Diabetic control and risk of tuberculosis: A cohort study
Diabetic control and risk of tuberculosis: A cohort study
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DOI：
10.1093/aje/kwn075
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发表时间：
2008-06-15
影响因子：
5
通讯作者：
Chang, Kwok C.
中科院分区：
文献类型：
--
作者：
Leung, Chi C.;Lam, Tai H.;Chang, Kwok C.
糖尿病与结核病有关。 2000年，在香港18个长者健康服务中心登记的42,116名65岁或以上的服务对象，通过全港结核病登记处，以他们的身分证号码作为唯一识别码，从登记后3个月至2005年12月31日期间进行前瞻性随访，以了解结核病的发展情况。通过对社会人口统计和其他背景变量进行调整，评估糖尿病和糖尿病控制对结核病风险的影响。糖尿病与活动性结核病、培养证实的结核病和肺结核（有或没有肺外受累）的风险适度增加相关，但与肺外结核（有或没有肺受累）的风险无关，调整后的风险比为 1.77（95% 置信区间：1.41、2.24）、1.91（95% 置信区间：1.45、2.52）、1.89 （95% 置信区间：1.48、2.42）和 1.00（95% 置信区间：0.54、1.86）。入组时血红蛋白 A1c < 7% 的糖尿病受试者风险并未增加。在糖尿病受试者中，基线血红蛋白 A1c >= 7%（vs. < 7%）时，观察到活动性结核、培养确诊结核和肺结核（而非肺外结核）的风险较高，调整后的风险比为 3.11（95% 置信区间：1.63、5.92）、3.08（95% 置信区间：1.44、6.57）、3.63 （95% 置信区间：1.79、7.33）和 0.77（95% 置信区间：0.18、3.35）。
Diabetes mellitus is associated with tuberculosis. A cohort of 42,116 clients aged 65 years or more, enrolled at 18 Elderly Health Service centers in Hong Kong in 2000, were followed up prospectively through the territory-wide tuberculosis registry for development of tuberculosis from 3 months after enrollment to December 31, 2005, by use of their identity card numbers as unique identifier. The effects of diabetes mellitus and diabetic control on tuberculosis risk were assessed with adjustment for sociodemographic and other background variables. Diabetes mellitus was associated with a modest increase in the risk of active, culture-confirmed, and pulmonary (with or without extrapulmonary involvement) but not extrapulmonary (with or without pulmonary involvement) tuberculosis, with adjusted hazard ratios of 1.77 (95% confidence interval: 1.41, 2.24), 1.91 (95% confidence interval: 1.45, 2.52), 1.89 (95% confidence interval: 1.48, 2.42), and 1.00 (95% confidence interval: 0.54, 1.86), respectively. Diabetic subjects with hemoglobin A1c < 7% at enrollment were not at increased risk. Among diabetic subjects, higher risks of active, culture-confirmed, and pulmonary but not extrapulmonary tuberculosis were observed with baseline hemoglobin A1c >= 7% (vs. < 7%), with adjusted hazard ratios of 3.11 (95% confidence interval: 1.63, 5.92), 3.08 (95% confidence interval: 1.44, 6.57), 3.63 (95% confidence interval: 1.79, 7.33), and 0.77 (95% confidence interval: 0.18, 3.35), respectively.