糖尿病が結核感染症の診断に与える影響
Linda Petrone1, Alessandra Aiello1, Saeid Najafi-Fard1
1Traslational Research Unit, National Institute for Infectious Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy.
まとめ
糖尿病と結核は症候群を形成し,結核感染症検査の精度に影響を与えます. 低血糖制御,高齢化,および併発性疾患は,検査の敏感性を低下させ,診断不足につながり,TB予防戦略を妨げます.
科学分野:
- 免疫学 免疫学とは
- 感染症 感染症は感染症です.
- エンドクリノロジー エンドクリノロジー
背景:
- 結核 (TB) と糖尿病 (DM) は症候群を形成し,結核のリスクと重症度を高めます.
- 糖尿病は免疫機能を低下させ,結核感染症 (TBI) 診断検査の正確性に潜在的に影響します.
- TBIの現在の診断方法は,皮膚検査とインターフェロン-γ放出アッセイ (IGRA) を含む.
研究 の 目的:
- TBI診断テストの正確性に対する糖尿病と血糖コントロールの影響を検討する.
- 糖尿病患者のTBIテストの成績に影響を与える要因を特定する.
- 結核-糖尿病症候群における結核予防のための戦略を策定する.
主な方法:
- 糖尿病患者集団におけるTBI診断の正確性を調べた研究の文献レビュー.
- 糖質コントロール,抗糖尿病薬,併発症などの要因の分析.
- IGRAと皮膚検査のパフォーマンスに関する証拠の統合.
主要な成果:
- 糖尿病患者のIGRA陽性性に関する不一致な発見が存在する;いくつかの研究はより高い割合を報告しているが,他の研究は感受性の低下または不確実な結果を示している.
- 限られた証拠によると,抗糖尿病薬はTBIテストの精度に大きな影響を与えないという.
- インスリンまたはメトホルミン療法は,TBIの有病率の低下と関連している可能性があり,改善された血糖コントロールによる潜在的な保護を示しています.
- 低血糖制御,高齢化,HIV,CKD,免疫抑制は,TBIテストの感度を下げ,診断不足につながる可能性があります.
結論:
- 糖尿病とそのコントロールは,TBIの診断の正確性に大きく影響し,しばしばテストの感度が低下し,診断不足につながります.
- これらの影響を明らかにし,結核-糖尿病症候群の文脈でWHOの終結結核戦略を最適化するために,さらなる研究が不可欠です.
- 併発症に対処し,血糖コントロールを改善することは,正確なTBI診断と効果的なTB予防に不可欠です.
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