Diabetes Care:潜伏性结核感染个体发生糖尿病的风险增加

2022-03-04 MedSci原创 MedSci原创

潜伏性结核感染与糖尿病发病率增加有关。这些结果对占全球人口25%的潜伏性结核感染患者具有重要意义。

在美国的横断面研究中,糖尿病患者的潜伏性结核感染患病率是非糖尿病患者的两倍。然而,潜伏性结核感染是否会导致糖尿病风险尚未明确。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员使用纵向数据来确定潜伏性结核感染是否与糖尿病发病率增加相关。

研究人员于2000年至2015年期间在退伍军人健康管理局接受治疗的美国退伍军人中进行了一项回顾性队列研究。研究人员纳入了所有接受结核菌素皮肤试验(TST)或干扰素-γ释放试验(IGRA)且既往没有糖尿病的患者。研究人员排除了有活动性结核病史的患者,以及在潜伏性结核感染检测之前或之后2年内被诊断为糖尿病的患者。随访患者直至糖尿病诊断、死亡或2015年。潜伏性结核感染定义为TST或IGRA阳性。研究人员通过使用ICD-9代码结合糖尿病药物处方来确定糖尿病。

在574113名符合条件的患者中,5.3%的患者同时接受了TST/IGRA检查,79.1%的患者仅接受了TST检查,15.6%的患者仅接受了IGRA检查。总体而言,6.6%的患者有潜伏性结核感染,潜伏性结核感染测试后随访了2535149人年(PY)(中位时间为3.2年)。与没有潜伏性结核感染的患者相比,患有潜伏性结核感染的患者糖尿病发病率(每100000PY)更高(1012 vs. 744;风险比[HR]为1.4[95%CI为1.3-1.4])。与没有潜伏性结核感染的患者相比,在调整协变量(调整后的HR[aHR]为1.2[95%CI为1.2-1.3])后,糖尿病发病率持续增加。在潜伏性结核感染患者中,接受潜伏性结核感染治疗的患者的糖尿病发病率与未接受治疗的患者相似(aHR为1.0[95%CI为0.9-1.1])。

由此可见,潜伏性结核感染与糖尿病发病率增加有关。这些结果对占全球人口25%的潜伏性结核感染患者具有重要意义。

原始出处:
 
Matthew J. Magee,et al.Increased Risk of Incident Diabetes Among Individuals With Latent Tuberculosis Infection.Diabetes care.2022.https://diabetesjournals.org/care/article-abstract/doi/10.2337/dc21-1687/144563/Increased-Risk-of-Incident-Diabetes-Among?redirectedFrom=fulltext

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