Department of Pathogen Biology, Anhui Province Key Laboratory of Zoonoses, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui China.
PLoS Negl Trop Dis. 2024 May 31;18(5):e0012217. doi: 10.1371/journal.pntd.0012217. eCollection 2024 May.
Dengue fever (DF) and West Nile fever (WNF) have become endemic worldwide in the last two decades. Studies suggest that individuals with diabetes mellitus (DM) are at a higher risk of developing severe complications from these diseases. Identifying the factors associated with a severe clinical presentation is crucial, as prompt treatment is essential to prevent complications and fatalities. This article aims to summarize and assess the published evidence regarding the link between DM and the risk of severe clinical manifestations in cases of DF and WNF.
METHODOLOGY/PRINCIPAL FINDINGS: A systematic search was conducted using the PubMed and Web of Science databases. 27 studies (19 on DF, 8 on WNF) involving 342,873 laboratory-confirmed patients were included in the analysis. The analysis showed that a diagnosis of DM was associated with an increased risk for severe clinical presentations of both DF (OR 3.39; 95% CI: 2.46, 4.68) and WNF (OR 2.89; 95% CI: 1.89, 4.41). DM also significantly increased the risk of death from both diseases (DF: OR 1.95; 95% CI: 1.09, 3.52; WNF: OR 1.74; 95% CI: 1.40, 2.17).
CONCLUSIONS/SIGNIFICANCE: This study provides strong evidence supporting the association between DM and an increased risk of severe clinical manifestations in cases of DF and WNF. Diabetic individuals in DF or WNF endemic areas should be closely monitored when presenting with febrile symptoms due to their higher susceptibility to severe disease. Early detection and appropriate management strategies are crucial in reducing the morbidity and mortality rates associated with DF and WNF in diabetic patients. Tailored care and targeted public health interventions are needed to address this at-risk population. Further research is required to understand the underlying mechanisms and develop effective preventive and therapeutic approaches.
登革热（DF）和西尼罗河热（WNF）在过去二十年已在全球流行。研究表明，糖尿病患者（DM）患这些疾病严重并发症的风险更高。确定与严重临床表现相关的因素至关重要，因为及时治疗对于预防并发症和死亡至关重要。本文旨在总结和评估已发表的关于 DM 与 DF 和 WNF 病例中严重临床表现风险之间关联的证据。
方法/主要发现：使用 PubMed 和 Web of Science 数据库进行了系统检索。共纳入 27 项研究（19 项关于 DF，8 项关于 WNF），涉及 342873 例经实验室确诊的患者。分析表明，DM 诊断与 DF（OR 3.39；95%CI：2.46，4.68）和 WNF（OR 2.89；95%CI：1.89，4.41）严重临床表现的风险增加相关。DM 还显著增加了这两种疾病的死亡风险（DF：OR 1.95；95%CI：1.09，3.52；WNF：OR 1.74；95%CI：1.40，2.17）。
结论/意义：本研究提供了强有力的证据支持 DM 与 DF 和 WNF 病例中严重临床表现风险增加之间的关联。在 DF 或 WNF 流行地区，出现发热症状的糖尿病患者应密切监测，因为他们更容易患严重疾病。早期发现和适当的管理策略对于降低糖尿病患者 DF 和 WNF 的发病率和死亡率至关重要。需要有针对性的护理和针对性的公共卫生干预措施来解决这一高危人群。需要进一步研究以了解潜在机制并开发有效的预防和治疗方法。
