身体质量指数和发生结核病的近距离结核病接触者
概括
识别患有结核病 (TB) 进展高风险的个体对于预防至关重要. 在IGRA阳性结核病接触者的低体重指数 (BMI) 表明结核病风险更高,表明有针对性的结核病预防疗法 (TPT).
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 大约95%感染了Mycobacterium结核病的个体不会发展为活跃结核病 (TB).
- 识别预测结核病进展的因素对于有效的预防策略至关重要.
研究的目的:
- 在结核病患者的密切接触中确定结核病进展的关键决定因素.
- 开发结核病进展的预测模型.
主要方法:
- 一项前性多中心队列研究 (RePORT-巴西) 招募了1846名肺结核病例接触者,从2015年至2019年.
- 使用尺寸缩小技术 (LASSO回归) 来选择预测模型的变量,包括临床和实验室数据.
- 模型在内部使用引导验证,通过ROC曲线评估预测准确性.
主要成果:
- 在1846名接触者中,有25人 (1.4%) 发展为结核病患者. 缺乏结核病预防治疗 (TPT) 是进展的重要风险因素 (aHR:11.79).
- 对于没有接受TPT的IGRA阳性接触者,体重指数 (BMI) <25 kg/m2与进展到活跃结核病 (aHR:0.87) 相反相关.
- 与BMI≥25 kg/m2 (8.4%对2.1%的结核病风险) 相比,IGRA阳性接触者与BMI<25 kg/m2的结核病进展风险高4.14倍.
结论:
- 低BMI (<25 kg/m2) 是一种易于测量的生物标志物,可识别高风险结核病进展的IGRA阳性结核病密切接触者.
- 通过低BMI和积极的IGRA状态来确定这一高风险群体的TPT向,可以加强结核病预防工作.
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