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结核病与糖尿病发病的因果关系。

The cause-effect relation of tuberculosis on incidence of diabetes mellitus.

机构信息

Laboratory of Molecular Cell Biology, Centre for DNA Fingerprinting and Diagnostics (CDFD), Hyderabad, India.

Regional Centre for Biotechnology, Faridabad, India.

出版信息

Front Cell Infect Microbiol. 2023 Jun 26;13:1134036. doi: 10.3389/fcimb.2023.1134036. eCollection 2023.

Abstract

Tuberculosis (TB) is one of the oldest human diseases and is one of the major causes of mortality and morbidity across the Globe. (Mtb), the causal agent of TB is one of the most successful pathogens known to mankind. Malnutrition, smoking, co-infection with other pathogens like human immunodeficiency virus (HIV), or conditions like diabetes further aggravate the tuberculosis pathogenesis. The association between type 2 diabetes mellitus (DM) and tuberculosis is well known and the immune-metabolic changes during diabetes are known to cause increased susceptibility to tuberculosis. Many epidemiological studies suggest the occurrence of hyperglycemia during active TB leading to impaired glucose tolerance and insulin resistance. However, the mechanisms underlying these effects is not well understood. In this review, we have described possible causal factors like inflammation, host metabolic changes triggered by tuberculosis that could contribute to the development of insulin resistance and type 2 diabetes. We have also discussed therapeutic management of type 2 diabetes during TB, which may help in designing future strategies to cope with TB-DM cases.

摘要

结核病(TB)是人类最古老的疾病之一,也是全球范围内导致死亡和发病的主要原因之一。(Mtb),结核病的病原体是已知对人类最成功的病原体之一。营养不良、吸烟、与人类免疫缺陷病毒(HIV)等其他病原体的合并感染,或糖尿病等状况会进一步加重结核病的发病机制。2 型糖尿病(DM)与结核病之间的关联是众所周知的,并且在糖尿病期间发生的免疫代谢变化导致对结核病的易感性增加。许多流行病学研究表明,在活动性结核病期间会发生高血糖,导致葡萄糖耐量受损和胰岛素抵抗。然而,这些影响的机制尚不清楚。在这篇综述中,我们描述了可能的因果因素,如炎症、宿主代谢变化,这些变化可能导致胰岛素抵抗和 2 型糖尿病的发生。我们还讨论了在结核病期间 2 型糖尿病的治疗管理,这可能有助于设计未来的策略来应对 TB-DM 病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f3d/10330781/ba41fc2b3107/fcimb-13-1134036-g001.jpg

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