肥胖与感染风险：来自丹麦献血者研究的结果。

Obesity and risk of infection: results from the Danish Blood Donor Study.

机构信息

From the aDepartment of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark; bDepartment of Clinical Immunology, Naestved Hospital, Naestved, Denmark; cDepartment of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark; dDepartment of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark; and eDepartment of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen S, Denmark.

出版信息

Epidemiology. 2015 Jul;26(4):580-9. doi: 10.1097/EDE.0000000000000301.

DOI:10.1097/EDE.0000000000000301

PMID:25978794

Abstract

BACKGROUND

It is well known that obesity complicates the course of several diseases. However, it is unknown whether obesity affects the risk of infection among healthy individuals.

METHODS

We included 37,808 healthy participants from the Danish Blood Donor Study, who completed a questionnaire on health-related items. Obesity was defined as a body mass index ≥ 30 kg/m(2). Infections among participants were identified by relevant ICD-10 codes in the Danish National Patient Register and Anatomical Therapeutic Chemical (ATC) codes in the Danish Prescription Register. Multivariable Cox proportional hazards analysis with age as the underlying timescale was used as the statistical model.

RESULTS

During 113,717 person-years of observation, 1,233 participants were treated for infection at a hospital. Similarly, during 58,411 person-years of observation, 15,856 participants filled at least one prescription of antimicrobials. Obesity was associated with risk of hospital-based treatment for infection (women: hazard ratio [HR] = 1.5, 95% confidence interval [CI] = 1.1, 1.9; men: HR = 1.5, 95% CI = 1.2, 1.9). For specific infections, obesity was associated with increased risk of abscesses (both sexes), infections of the skin and subcutaneous tissue (men), and respiratory tract infections and cystitis (women). Similarly, obesity was associated with filled prescriptions of antimicrobials overall (women: HR = 1.22, 95% CI = 1.14, 1.30; men: HR = 1.23, 95% CI: 1.15, 1.33) and particularly with phenoxymethylpenicillin, macrolides, dicloxacillin and flucloxacillin, and broad-spectrum penicillins.

CONCLUSIONS

In a large cohort of healthy individuals, obesity was associated with risk of infection. This result warrants further studies of metabolism and the immune response.

摘要

背景

众所周知，肥胖会使多种疾病的病程复杂化。然而，目前尚不清楚肥胖是否会影响健康人群的感染风险。

方法

我们纳入了来自丹麦献血者研究的 37808 名健康参与者，他们完成了一份关于健康相关项目的问卷。肥胖定义为体质指数（BMI）≥30kg/m2。参与者的感染通过丹麦国家患者登记处的相关 ICD-10 编码和丹麦处方登记处的解剖治疗化学（ATC）编码确定。使用年龄作为基础时间尺度的多变量 Cox 比例风险分析作为统计模型。

结果

在 113717 人年的观察期间，有 1233 名参与者因感染在医院接受治疗。同样，在 58411 人年的观察期间，有 15856 名参与者至少开了一张抗生素处方。肥胖与医院治疗感染的风险相关（女性：风险比[HR] = 1.5，95%置信区间[CI] = 1.1，1.9；男性：HR = 1.5，95%CI = 1.2，1.9）。对于特定的感染，肥胖与脓肿（两性）、皮肤和皮下组织感染（男性）以及呼吸道感染和膀胱炎（女性）的风险增加相关。同样，肥胖与抗生素的总体处方相关（女性：HR = 1.22，95%CI = 1.14，1.30；男性：HR = 1.23，95%CI：1.15，1.33），特别是与苯氧甲基青霉素、大环内酯类、双氯西林和氟氯西林以及广谱青霉素相关。