Higher Serum Cholesterol Levels Are Associated With Reduced Systemic Inflammation and Mortality During Tuberculosis Treatment Independent of Body Mass Index.
Higher Serum Cholesterol Levels Are Associated With Reduced Systemic Inflammation and Mortality During Tuberculosis Treatment Independent of Body Mass Index.
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DOI：
10.3389/fcvm.2021.696517
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发表时间：
2021
影响因子：
3.6
通讯作者：
Karakousis PC
中科院分区：
文献类型：
--
作者：
Chidambaram V;Zhou L;Ruelas Castillo J;Kumar A;Ayeh SK;Gupte A;Wang JY;Karakousis PC
背景：脂质在结核病（TB）的发病机制中起着核心作用。血脂水平对结核病治疗（ATT）结果的影响及其与血清炎症标志物的关系尚未得到表征。研究方法：我们在国立台湾大学医院对药物敏感的结核病患者进行了回顾性队列研究，评估了基线血脂水平（如低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、总胆固醇（TC）和甘油三酯（TG））与ATT前9个月内全因死亡率和感染相关死亡率以及基线炎症标志物（即C反应蛋白（CRP））的相关性。总白细胞计数（WBC）和嗜中性粒细胞-淋巴细胞比率（NL比率）。结果：514例中，全因死亡129例（26.6%），感染死亡72例（14.0%）。多变量Cox回归分析显示，HDL第三个三分位数的全因死亡率校正风险比（aHR）较低，（aHR 0.17，95% CI 0.07-0.44）和TC（aHR 0.30，95% CI 0.14-0.65），HDL第三个三分位数中感染相关死亡率较低（aHR 0.30，95% CI 0.14-0.65）和TC（aHR 0.30，95% CI 0.14-0.65）。多变量分析显示LDL和TG的第三个三分位数无相关性。类似地，使用线性回归分析，HDL和TC的第三个三分位数具有较低的基线炎症标志物水平，例如CRP、WBC和NL比率。体重指数（BMI）未显示混杂或效应改变的证据。结论：较高的基线血清胆固醇水平与结核病患者的全因和感染相关死亡率的风险较低以及炎症标志物水平较低相关。BMI没有改变或混淆这种关联。
Background: Lipids play a central role in the pathogenesis of tuberculosis (TB). The effect of serum lipid levels on TB treatment (ATT) outcomes and their association with serum inflammatory markers have not yet been characterized. Methods: Our retrospective cohort study on drug-susceptible TB patients, at the National Taiwan University Hospital, assessed the association of baseline serum lipid levels such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC) and triglycerides (TG) with all-cause and infection-related mortality during first 9 months of ATT and baseline inflammatory markers namely C-reactive protein (CRP), total leukocyte count (WBC), and neutrophil-lymphocyte ratio (NL ratio). Results: Among 514 patients, 129 (26.6%) died due to any-cause and 72 (14.0%) died of infection. Multivariable Cox-regression showed a lower adjusted hazard ratio (aHR) of all-cause mortality in the 3rd tertiles of HDL (aHR 0.17, 95% CI 0.07–0.44) and TC (aHR 0.30, 95% CI 0.14-0.65), and lower infection-related mortality in the 3rd tertile of HDL (aHR 0.30, 95% CI 0.14–0.65) and TC (aHR 0.30, 95% CI 0.14–0.65) compared to the 1st tertile. The 3rd tertiles of LDL and TG showed no association in multivariable analysis. Similarly, 3rd tertiles of HDL and TC had lower levels of baseline inflammatory markers such as CRP, WBC, and NL ratio using linear regression analysis. Body mass index (BMI) did not show evidence of confounding or effect modification. Conclusions: Higher baseline serum cholesterol levels were associated with lower hazards of all-cause and infection-related mortality and lower levels of inflammatory markers in TB patients. BMI did not modify or confound this association.