Tuberculosis and diabetes mellitus: convergence of two epidemics.
Tuberculosis and diabetes mellitus: convergence of two epidemics.
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DOI：
10.1016/s1473-3099(09)70282-8
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发表时间：
2009-12
影响因子：
56.3
通讯作者：
Chaisson, Richard E.
中科院分区：
文献类型：
--
作者：
Dooley, Kelly E.;Chaisson, Richard E.
几个世纪以来，人们已经认识到糖尿病和肺结核之间的联系。近几十年来，结核病发病率在高收入国家有所下降，但在艾滋病毒感染率高、营养不良发生率高、生活条件拥挤或结核病控制基础设施差的国家，发病率仍然很高。与此同时，在肥胖的推动下，全球糖尿病患病率正在飙升。越来越多的证据表明，糖尿病是结核病的一个重要危险因素，并可能影响疾病的表现和治疗反应。此外，结核病可能诱发葡萄糖耐受不良，使糖尿病患者的血糖控制恶化。我们回顾了结核病和糖尿病的流行病学，并简要介绍了糖尿病在结核病的易感性、临床表现和治疗反应中的作用。此外，我们还综述了糖尿病引起结核病的潜在机制、结核病对糖尿病控制的影响以及与糖尿病和结核病联合治疗相关的药代动力学问题。
The link between diabetes mellitus and tuberculosis has been recognised for centuries. In recent decades, tuberculosis incidence has declined in high-income countries, but incidence remains high in countries that have high rates of infection with HIV, high prevalence of malnutrition and crowded living conditions, or poor tuberculosis control infrastructure. At the same time, diabetes mellitus prevalence is soaring globally, fuelled by obesity. There is growing evidence that diabetes mellitus is an important risk factor for tuberculosis and might affect disease presentation and treatment response. Furthermore, tuberculosis might induce glucose intolerance and worsen glycaemic control in people with diabetes. We review the epidemiology of the tuberculosis and diabetes epidemics, and provide a synopsis of the evidence for the role of diabetes mellitus in susceptibility to, clinical presentation of, and response to treatment for tuberculosis. In addition, we review potential mechanisms by which diabetes mellitus can cause tuberculosis, the effects of tuberculosis on diabetic control, and pharmacokinetic issues related to the co-management of diabetes and tuberculosis.