糖尿病是结核病疾病的危险因素
Juan Va Franco1, Brenda Bongaerts1, Maria-Inti Metzendorf1
1Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
The Cochrane database of systematic reviews
|August 23, 2024
概括
糖尿病显著增加患结核病 (TB) 的风险. 这一对48项研究的元分析强调了需要综合战略,以全球管理糖尿病和结核病.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 传染病研究 传染病研究
背景情况:
- 结核病 (TB) 仍然是主要的传染性死亡原因,在2022年有1060万例.
- 糖尿病 (DM) 越来越被认为是影响结核病发病率,死亡率,复发和耐药性的重要危险因素.
研究的目的:
- 评估糖尿病在预测结核病的预后价值,包括成年人,青少年和儿童.
主要方法:
- 在主要数据库 (PubMed,世卫组织全球医学指数,ICTRP) 进行了系统的文献搜索.
- 包括的研究包括了回顾性和前性设计,评估了基线糖尿病状况和结核病发病率/复发作为结果.
- 用随机效应模型对调整后的危险比率,风险比率和赔率比率进行了元分析,证据确定性以GRADE评级.
主要成果:
- 对48项队列研究 (超过6100万参与者) 的分析表明,DM增加了结核病的风险 (HR 1.90,低确定性).
- 随访时间<10年 (HR 1.52,中等确定性) 的风险更一致,但在≥10年 (HR 2.44,低确定性) 的风险更高.
- 此外,DM还增加了结核病的几率 (OR 1.61,低确定性) 和风险 (RR 1.60,中等确定性).
结论:
- 糖尿病是短期和长期发展结核病的可能危险因素.
- 针对糖尿病管理的综合政策对于实现全球结核病控制目标至关重要.
- 需要进一步进行大规模,高质量的队列研究,特别是在代表性不足的地区,包括儿童/青少年.
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