在乌干达城市中，患有肺结核的女性体组织质量减少与死亡率的增加有关。
Lean tissue mass wasting is associated with increased risk of mortality among women with pulmonary tuberculosis in urban Uganda.
机构信息
Department of Paediatrics & Child Health, College of Health Sciences, Makerere University Kampala, Uganda.
出版信息
Ann Epidemiol. 2012 Jul;22(7):466-73. doi: 10.1016/j.annepidem.2012.04.007. Epub 2012 May 9.
OBJECTIVES
We assessed the impact of wasting on survival in patients with tuberculosis by using a precise height-normalized lean tissue mass index (LMI) estimated by bioelectrical impedance analysis and body mass index (BMI).
METHODS
In a retrospective cohort study, 747 adult pulmonary patients with tuberculosis who were screened for HIV and nutritional status were followed for survival.
RESULTS
Of 747 patients, 310 had baseline wasting by BMI (kg/m(2)) and 103 by LMI (kg/m(2)). Total deaths were 105. Among men with reduced BMI, risk of death was 70% greater (hazard ratio [HR] 1.7, 95% confidence interval [95% CI] 1.03-2.81) than in men with normal BMI. Survival did not differ by LMI among men (HR 1.1; 95% CI 0.5-2.9). In women, both the BMI and LMI were associated with survival. Among women with reduced BMI, risk of death was 80% greater (HR 1.8; 95% CI 0.9-3.5) than in women with normal BMI; risk of death was 5-fold greater (HR 5.0; 95% CI 1.6-15.9) for women with low LMI compared with women with normal LMI.
CONCLUSIONS
Wasting assessed by reduced BMI is associated with an increased risk for death among both men and women whereas reduced LMI is among women with tuberculosis.
目的
我们通过使用生物电阻抗分析和体重指数（BMI）来估计精确的身高归一化瘦组织质量指数（LMI），评估消瘦对结核病患者生存的影响。
方法
在一项回顾性队列研究中，对 747 名接受 HIV 和营养状况筛查的成人肺结核肺部患者进行了随访，以评估生存情况。
结果
在 747 名患者中，310 名患者根据 BMI（kg/m2）存在基线消瘦，103 名患者根据 LMI（kg/m2）存在基线消瘦。总死亡人数为 105 人。在 BMI 降低的男性中，死亡风险增加了 70%（危险比 [HR] 1.7，95%置信区间 [95%CI] 1.03-2.81），而 BMI 正常的男性中，死亡风险没有差异。在男性中，LMI 与生存无关（HR 1.1；95%CI 0.5-2.9）。在女性中，BMI 和 LMI 都与生存有关。在 BMI 降低的女性中，死亡风险增加了 80%（HR 1.8；95%CI 0.9-3.5），而 BMI 正常的女性中，死亡风险增加了 5 倍（HR 5.0；95%CI 1.6-15.9），而 LMI 降低的女性则与 LMI 正常的女性相比。
结论
在男性和女性中，BMI 降低与死亡风险增加相关，而在女性中，LMI 降低与结核病相关。
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