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A Prospective Cohort Study of Bioavailable 25-Hydroxyvitamin D Levels as a Marker of Vitamin D Status in Nontuberculous Mycobacterial Pulmonary Disease
Authors:Byoung-Soo Kwon  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  Ho-Il Yoon  Choon-Taek Lee  Junghan Song  Jae-Ho Lee
Institution:1.Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si 13620, Gyeonggi-do, Korea; (B.-S.K.); (E.-S.K.); (S.-Y.L.); (M.-J.S.); (Y.-W.K.); (Y.-J.L.); (J.-S.P.); (Y.-J.C.); (H.-I.Y.); (C.-T.L.);2.Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam-si 13620, Gyeonggi-do, Korea; (K.L.); (S.-H.J.); (J.S.)
Abstract:Research on vitamin D in patients with nontuberculous mycobacterial (NTM) pulmonary disease (PD) is limited. We aimed to compare the vitamin D parameters of patients with NTM-PD to those of a healthy control group, and to assess the possible predictive markers for a clinical response. We prospectively enrolled 53 patients with NTM-PD between January 2014 and December 2016. The clinical data and vitamin D indices, including total, free, bioavailable 25-(OH)D, and vitamin D binding protein (VDBP) genotyping, were measured at baseline and six months after enrollment. An external dataset of 226 healthy controls was compared with the NTM-PD group. The mean age of subjects was 53 years; 54.5% were male. The NTM-PD group was older, predominantly female, and had a lower body mass index (BMI) than the controls. The proportion of patients with vitamin D concentration <50 nmol/L was 52.8% in the NTM-PD group and 54.9% in the control group (p = 0.789). The bioavailable 25-(OH)D concentrations of the NTM-PD group and the controls were similar (6.9 nmol/L vs. 7.6 nmol/L, p = 0.280). In the multivariable analysis, bioavailable 25-(OH)D concentrations were associated with NTM-PD, adjusting for age, sex, BMI, and VDBP levels. Bioavailable 25-(OH)D concentrations were significantly associated with susceptibility to NTM-PD, but not with treatment outcomes. Lower bioavailable 25-(OH)D might be a risk factor for NTM-PD.
Keywords:nontuberculous mycobacterial  vitamin D  bioavailable
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