身体質量指数と結核の発生 結核と密接な接触者
María B Arriaga1,2, Gustavo Amorim3, Marina C Figueiredo1
1Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
まとめ
低体量指数 (BMI) は,暴露後に活性結核 (TB) を発症するリスクが高い個人を特定します. これらの高リスクの接触者を特定することで 予防戦略を向上させることができます
科学分野:
- 感染症 疫学
- 公衆衛生
- バイオ統計学
背景:
- Mycobacterium tuberculosis (M. tuberculosis) に感染した人のほとんどは,活発な結核 (TB) を発症しません.
- 結核の進行を予測する要因を特定することは 標的を絞った予防に不可欠です
研究 の 目的:
- 結核患者との密接な接触において結核の進行を決定する要因を特定する.
- 結核の進行を予測するモデルを開発する.
主な方法:
- 1846人の結核接触者を24ヶ月間追跡した前向きなコホート研究 (RePORT- ブラジル).
- LASSO回帰は,TBの進行モデルのための予測値を選択するために,次元縮小に使用されます.
- すべての接触者,IGRA陽性接触者,および結核予防療法 (TPT) を受けていないIGRA陽性接触者についてモデルを開発した.
主要な成果:
- 25人 (1. 4%) の接触者は結核に進行した. TPTの欠如は,進行の重要な危険因子でした.
- すべてのコンタクトの予測モデルは,ROC曲線の下の面積を0.80を達成しました.
- TPTを受けていないIGRA陽性接触者の中で,BMI < 25kg/ m2は,BMI ≥ 25kg/ m2と比較して,TB進行の4. 14倍の増加と関連していました.
結論:
- 低BMI (<25 kg/ m2) は,結核病の進行リスクの高いIGRA陽性近接者を識別する容易に入手可能なバイオマーカーです.
- 低BMIの個人を対象に結核予防療法を行うことで結核予防の取り組みが強化されます.
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