在PLHIV患者中,BMI作为从结核病感染向活跃结核病进展的预测指标
D Nguenha1, F Ndebele2, B Saavedra3
1Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;, Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centers, Location University of Amsterdam, Amsterdam, The Netherlands.
低体重指数 (BMI) 会增加感染艾滋病毒 (PLHIV) 的人的结核病 (TB) 风险. 体重指数和结核病发病率之间的关系是复杂的,不是严格的线性,随着体重指数上升到大约25kg/m2,风险会降低.
科学领域:
- 传染病流行病学 传染病流行病学
- 艾滋病毒/艾滋病研究研究
- 营养科学 营养科学
背景情况:
- 低体重指数 (BMI) 是肺结核 (TB) 进展的重要全球风险因素.
- 艾滋病毒感染者 (PLHIV) 中的BMI和结核病发病率之间的关联以及这种关系的确切功能形式仍未得到充分研究.
研究的目的:
- 调查艾滋病毒感染者 (PLHIV) 体质指数 (BMI) 和结核病 (TB) 发病率之间的关联.
- 用先进的统计模型来确定BMI和结核病发病率之间的关系的功能形式.
主要方法:
- 一个随机对照试验的二次分析,涉及南非,莫桑比克和埃塞俄比亚的PLHIV的结核病预防疗法.
- 利用多变量分数多项式 (MFP) 来探索BMI的功能形式和Cox回归用于时间到TB建模.
主要成果:
- 总共有76例结核病事件被记录下来,每100人年发生率为1.2例.
- 较低的基线BMI (<18.5 kg/m2) 显著增加了结核病危险 (aHR 2.6),而高的BMI (≥30 kg/m2) 显示了降低的危险 (aHR 0.5).
- 多片分析表明,结核病发病率随着BMI上升到~25 kg/m2而下降,随后下降速度较慢,这表明复杂的,反向的日志线性关联.
结论:
- 在艾滋病毒感染者 (PLHIV) 中,体重指数 (BMI) 与结核病 (TB) 发病率呈反向日志线性关联.
- 在PLHIV中,BMI和结核病发病率之间的关系比简单的日志线性模型所暗示的要复杂得多,这凸显了对细微了解的需要.
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