哈萨克斯坦肺结核的流行病学和遗传学方面。

Epidemiological and genetic aspects of pulmonary tuberculosis in Kazakhstan.

机构信息

Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan.

出版信息

J Infect Public Health. 2024 Oct;17(10):102540. doi: 10.1016/j.jiph.2024.102540. Epub 2024 Sep 7.

DOI:10.1016/j.jiph.2024.102540

PMID:39260130

Abstract

OBJECTIVE

Tuberculosis is a major health problem in many countries, including Kazakhstan. Host genetics can affect TB risk, and epidemiological and social factors may contribute to disease progression. Due to the high incidence of pulmonary tuberculosis in the country, our research aimed to study the epidemiological and genetic aspects of pulmonary tuberculosis in Kazakhstan.

MATERIAL AND METHODS

1026 participants of Central Asian origin were recruited in the study: 342 individuals diagnosed with active PTB, 342 household contacts, and 342 controls without a family history of TB. Genetic polymorphisms of selected genes were determined by real-time polymerase chain reaction. The association between the risk of pulmonary TB and polymorphisms was evaluated using logistic regression and assessed with the ORs and their corresponding 95 % CIs, and the significance level was determined as p < 0.05.

RESULTS

Epidemiological data revealed that underweight BMI (χ² = 89.97, p < 0.001), employment (χ² = 39.28, p < 0.001), and diabetes (χ² = 12.38, p < 0.001) showed a significant association with PTB. A/T polymorphism of the IFG gene showed a lower risk, and A/A polymorphism showed an increased risk of susceptibility to TB. A/A polymorphism of the IFG gene was associated with an almost 3-fold increased risk of PTB, and A/T polymorphism of the IFG gene was associated with a decreased risk of PTB (OR = 0.67, 95 % CI = 0.49-0.92, p = 0.01). The analysis revealed a decreased risk of PTB for A/A polymorphism of the VDR ApaI (OR = 0.67, 95 % CI = 0.46-0.97, p < 0.05). A/A polymorphism of the TLR8 gene was associated with a 1.5-fold increased risk of PTB (OR = 1.53, 95 % CI = 1.00-2.33, p < 0.05).

CONCLUSION

Results showed that gender, employment, underweight BMI and diabetes are associated with PTB incidence in our study cohort. The A/A genotype of the IFG (rs2430561) and an A/A genotype of the TLR8 (rs3764880) genes were associated with an increased risk of PTB. A/T polymorphism of the IFG (rs2430561) and A/A polymorphism of the VDR ApaI were associated with a decreased risk of PTB.

摘要

目的

结核病是许多国家（包括哈萨克斯坦）的一个主要健康问题。宿主遗传学可以影响结核病的风险，而流行病学和社会因素可能会导致疾病的进展。由于该国肺结核的发病率很高，我们的研究旨在研究哈萨克斯坦肺结核的流行病学和遗传学方面。

材料和方法

本研究招募了 1026 名中亚血统的参与者：342 名确诊患有活动性肺结核的个体、342 名家庭接触者和 342 名无结核病家族史的对照者。通过实时聚合酶链反应确定选定基因的遗传多态性。使用逻辑回归评估肺结核风险与多态性之间的关联，并使用 OR 及其相应的 95%CI 进行评估，显著性水平确定为 p<0.05。

结果

流行病学数据显示，体重指数不足（χ²=89.97，p<0.001）、就业（χ²=39.28，p<0.001）和糖尿病（χ²=12.38，p<0.001）与肺结核有显著关联。IFG 基因的 A/T 多态性显示出较低的风险，而 A/A 多态性显示出对结核病的易感性增加。IFG 基因的 A/A 多态性与肺结核的风险增加近 3 倍相关，而 IFG 基因的 A/T 多态性与肺结核的风险降低相关（OR=0.67，95%CI=0.49-0.92，p=0.01）。分析显示，VDR ApaI 的 A/A 多态性降低了肺结核的风险（OR=0.67，95%CI=0.46-0.97，p<0.05）。TLR8 基因的 A/A 多态性与肺结核的风险增加 1.5 倍相关（OR=1.53，95%CI=1.00-2.33，p<0.05）。

结论

结果表明，在我们的研究队列中，性别、就业、体重指数不足和糖尿病与肺结核的发病率有关。IFG（rs2430561）的 A/A 基因型和 TLR8（rs3764880）的 A/A 基因型与肺结核的风险增加有关。IFG（rs2430561）的 A/T 多态性和 VDR ApaI 的 A/A 多态性与肺结核的风险降低有关。