肥胖与住院成年患者登革热严重程度的相关性。

The association of obesity and dengue severity in hospitalized adult patients.

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, Graduate Institute of Medicine, College of Medicine, Sepsis Research Center, Center for Tropical Medicine and Infectious Disease, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Biochemistry and Microbiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan.

出版信息

J Microbiol Immunol Infect. 2023 Apr;56(2):267-273. doi: 10.1016/j.jmii.2022.08.008. Epub 2022 Aug 18.

DOI:10.1016/j.jmii.2022.08.008

PMID:36055945

Abstract

BACKGROUND

Obesity is associated with unfavorable outcomes for infectious diseases. Most researches exploring the association between nutritional status and dengue severity have focused on pediatric populations, with only few studies assessing adult patients.

METHODS

Adult patients with laboratory-confirmed dengue admitted to a tertiary hospital in southern Taiwan between 2014 and 2015 were enrolled retrospectively. Demographics, comorbidities, clinical presentation, laboratory findings, and outcomes were obtained from case-record forms. Patients were categorized into obese group and nonobese group. The obese group comprised patients with a body mass index of ≥27.5 kg/m.

RESULTS

A total of 1417 hospitalized patients with dengue were evaluated. The mean age was 57.9 years (range: 18-92 years). The obese and nonobese groups comprised 333 (23.5%) and 1084 (76.5%) patients, respectively. The obese group included more patients with hypertension (85%, p < 0.001), diabetes mellitus (33%, p < 0.001), and congestive heart failure (6.3%, p = 0.049). Multivariate analysis revealed that the obese group had more petechiae (AOR: 1.353, 95% CI: 1.025-1.786, p = 0.033), more dyspnea (AOR: 1.380, 95% CI: 1.015-1.876, p = 0.040), and more severe hepatitis (AOR: 2.061, 95% CI: 1.050-4.048, p = 0.036). The obese group also had higher peak hematocrit values (44.1%, p < 0.001) and lower nadir platelet count (45.3 × 10/μL, p = 0.049) than the nonobese group.

CONCLUSION

In adult patients with dengue, obese group had more petechiae, dyspnea, severe hepatitis, lower nadir of platelet count, and higher peak hematocrit level. We observed no difference in severe dengue or mortality between obese and nonobese group.

摘要

背景

肥胖与传染病的不良结局有关。大多数探索营养状况与登革热严重程度之间关系的研究都集中在儿科人群，只有少数研究评估了成年患者。

方法

回顾性纳入 2014 年至 2015 年在台湾南部一家三级医院住院的实验室确诊为登革热的成年患者。从病历表中获取人口统计学、合并症、临床表现、实验室检查和结局。将患者分为肥胖组和非肥胖组。肥胖组患者的身体质量指数（BMI）≥27.5kg/m。

结果

共评估了 1417 例住院登革热患者。平均年龄为 57.9 岁（范围：18-92 岁）。肥胖组和非肥胖组分别包括 333（23.5%）和 1084 例（76.5%）患者。肥胖组患者中高血压（85%，p<0.001）、糖尿病（33%，p<0.001）和充血性心力衰竭（6.3%，p=0.049）患者比例更高。多因素分析显示，肥胖组患者瘀点更多（优势比：1.353，95%可信区间：1.025-1.786，p=0.033）、呼吸困难更多（优势比：1.380，95%可信区间：1.015-1.876，p=0.040）和更严重的肝炎（优势比：2.061，95%可信区间：1.050-4.048，p=0.036）。肥胖组患者的峰值血细胞比容值更高（44.1%，p<0.001），血小板计数最低值更低（45.3×10/μL，p=0.049）。