Body mass index and risk of tuberculosis and death.
Body mass index and risk of tuberculosis and death.
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体重指数和结核病和死亡的风险。
DOI：
10.1097/qad.0b013e32833a2a4a
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发表时间：
2010-06-19
期刊：
影响因子：
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通讯作者：
Martinson NA
中科院分区：
文献类型：
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作者：
Hanrahan CF;Golub JE;Mohapi L;Tshabangu N;Modisenyane T;Chaisson RE;Gray GE;McIntyre JA;Martinson NA
高BMI已被证明对未感染艾滋病毒的人预防结核病（TB）以及艾滋病毒感染者的疾病进展和死亡率具有保护作用。我们在南非索韦托的hiv感染成人队列中研究了BMI对全因死亡率和结核病发病率的影响。在2003年至2008年期间，对3456名南非成年艾滋病毒感染者进行了前瞻性随访，并进行了定期监测。主要暴露是BMI，关注的结果是全因死亡率和新诊断的结核病发作。Cox比例风险模型评估了与死亡率或偶发结核病风险的关联。基线BMI为18.5或以下的死亡率为10.4/100人年，基线BMI为18.6-25的死亡率为3.6/100人年，基线BMI为25.1-30的死亡率为1.7/100人年，基线BMI大于30的死亡率为1.6/100人年。与BMI正常的参与者相比，超重和肥胖参与者的死亡风险显著降低[校正风险比分别为0.59（95%置信区间，CI 0.40-0.87）和0.48 (95% CI 0.29-0.80)]。按基线BMI计算的结核病发病率为：体重过轻者7.3/100人年，正常者6.0/100人年，超重者3.2/100人年，肥胖者1.9/100人年。与BMI正常的人相比，BMI超重和肥胖的人患结核病的风险显著降低[校正风险比分别为0.56 （95% CI 0.38-0.83）和0.33 (95% CI 0.19-0.55)]。在对HAART的使用和CD4细胞计数进行调整后，肥胖和超重BMI的hiv感染者的死亡率和结核病风险均显著降低。
High BMI has been shown to be protective against tuberculosis (TB) among HIV-uninfected individuals, as well as against disease progression and mortality among those with HIV. We examined the effect of BMI on all-cause mortality and TB incidence among a cohort of HIV-infected adults in Soweto, South Africa. A clinical cohort of 3456 HIV-infected adults from South Africa was prospectively followed from 2003 to 2008 with regular monitoring. The primary exposure was BMI and the outcomes of interest were all-cause mortality and a newly diagnosed episode of TB. Cox proportional hazard models assessed associations with risk of mortality or incident TB. Incidence rates of mortality were 10.4/100 person-years for baseline BMI of 18.5 or less, 3.6/100 person-years for baseline BMI 18.6–25, 1.7/100 person-years for baseline BMI 25.1–30, and 1.6/100 person-years for baseline BMI more than 30. Compared to those with normal BMI, overweight and obese participants had a significantly reduced risk of mortality [adjusted hazard ratio 0.59 (95% confidence interval, CI 0.40–0.87) and 0.48 (95% CI 0.29–0.80), respectively]. Incidence rates of TB by baseline BMI were 7.3/100 person-years for underweight, 6.0/100 person-years for normal, 3.2/100 person-years for overweight, and 1.9/100 person-years for obese. Compared to those with normal BMI, those with overweight and obese BMI were at a significantly reduced risk of developing TB [adjusted hazard ratio 0.56 (95% CI 0.38–0.83) and 0.33 (95% CI 0.19–0.55), respectively]. HIV-infected individuals with obese and overweight BMI have a significantly reduced risk of both mortality and TB, after adjusting for HAART use and CD4 cell count.