Hu Xinsong, Liu Jiongya, Shao Yan, Li Guoli, Song Honghuan, Liu Qiao, Chen Cheng, Zhu Limei
School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing 210009, China.
Toxics. 2024 Jan 22;12(1):94. doi: 10.3390/toxics12010094.
The association between smoking exposure and latent tuberculosis infection (LTBI) has been investigated in a few studies; however, further investigation is needed. In this study, the 2011-2012 NHANES population was used to evaluate smoking exposure and LTBI risk. A total of 7042 participants with available LTBI results and without active tuberculosis were included for analysis. Smoking was defined as participants who smoked at least 100 cigarettes in their life. Both univariable and multivariable analysis were adopted to evaluate smoking exposure, as well as related factors on the risk of LTBI. LTBI rates among current smokers (12.1%) and former smokers (9.9%) were higher than non-smokers (5.9%). However, current smokers and former smokers were not significantly associated with LTBI risk when compared to non-smokers after adjusting by age and sex in the multivariable analysis. Meanwhile, we found that passive smoking was not associated with LTBI (adjusted odds ratio (AOR), 0.85; 95%CI, 0.66-1.09). In multivariable analysis, current smoking was associated with LTBI (OR, 1.67; 95%CI, 1.28-2.19), while former smokers had an increased OR of LTBI, but the OR did not reach statistical significance (OR, 1.15; 95%CI, 0.90-1.48). Household tuberculosis (TB) contact was also related to LTBI (OR, 1.93; 95%CI, 1.25-2.99). However, BMI and diabetes were not found to be associated with LTBI. Smoking, especially current smoking, was significantly associated with LTBI. LTBI screening should be recommended for active smokers. Former smoking and passive smoking exposure were not found to have a significant relationship with LTBI risk. However, the high LTBI rate among quitters indicated we should pay more attention to former smokers with LTBI.
已有一些研究对吸烟暴露与潜伏性结核感染（LTBI）之间的关联进行了调查；然而，仍需进一步研究。在本研究中，使用2011 - 2012年美国国家健康与营养检查调查（NHANES）人群来评估吸烟暴露情况和LTBI风险。共有7042名有可用LTBI结果且无活动性结核病的参与者纳入分析。吸烟定义为一生中至少吸过100支香烟的参与者。采用单变量和多变量分析来评估吸烟暴露情况以及与LTBI风险相关的因素。当前吸烟者（12.1%）和既往吸烟者（9.9%）的LTBI率高于非吸烟者（5.9%）。然而，在多变量分析中按年龄和性别调整后，与非吸烟者相比，当前吸烟者和既往吸烟者与LTBI风险无显著关联。同时，我们发现被动吸烟与LTBI无关（调整后的优势比（AOR）为0.85；95%置信区间为0.66 - 1.09）。在多变量分析中，当前吸烟与LTBI相关（优势比为1.67；95%置信区间为1.28 - 2.19），而既往吸烟者的LTBI优势比有所增加，但未达到统计学显著性（优势比为1.15；95%置信区间为0.90 - 1.48）。家庭结核病（TB）接触也与LTBI相关（优势比为1.93；95%置信区间为1.25 - 2.99）。然而，未发现体重指数（BMI）和糖尿病与LTBI有关。吸烟，尤其是当前吸烟，与LTBI显著相关。应建议现吸烟者进行LTBI筛查。未发现既往吸烟和被动吸烟暴露与LTBI风险有显著关系。然而，戒烟者中较高的LTBI率表明我们应更加关注有LTBI的既往吸烟者。
