Liu Qiao, Yan Wenxin, Liu Runqing, Bo Ershu, Liu Jue, Liu Min
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
School of Health Humanities, Peking University, Beijing, China.
Front Med (Lausanne). 2022 Apr 25;9:899821. doi: 10.3389/fmed.2022.899821. eCollection 2022.
The estimated global latent tuberculosis infection (LTBI) burden indicates a large reservoir of population at risk of developing active tuberculosis (TB). Previous studies suggested diabetes mellitus (DM) might associate with LTBI, though still controversial. We aimed to systematically assess the association between DM and LTBI.
We searched PubMed, Embase, Cochrane Library and Web of Science. Observational studies reporting the number of LTBI and non-LTBI individuals with and without DM were included. Random-effects or fixed-effects models were used to estimate the pooled effect by risk ratios (RRs) and odds ratios (ORs) and its 95% confidence interval (CI), using the original number of participants involved.
20 studies involving 4,055,082 participants were included. The pooled effect showed a significant association between DM and LTBI (for cohort studies, = 1.62, 95% CI: 1.02-2.56; for cross-sectional studies, = 1.55, 95% CI: 1.30-1.84). The pooled OR was high in studies with healthcare workers (5.27, 95% CI: 1.52-8.20), refugees (2.88, 95% CI: 1.93-4.29), sample size of 1,000-5,000 (1.99, 95% CI: 1.49-2.66), and male participants accounted for less than 40% (2.28, 95% CI: 1.28-4.06). Prediabetes also associated with LTBI ( = 1.36, 95% CI: 1.01-1.84).
The risk of LTBI was found to be a 60% increase in DM patients, compared with non-DM patients. LTBI screening among DM patients could be of vital importance. More studies are needed to explore appropriate strategies for targeted LTBI screening among DM patients.
全球潜伏性结核感染（LTBI）负担估计表明，有大量人群有发展为活动性结核病（TB）的风险。先前的研究表明，糖尿病（DM）可能与LTBI有关，尽管仍存在争议。我们旨在系统评估DM与LTBI之间的关联。
我们检索了PubMed、Embase、Cochrane图书馆和科学网。纳入报告有和没有DM的LTBI和非LTBI个体数量的观察性研究。使用随机效应或固定效应模型，通过风险比（RRs）和比值比（ORs）及其95%置信区间（CI）来估计合并效应，使用所涉及的原始参与者数量。
纳入了20项涉及4,055,082名参与者的研究。合并效应显示DM与LTBI之间存在显著关联（队列研究中，RR = 1.62，95% CI：1.02 - 2.56；横断面研究中，RR = 1.55，95% CI：1.30 - 1.84）。在医护人员研究（OR = 5.27，95% CI：1.52 - 8.20）、难民研究（OR = 2.88，95% CI：1.93 - 4.29）、样本量为1000 - 5000的研究（OR = 1.99，95% CI：1.49 - 2.66）以及男性参与者占比不到40%的研究（OR = 2.28，95% CI：1.28 - 4.06）中，合并OR值较高。糖尿病前期也与LTBI有关（RR = 1.36，95% CI：1.01 - 1.84）。
发现DM患者发生LTBI的风险比非DM患者增加60%。对DM患者进行LTBI筛查可能至关重要。需要更多研究来探索针对DM患者进行有针对性LTBI筛查的合适策略。
