身体质量指数和发生结核病的近距离接触者
María B Arriaga1,2, Gustavo Amorim3, Marina C Figueiredo1
1Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
概括
低体重指数 (BMI) 识别了暴露后患有活跃结核病 (TB) 的风险较高的人. 识别这些高风险结核病接触者可以改善预防策略.
科学领域:
- 传染病流行病学
- 公共卫生
- 生物统计学
背景情况:
- 大多数感染 Mycobacterium 结核病 (M. 结核病) 的患者不会患有活跃结核病 (TB).
- 鉴定可预测结核病进展的因素对于有针对性的预防至关重要.
研究的目的:
- 在结核病患者的密切接触者中确定结核病进展的决定因素.
- 开发结核病进展的预测模型.
主要方法:
- 对1846名结核病接触者进行了24个月的前性队列研究 (RePORT- 巴西).
- 用于选择结核病进展模型的预测因素的LASSO回归.
- 对所有接触者,IGRA阳性接触者和不接受结核病预防治疗 (TPT) 的IGRA阳性接触者开发模型.
主要成果:
- 25名 (1.4%) 的接触者发展为结核病患者. 缺乏TPT是导致病变进展的重要危险因素.
- 对所有接触的预测模型实现了ROC曲线下的面积为0.80.
- 在没有接受TPT的IGRA阳性接触者中,体重指数 (BMI) < 25 kg/ m2与体重指数≥ 25 kg/ m2相比,结核病进展风险增加了4. 14倍.
结论:
- 低BMI (<25 kg/ m2) 是一种易于获得的生物标志物,可以识别高风险的IGRA阳性结核病密切接触者.
- 针对低BMI患者进行结核病预防治疗可以加强结核病预防工作.
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