Zayar Nyi Nyi, Chotipanvithayakul Rassamee, Bjertness Espen, Htet Aung Soe, Geater Alan Frederick, Chongsuvivatwong Virasakdi
Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Int J Gen Med. 2023 Dec 13;16:5909-5920. doi: 10.2147/IJGM.S439141. eCollection 2023.
We investigated the association of TB patients and their household contacts with diabetes mellitus (DM) and hypertension compared to the general population, and the mediating effects of risk behaviors including current smoking, alcohol drinking, and poor diet quality.
A cross-sectional study on screening for DM, hypertension, and risk behaviors among newly diagnosed TB patients (n = 221) and their household contacts (n = 257) aged 25-74 years in Yangon in 2018. Health data of the general population (n = 755) were obtained from an NCD risk factor survey in Yangon. A directed acyclic graph is used to identify possible pathways of association between variables. Associations are presented as adjusted odds ratios (aOR).
Compared to the general population, both TB patients and their household contacts were associated with current smoking and drinking, and TB patients were more likely to be underweight. Without considering mediating effects, TB patients had higher odds of DM (aOR = 6.3, 95% CI: 3.8-10.6), but both TB patients and household contacts had lower odds of hypertension (aOR = 0.54; 95% CI: 0.33-0.87) and (aOR = 0.68; 95% CI: 0.47-0.98), respectively. The body mass index-mediated pathway reduced the odds of DM and hypertension among TB patients (aOR = 3.4; 95% CI: 2.2-5.3) and (aOR = 0.3; 95% CI: 0.2-0.5), respectively.
The shared risk behaviors among TB patients and household contacts with high burden of DM in TB patients endorse screening of risk behaviors and strengthening the integration of NCD services among TB patients and household contacts in this dual-burden country.
我们调查了与普通人群相比，结核病患者及其家庭接触者与糖尿病（DM）和高血压的关联，以及包括当前吸烟、饮酒和不良饮食质量在内的风险行为的中介作用。
2018年在仰光对25至74岁新诊断的结核病患者（n = 221）及其家庭接触者（n = 257）进行了一项关于糖尿病、高血压和风险行为筛查的横断面研究。普通人群（n = 755）的健康数据来自仰光的一项非传染性疾病风险因素调查。使用有向无环图来识别变量之间可能的关联途径。关联以调整后的优势比（aOR）表示。
与普通人群相比，结核病患者及其家庭接触者均与当前吸烟和饮酒有关联，且结核病患者更有可能体重过轻。在不考虑中介作用的情况下，结核病患者患糖尿病的几率更高（aOR = 6.3，95%置信区间：3.8 - 10.6），但结核病患者及其家庭接触者患高血压的几率较低，分别为（aOR = 0.54；95%置信区间：0.33 - 0.87）和（aOR = 0.68；95%置信区间：0.47 - 0.98）。体重指数介导的途径分别降低了结核病患者患糖尿病和高血压的几率（aOR = 3.4；95%置信区间：2.2 - 5.3）和（aOR = 0.3；95%置信区间：0.2 - 0.5）。
结核病患者及其家庭接触者中存在共同的风险行为，且结核病患者中糖尿病负担较重，这支持在这个双重负担国家对结核病患者及其家庭接触者进行风险行为筛查，并加强非传染性疾病服务的整合。
