PMID- 33750328
OWN - NLM
STAT- MEDLINE
DCOM- 20210426
LR  - 20210426
IS  - 1471-2318 (Electronic)
IS  - 1471-2318 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Mar 9
TI  - Association between body mass index and severe infection in older adults with 
      microscopic polyangiitis: a retrospective cohort in Japan.
PG  - 171
LID - 10.1186/s12877-021-02123-y [doi]
LID - 171
AB  - BACKGROUND: Although previous studies have evaluated risk factors for the 
      incidence of severe infection in patients with antineutrophil cytoplasmic 
      antibody-associated vasculitis (AAV), the relationship between body mass index 
      (BMI) and severe infection in AAV has not been elucidated. We hypothesized that 
      older adults with AAV and a low BMI would be at a higher risk of infection. We 
      therefore investigated the association between underweight status at AAV 
      diagnosis and subsequent occurrence of severe infection in older adults with AAV. 
      METHODS: This single-center retrospective cohort study included 93 consecutive 
      older adults with microscopic polyangiitis (MPA) treated at the Aichi Medical 
      University Hospital in Japan between 2004 and 2018. The relationships between BMI 
      at diagnosis and subsequent first severe infection were assessed using 
      multivariate Cox proportional hazards models. The cumulative probability of the 
      development of the first severe infection was calculated using the Kaplan-Meier 
      method and the log-rank test. The level of statistical significance was set at 
      P <  0.05. RESULTS: During the median follow-up period of 19 (6-53) months, 29 
      (31.2%) patients developed at least one severe infection. Older age (adjusted 
      hazard ratio [HR] = 2.02, 95% confidence interval [CI]: 1.14-3.52, per 10 years; 
      P =  0.016), low BMI (< 18.5 kg/m(2) compared with normal BMI 
      [18.5-23.0 kg/m(2)], adjusted HR =  2.63, 95% CI: 1.11-6.19; P =  0.027), and use 
      of methylprednisolone pulse therapy (adjusted HR = 2.48, 95% CI: 1.07-5.76; 
      P =  0.034) were found to be significant predictors of severe infection. 
      CONCLUSIONS: Low BMI was associated with a higher risk of severe infection in 
      older adults with MPA, suggesting that careful management may be required to 
      prevent this complication in this vulnerable group. Further studies are needed to 
      elucidate the optimal treatment strategy for these patients.
FAU - Sugiyama, Hirokazu
AU  - Sugiyama H
AD  - Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 
      Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan.
FAU - Yamaguchi, Makoto
AU  - Yamaguchi M
AD  - Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 
      Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan.
FAU - Katsuno, Takayuki
AU  - Katsuno T
AD  - Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 
      Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan.
FAU - Iwagaitsu, Shiho
AU  - Iwagaitsu S
AD  - Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 
      Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan.
FAU - Nobata, Hironobu
AU  - Nobata H
AD  - Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 
      Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan.
FAU - Kinashi, Hiroshi
AU  - Kinashi H
AD  - Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 
      Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan.
FAU - Banno, Shogo
AU  - Banno S
AD  - Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 
      Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan.
FAU - Ando, Masahiko
AU  - Ando M
AD  - Data Coordinating Center, Department of Advanced Medicine, Nagoya University 
      Hospital, Nagoya, Japan.
FAU - Kubo, Yoko
AU  - Kubo Y
AD  - Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Ishimoto, Takuji
AU  - Ishimoto T
AD  - Department of Nephrology and Renal Replacement Therapy, Nagoya University 
      Graduate School of Medicine, Nagoya, Japan.
FAU - Ito, Yasuhiko
AU  - Ito Y
AUID- ORCID: 0000-0002-9676-6961
AD  - Department of Nephrology and Rheumatology, Aichi Medical University, 1-1 
      Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan. yasuito@aichi-med-u.ac.jp.
LA  - eng
PT  - Journal Article
DEP - 20210309
PL  - England
TA  - BMC Geriatr
JT  - BMC geriatrics
JID - 100968548
SB  - IM
MH  - Aged
MH  - Body Mass Index
MH  - Cohort Studies
MH  - Humans
MH  - Japan/epidemiology
MH  - *Microscopic Polyangiitis/diagnosis/epidemiology
MH  - Retrospective Studies
PMC - PMC7942001
OTO - NOTNLM
OT  - Antibodies, Antineutrophil cytoplasmic antibody-associated Vasculitis
OT  - Body mass index
OT  - Infection
COIS- The authors declare that they have no competing interests.
EDAT- 2021/03/23 06:00
MHDA- 2021/04/27 06:00
PMCR- 2021/03/09
CRDT- 2021/03/22 18:03
PHST- 2020/09/14 00:00 [received]
PHST- 2021/03/01 00:00 [accepted]
PHST- 2021/03/22 18:03 [entrez]
PHST- 2021/03/23 06:00 [pubmed]
PHST- 2021/04/27 06:00 [medline]
PHST- 2021/03/09 00:00 [pmc-release]
AID - 10.1186/s12877-021-02123-y [pii]
AID - 2123 [pii]
AID - 10.1186/s12877-021-02123-y [doi]
PST - epublish
SO  - BMC Geriatr. 2021 Mar 9;21(1):171. doi: 10.1186/s12877-021-02123-y.