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体重指数和结核风险:更新的系统文献综述和剂量反应元分析
Matthew J Saunders1,2, J Peter Cegielski3, Rebecca A Clark4
1Institute for Infection and Immunity, City St George's, University of London, London, United Kingdom.
International journal of epidemiology
|September 8, 2025
概括
下肢体质量指数 (BMI) 显著增加结核病风险,特别是在体重不足的人群中. 这项研究证实营养状况是推动全球结核病流行的一个关键因素.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 营养科学 营养科学
背景情况:
- 营养状况与结核病 (TB) 风险之间的联系至关重要,但尚未完全理解.
- 这项研究建立在2009年审查的基础上,审查了体重指数 (BMI) 和结核病风险.
研究的目的:
- 系统地审查和分析2009年至2024年期间发表的关于BMI与成年人结核病风险之间的关系的新研究.
- 量化BMI和结核病风险之间的剂量反应关系在不同人群中.
主要方法:
- 对2009-2024年成人BMI和结核病风险的研究进行系统的文献搜索.
- 用重新抽样进行剂量反应元分析,在类别内分配中位数BMI值.
- 按人口群体 (一般,艾滋病毒阳性,糖尿病) 和国家结核病负担分层划分.
- 应用线性,受限制的立方线条和断片线性模型来评估关系.
主要成果:
- 在整个BMI范围 (15.0-35.0 kg/m2) 中,在BMI和结核病风险之间观察到一个反向的剂量反应关系.
- 确定了一种非线性关系:BMI<25.0 kg/m2 (18.0%) 的风险急剧下降,BMI≥25.0 kg/m2 (6.9%) 的风险在一般人群中逐渐下降.
- 在HIV阳性个体中,BMI<23.0 kg/m2的风险降低为15.3%,BMI≥23.0 kg/m2的风险降低为2.6%.
- 营养不良 (BMI <18.5 kg/m2) 与结核病相对风险增加5.0倍有关.
结论:
- 营养状况,特别是BMI,是全球结核病流行病的独立和重要的驱动因素.
- 针对结核病的公共卫生战略应考虑营养状况干预措施.
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