Division of Epidemiology and Biostatistics, Georgia State University, Atlanta, Georgia.
Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Int J Tuberc Lung Dis. 2018 Nov 1;22(11):1258-1268. doi: 10.5588/ijtld.18.0045.
The intersection of tuberculosis (TB) with non-communicable diseases (NCDs), including diabetes mellitus (DM), chronic lung disease (CLD), and cardiovascular disease (CVD), has emerged as a critical clinical and public health challenge. Rapidly expanding NCD epidemics threaten TB control in low- and middle-income countries, where the prevention and treatment of TB disease remain a great burden. However, to date, the notion that TB may adversely impact NCD risk and severity has not been well explored. This review summarizes biomedical hypotheses, findings from animal models, and emerging epidemiologic data related to the progression of DM, CLD and CVD during and after active TB disease. We conclude that there is sufficient empirical evidence to justify a greater research emphasis on the syndemic interaction between TB and NCD.
结核病（TB）与非传染性疾病（NCDs）的交叉，包括糖尿病（DM）、慢性肺病（CLD）和心血管疾病（CVD），已成为一个严峻的临床和公共卫生挑战。快速扩张的 NCD 流行病对中低收入国家的 TB 控制构成威胁，而这些国家的 TB 疾病的预防和治疗仍然是一个巨大的负担。然而，迄今为止，TB 可能对 NCD 的风险和严重程度产生不利影响的观点尚未得到充分探索。本综述总结了与 DM、CLD 和 CVD 在活动性 TB 疾病期间和之后进展相关的生物医学假说、动物模型研究结果和新兴的流行病学数据。我们的结论是，有足够的经验证据证明有必要更加重视 TB 和 NCD 之间的综合征相互作用的研究。
