Stevenson Catherine R, Critchley Julia A, Forouhi Nita G, Roglic Gojka, Williams Brian G, Dye Christopher, Unwin Nigel C
Medical Research Council Epidemiology Unit, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK.
Chronic Illn. 2007 Sep;3(3):228-45. doi: 10.1177/1742395307081502.
Tuberculosis (TB) remains a major global public health problem. In the past, a relationship between TB and diabetes mellitus (DM) was recognized, and its importance was acknowledged through joint treatment clinics. However, this is rarely highlighted in current research or control priorities. This paper aims to evaluate the evidence for an association between these two diseases.
A Medline literature search was undertaken, supplemented by checking references and contacting experts. We critically appraised studies that quantified the association between TB and DM, and were published after 1995. We assessed study quality according to criteria such as sample size, method of selection of cases and controls, losses to follow-up, quality and method of control of confounding, and summarized the results narratively and in tabular form.
All studies identified statistically significant and clinically important associations, with the increase in risk or odds of TB varying between 1.5- and 7.8-fold for those with DM. Risk was highest at younger ages. Most studies had not measured and controlled adequately for potential major confounders.
There is strong evidence for an association between TB and DM, which has potential public health implications. Further well-designed studies are needed to assess the magnitude precisely.
结核病仍然是一个重大的全球公共卫生问题。过去，人们认识到结核病与糖尿病之间的关系，并通过联合治疗诊所承认了其重要性。然而，在当前的研究或控制重点中，这一点很少被强调。本文旨在评估这两种疾病之间关联的证据。
进行了Medline文献检索，并通过检查参考文献和联系专家进行补充。我们严格评估了1995年后发表的量化结核病与糖尿病之间关联的研究。我们根据样本量、病例和对照的选择方法、随访失访情况、混杂因素控制的质量和方法等标准评估研究质量，并以叙述和表格形式总结结果。
所有研究均确定了具有统计学意义和临床重要性的关联，糖尿病患者患结核病的风险或几率增加幅度在1.5至7.8倍之间。风险在较年轻年龄段最高。大多数研究没有对潜在的主要混杂因素进行充分测量和控制。
有强有力的证据表明结核病与糖尿病之间存在关联，这具有潜在的公共卫生意义。需要进一步设计良好的研究来精确评估其程度。
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