |
Bioavailable 25-(OH)D | 7.0 (4.3–10.7) | 6.1 (2.4–7.2) | 0.242 |
24,25-(OH)2D3 | 3.1 (1.7–7.7) | 2.2 (1.4–4.1) | 0.192 |
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Kwon, B.-S.; Lee, K.; Kim, E.-S.; Jun, S.-H.; Lim, S.-Y.; Song, M.-J.; Kim, Y.-W.; Lee, Y.-J.; Park, J.-S.; Cho, Y.-J.; et al. A Prospective Cohort Study of Bioavailable 25-Hydroxyvitamin D Levels as a Marker of Vitamin D Status in Nontuberculous Mycobacterial Pulmonary Disease. Nutrients 2021, 13, 2524. https://doi.org/10.3390/nu13082524
Kwon B-S, Lee K, Kim E-S, Jun S-H, Lim S-Y, Song M-J, Kim Y-W, Lee Y-J, Park J-S, Cho Y-J, et al. A Prospective Cohort Study of Bioavailable 25-Hydroxyvitamin D Levels as a Marker of Vitamin D Status in Nontuberculous Mycobacterial Pulmonary Disease. Nutrients. 2021; 13(8):2524. https://doi.org/10.3390/nu13082524
Chicago/Turabian StyleKwon, Byoung-Soo, Kyunghoon Lee, Eun-Sun Kim, Sun-Hee Jun, Sung-Yoon Lim, Myung-Jin Song, Yeon-Wook Kim, Yeon-Joo Lee, Jong-Sun Park, Young-Jae Cho, and et al. 2021. "A Prospective Cohort Study of Bioavailable 25-Hydroxyvitamin D Levels as a Marker of Vitamin D Status in Nontuberculous Mycobacterial Pulmonary Disease" Nutrients 13, no. 8: 2524. https://doi.org/10.3390/nu13082524