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在秘鲁北利马的结核病患者中,血糖异常与结核分枝杆菌谱系相关。

Dysglycemia is associated with Mycobacterium tuberculosis lineages in tuberculosis patients of North Lima-Peru.

作者信息

Lopez Kattya, Arriaga María B, Aliaga Juan G, Barreda Nadia N, Sanabria Oswaldo M, Huang Chuan-Chin, Zhang Zibiao, García-de-la-Guarda Ruth, Lecca Leonid, Calçada Carvalho Anna Cristina, Kritski Afrânio L, Calderon Roger I

机构信息

Socios En Salud Sucursal Peru, Lima, Peru.

Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos, Lima, Peru.

出版信息

PLoS One. 2021 Jan 28;16(1):e0243184. doi: 10.1371/journal.pone.0243184. eCollection 2021.

Abstract

This study was performed to investigate the role of dysglycemia on the genetic diversity of Mycobacterium tuberculosis (MTB) among pulmonary tuberculosis (TB) patients to build scientific evidence about the possible mechanisms of TB transmission. MTB isolates obtained of patients affected by pulmonary tuberculosis from health care facilities of North Lima-Peru, were analyzed using whole genome sequencing and 24-locus mycobacterial interspersed repetitive-unit -variable-number tandem repeats (MIRU-VNTR). Subsequently, clinical and epidemiological characteristics were associated with clustering, lineages and comorbid conditions. The analysis carried out 112 pulmonary TB patients from various health centers in North Lima, 17 (15%) had diabetes mellitus (DM) and 33 (29%) had pre-diabetes (PDM). Latin American-Mediterranean, Haarlem and Beijing were the most frequent MTB lineages found in those patients. Previous TB (adjusted odds ratio [aOR] = 3.65; 95%CI: 1.32-17.81), age (aOR = 1.12; 95%CI: 1.03-1.45) and Beijing lineage (aOR = 3.53; 95%CI: 1.08-13.2) were associated with TB-DM comorbidity. Alcoholism (aOR = 2.92; 95%CI: 1.10-8.28), age (aOR = 1.05; 95%CI: 1.03-1.12) and Haarlem lineage (aOR = 2.54; 95%CI: 1.04-6.51) were associated with TB-PDM comorbidity. Beijing and Haarlem lineages were independently associated with TB-DM and TB-PDM comorbidities, respectively. Although these findings may be surprising, we must be cautious to suggest that dysglycemia could be associated with a highly clustering and predisposition of MTB lineages related to a serious impact on the severity of TB disease, which requires further research.

摘要

本研究旨在探讨血糖异常在肺结核(TB)患者中对结核分枝杆菌(MTB)基因多样性的作用,以建立关于TB传播可能机制的科学证据。从秘鲁北利马的医疗机构获取的肺结核患者的MTB分离株,采用全基因组测序和24位点分枝杆菌散布重复单位-可变数目串联重复序列(MIRU-VNTR)进行分析。随后,将临床和流行病学特征与聚类、谱系和合并症相关联。该分析纳入了来自北利马各健康中心的112例肺结核患者,其中17例(15%)患有糖尿病(DM),33例(29%)患有糖尿病前期(PDM)。拉丁美洲-地中海、哈勒姆和北京是在这些患者中发现的最常见的MTB谱系。既往TB(调整优势比[aOR]=3.65;95%置信区间:1.32-17.81)、年龄(aOR=1.12;95%置信区间:1.03-1.45)和北京谱系(aOR=3.53;95%置信区间:1.08-13.2)与TB-DM合并症相关。酗酒(aOR=2.92;95%置信区间:1.10-8.28)、年龄(aOR=1.05;95%置信区间:1.03-1.12)和哈勒姆谱系(aOR=2.54;95%置信区间:1.04-6.51)与TB-PDM合并症相关。北京和哈勒姆谱系分别与TB-DM和TB-PDM合并症独立相关。尽管这些发现可能令人惊讶,但我们必须谨慎地提出,血糖异常可能与MTB谱系的高度聚类和易感性相关,这对TB疾病的严重程度有严重影响,这需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b3/7843012/e5b13f34f6a8/pone.0243184.g001.jpg

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