Nutrition, diabetes and tuberculosis in the epidemiological transition.
Nutrition, diabetes and tuberculosis in the epidemiological transition.
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DOI：
10.1371/journal.pone.0021161
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Williams BG
中科院分区：
文献类型：
--
作者：
Dye C;Bourdin Trunz B;Lönnroth K;Roglic G;Williams BG
糖尿病患病率和体重指数反映了人群的营养状况，但对结核病风险具有相反的影响。糖尿病和BMI之间的相互作用可能有助于或阻碍不断增长、老龄化和城市化人口的结核病控制。我们汇编了描述高(印度)和低(韩国)结核病负担国家的男性和女性在城乡地区的BMI、糖尿病患病率和人口年龄结构的时间变化的数据。利用公布的与这些因素相关的结核病风险数据，我们计算了1998至2008年间结核病发病率的预期变化。在印度，由于老龄化、城市化、体重指数变化和糖尿病患病率上升的不利影响，结核病发病率的增长(28%)将比人口规模(22%)更快(从170万人增加到210万人)，导致10年内人均结核病发病率增加5.5%。在印度，大多数居住在农村地区的男性的体重指数下降抵消了总体营养改善的影响。1998年至2008年间，印度糖尿病患病率不断上升，使糖尿病患者的年结核病病例数量增加了46%。相比之下，在韩国，由于城市化、BMI增加和糖尿病患病率下降的积极影响，结核病病例数量的增长(6.1%，从40,200例增加到42,800例)慢于人口规模(14%)。因此，人均结核病发病率在10年内下降了7.8%。在韩国，快速的人口老龄化是最严重的不良影响。在发病率较高的印度，与发病率较低的韩国相比，营养和人口结构的变化对结核病有更强的不利影响。这两个国家的不利影响可以通过早期药物治疗来克服，但如果不加以控制，可能会导致结核病发病率的加速上升。结核病危险因素的预防和管理将通过化疗加强对结核病的控制。
Diabetes prevalence and body mass index reflect the nutritional profile of populations but have opposing effects on tuberculosis risk. Interactions between diabetes and BMI could help or hinder TB control in growing, aging, urbanizing populations. We compiled data describing temporal changes in BMI, diabetes prevalence and population age structure in rural and urban areas for men and women in countries with high (India) and low (Rep. Korea) TB burdens. Using published data on the risks of TB associated with these factors, we calculated expected changes in TB incidence between 1998 and 2008. In India, TB incidence cases would have increased (28% from 1.7 m to 2.1 m) faster than population size (22%) because of adverse effects of aging, urbanization, changing BMI and rising diabetes prevalence, generating an increase in TB incidence per capita of 5.5% in 10 years. In India, general nutritional improvements were offset by a fall in BMI among the majority of men who live in rural areas. The growing prevalence of diabetes in India increased the annual number of TB cases in people with diabetes by 46% between 1998 and 2008. In Korea, by contrast, the number of TB cases increased more slowly (6.1% from 40,200 to 42,800) than population size (14%) because of positive effects of urbanization, increasing BMI and falling diabetes prevalence. Consequently, TB incidence per capita fell by 7.8% in 10 years. Rapid population aging was the most significant adverse effect in Korea. Nutritional and demographic changes had stronger adverse effects on TB in high-incidence India than in lower-incidence Korea. The unfavourable effects in both countries can be overcome by early drug treatment but, if left unchecked, could lead to an accelerating rise in TB incidence. The prevention and management of risk factors for TB would reinforce TB control by chemotherapy.
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影响因子：
168.9
作者：
Dye, C;Garnett, GP;Williams, BG
通讯作者：
Williams, BG
影响因子：
16.2
作者：
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影响因子：
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