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肺结核幸存者与心血管疾病风险:基于韩国全国性调查的分析

Tuberculosis survivors and the risk of cardiovascular disease: analysis using a nationwide survey in Korea.

作者信息

Yang Jiyoul, Kim Sun-Hyung, Sim Jae Kyeom, Gu Seonhye, Seok Jeong Won, Bae Dae-Hwan, Cho Jun Yeun, Lee Ki Man, Choe Kang Hyeon, Lee Hyun, Yang Bumhee, Min Kyung Hoon

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

出版信息

Front Cardiovasc Med. 2024 Aug 9;11:1364337. doi: 10.3389/fcvm.2024.1364337. eCollection 2024.

Abstract

BACKGROUND

Although the association between tuberculosis (TB) and cardiovascular disease (CVD) has been reported in several studies and is explained by mechanisms related to chronic inflammation, few studies have comprehensively evaluated the association between TB and CVD in Korea.

METHODS

Using the Korea National Health and Nutrition Survey, we classified individuals according to the presence or absence of previous pulmonary TB was defined as the formal reading of a chest radiograph or a previous diagnosis of pulmonary TB by a physician. Using multivariable logistic regression analyses, we evaluated the association between the 10-year atherosclerotic cardiovascular disorder (ASCVD) risk and TB exposure, as well as the 10-year ASCVD risk according to epidemiological characteristics.

RESULTS

Among the 69,331 participants, 4% ( = 3,101) had post-TB survivor group. Comparing the 10-year ASCVD risk between the post-TB survivor and control groups, the post-TB survivor group had an increased 10-year ASCVD risk in the high-risk group (40.46% vs. 24.00%,  < 0.001). Compared to the control group, the intermediate- and high-risk groups had also significantly increased 10-year ASCVD risks (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04-1.23 and OR 1.69, 95% CI 1.59-1.78, respectively) in the post-TB survivor group. In the association of CVD among post-TB survivors according to epidemiologic characteristics, age [adjusted OR (aOR) 1.10, 95% CI 1.07-1.12], current smoking (aOR 2.63, 95% CI 1.34-5.14), a high family income (aOR 2.48, 95% CI 1.33-4.62), diabetes mellitus (aOR 1.97, 95% CI 1.23-3.14), and depression (aOR 2.06, 95% CI 1.03-4.10) were associated with CVD in the post-TB survivor group.

CONCLUSIONS

Our study findings suggest a higher 10-year ASCVD risk among TB survivors than healthy participants. This warrants long-term cardiovascular monitoring and management of the post-TB population.

摘要

背景

尽管多项研究报告了结核病(TB)与心血管疾病(CVD)之间的关联,并通过与慢性炎症相关的机制进行了解释,但在韩国,很少有研究全面评估结核病与心血管疾病之间的关联。

方法

利用韩国国家健康与营养调查,我们根据是否有既往肺结核病史对个体进行分类,既往肺结核定义为胸部X光片的正式解读或医生先前对肺结核的诊断。通过多变量逻辑回归分析,我们评估了10年动脉粥样硬化性心血管疾病(ASCVD)风险与结核病暴露之间的关联,以及根据流行病学特征得出的10年ASCVD风险。

结果

在69331名参与者中,4%(n = 3101)有结核病后存活组。比较结核病后存活组与对照组之间的10年ASCVD风险,结核病后存活组在高危组中的10年ASCVD风险增加(40.46%对24.00%,P < 0.001)。与对照组相比,结核病后存活组的中危和高危组的10年ASCVD风险也显著增加(优势比[OR]分别为1.14,95%置信区间[CI]为1.04 - 1.23;OR为1.69,95% CI为1.59 - 1.78)。在根据流行病学特征分析结核病后存活者的心血管疾病关联时,年龄[调整后OR(aOR)为1.10,95% CI为1.07 - 1.12]、当前吸烟(aOR为2.63,95% CI为1.34 - 5.14)、高家庭收入(aOR为2.48,95% CI为1.33 - 4.62)、糖尿病(aOR为1.97,95% CI为1.23 - 3.14)和抑郁症(aOR为2.06,95% CI为1.03 - 4.10)与结核病后存活组的心血管疾病相关。

结论

我们的研究结果表明,结核病存活者的10年ASCVD风险高于健康参与者。这需要对结核病后人群进行长期的心血管监测和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0425/11341360/54a734ff1163/fcvm-11-1364337-g001.jpg

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