Yen Yung-Feng, Chuang Pei-Hung, Yen Muh-Yong, Lin Shu-Yi, Chuang Peing, Yuan Mei-Jen, Ho Bo-Lung, Chou Pesus, Deng Chung-Yeh
From the Section of Infectious Diseases, Taipei City Hospital, Taipei City Government (YY); School of Medicine, National Yang-Ming University (YY); Center for Prevention and Treatment of Occupational Injury and Diseases, Taipei Veterans General Hospital (PC); Division of Clinical Toxicology and Occupational Medicine, Department of Medicine, Taipei Veterans General Hospital (PC); Department of Disease Control and Prevention, Taipei City Hospital, Taipei City Government (MY, PC, MY); Department of Education and Research, Taipei City Hospital (SL); Department of Chest Medicine, Taipei City Hospital, Taipei City Government (BH); Community Medicine Research Center and Institute of Public Health, National Yang-Ming University (PC); and Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan (CD).
Medicine (Baltimore). 2016 Jan;95(1):e2300. doi: 10.1097/MD.0000000000002300.
Evidence regarding the association between body mass index (BMI) and mortality in TB patients is limited and inconsistent. We investigated the effect of BMI on TB-specific and non-TB-specific mortality in TB patients. All adult Taiwanese with TB in Taipei, Taiwan, during 2011 to 2012 were included in this retrospective cohort study. Multinomial logistic regression was used to evaluate associations of BMI with cause of death in TB patients. Of the 1608 eligible patients, 83.6% (1345) were successfully treated, 3.3% (53) died of TB-specific causes, and 13.1% (210) died of non-TB-specific causes. Mean age was 64.6 years, and 67.5% of patients were male. After controlling for potential confounders, underweight was significantly associated with higher risks of all-cause mortality (adjusted odds ratio [AOR], 1.66; 95% confidence interval [CI], 1.21-2.30), TB-specific mortality (AOR, 2.14; 95% CI, 1.18-3.89), and non-TB-specific mortality (AOR, 1.58; 95% CI, 1.11-2.25) during TB treatment, while overweight was not. When gender differences on the association of BMI with mortality were considered, underweight only significantly increased risks of TB-specific (AOR, 2.37; 95% CI, 1.19-4.72) and non-TB-specific mortality (AOR, 1.58; 95% CI, 1.05-2.37) during treatment in male patients, but not female subjects.T he present findings indicate that underweight was associated with higher risks of TB-specific and non-TB-specific mortality during TB treatment, particularly in male patients.
关于体重指数（BMI）与结核病患者死亡率之间关联的证据有限且不一致。我们调查了BMI对结核病患者结核病特异性和非结核病特异性死亡率的影响。本回顾性队列研究纳入了2011年至2012年期间台湾台北市所有成年结核病患者。采用多项逻辑回归来评估BMI与结核病患者死因之间的关联。在1608名符合条件的患者中，83.6%（1345例）得到成功治疗，3.3%（53例）死于结核病特异性原因，13.1%（210例）死于非结核病特异性原因。平均年龄为64.6岁，67.5%的患者为男性。在控制潜在混杂因素后，体重过轻与结核病治疗期间全因死亡率（调整优势比[AOR]，1.66；95%置信区间[CI]，1.21 - 2.30）、结核病特异性死亡率（AOR，2.14；95% CI，1.18 - 3.89）和非结核病特异性死亡率（AOR，1.58；95% CI，1.11 - 2.25）的较高风险显著相关，而超重则不然。当考虑BMI与死亡率关联的性别差异时，体重过轻仅在男性患者治疗期间显著增加结核病特异性（AOR，2.37；95% CI，1.19 - 4.72）和非结核病特异性死亡率（AOR，1.58；95% CI，1.05 - 2.37）的风险，而在女性患者中并非如此。本研究结果表明，体重过轻与结核病治疗期间结核病特异性和非结核病特异性死亡率的较高风险相关，尤其是在男性患者中。
