既往结核病与艾滋病毒感染者心脏代谢谱改变的关系：乌干达的一项比较横断面研究

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2025-04-01 DOI:10.1016/j.jctube.2025.100523

Joseph Baruch Baluku , Diana Karungi , Brenda Namanda , Sharon Namiiro , Shamim Katusabe , Angut Mary Madalen , Martin Nabwana , Ronald Olum , Felix Bongomin , Edwin Nuwagira , Grace Kansiime , Christian Kraef , Megan Shaughnessy , Joshua Rhein , David Meya

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引用次数: 0

摘要

背景：心血管疾病（CVD）是HIV感染者（PWH）死亡的主要原因，但结核病（TB）等合并感染对CVD风险的影响仍未得到充分探讨。我们的目的是比较有和没有结核病病史的PWH的心脏代谢谱，以确定结核病病史是否与不同的心脏代谢谱相关。方法我们在乌干达坎帕拉的一家三级医院进行了一项比较的横断面研究。参与者随机抽取年龄≥18岁且接受抗逆转录病毒治疗的PWH。具体来说，我们纳入了有和没有先前活动性结核病的PWH（比例为1:1）。测量人体测量、血压、空腹血糖（FBG）、血脂和糖化血红蛋白。结果共纳入396名参与者（196名结核病幸存者和200名对照组）。结核病幸存者的中位空腹血糖较高(5.5 vs. 5.1 mmol/l, p <；0.001)和更高的糖尿病患病率（17.9%比9.5%,p = 0.015）。然而，他们的身体质量指数较低(23.0比25.1 kg/m2, p <；0.001)和腰围（81.0比84.0 cm, p = 0.026）。结核病幸存者的HDL-c水平较高(1.0 vs 0.8 mmol/l, p <；0.001)，较低的LDL-c水平(2.7 vs. 3.1 mmol/l, p <；0.001)和较低的血脂异常患病率(81.7%对96.5%,p <；0.001)。既往结核病与较高的FBG患病率（调整患病率比（aPR） 1.79, 95% CI 1.10-2.92）和DM （aPR 2.34, 95% CI 1.11-4.94）独立相关，但降低肥胖风险（aPR 0.42, 95% CI 0.20-0.88）。结论：与没有结核病史的结核病幸存者相比，感染艾滋病毒的结核病幸存者患糖尿病的风险更高，但肥胖的风险较低，这表明需要对结核病幸存者进行血糖监测。

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Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda

Background

Cardiovascular disease (CVD) is the leading cause of mortality among people with HIV (PWH), but the influence of co-infections like tuberculosis (TB) on CVD risk remains underexplored. We aimed to compare cardiometabolic profiles of PWH with and without prior TB to determine if prior TB is associated with distinct cardiometabolic profiles.

Methods

We conducted a comparative, cross-sectional study at a tertiary hospital in Kampala, Uganda. Participants were randomly sampled PWH aged ≥ 18 years on antiretroviral therapy. Specifically, we enrolled PWH with and without prior active TB (ratio of 1:1). Anthropometric measurements, blood pressure, fasting blood glucose (FBG), lipid profile, and glycated hemoglobin were assessed.

Results

A total of 396 participants were enrolled (196 TB survivors and 200 controls). TB survivors had higher median FBG (5.5 vs. 5.1 mmol/l, p < 0.001) and a higher prevalence of DM (17.9 % vs. 9.5 %, p = 0.015). However, they had lower body mass index (23.0 vs. 25.1 kg/m², p < 0.001) and waist circumference (81.0 vs. 84.0 cm, p = 0.026). TB survivors had higher HDL-c levels (1.0 vs. 0.8 mmol/l, p < 0.001), lower LDL-c levels (2.7 vs. 3.1 mmol/l, p < 0.001) and lower prevalence of dyslipidemia (81.7 % vs. 96.5 %, p < 0.001). Prior TB was independently associated with higher prevalence of elevated FBG (adjusted prevalence ratio (aPR) 1.79, 95 % CI 1.10–2.92) and DM (aPR 2.34, 95 % CI 1.11–4.94), but decreased risk of obesity (aPR 0.42, 95 % CI 0.20–0.88).

Conclusion

TB survivors with HIV exhibit a higher risk of DM but lower risk of obesity compared to those without a history of TB, indicating a need for blood glucose monitoring among TB survivors.

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.