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血清球蛋白与美国潜伏结核感染患者糖尿病的关系:一项横断面研究。

Association between serum globulins and diabetes mellitus in American latent tuberculosis infection patients: A cross-sectional study.

机构信息

Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China.

ICU, Tuberculosis Department, 8th Medical Center of Chinese PLA General Hospital Tuberculosis Research Institute, Beijing, China.

出版信息

Medicine (Baltimore). 2024 Oct 4;103(40):e39949. doi: 10.1097/MD.0000000000039949.

Abstract

Diabetes mellitus (DM) is predisposing to the development of latent tuberculosis infection (LTBI). An understanding of the underlying factors of LTBI-DM is important for tuberculosis prevention and control. This study aims to evaluate the association between LTBI and DM among the noninstitutionalized civilian population in the United States, focusing on the impact of serum globulins. We performed a cross-sectional study design using public data from 2011 to 2012 National Health and Nutrition Examination Survey, focusing on participants diagnosed with LTBI who were aged 20 and above. Weighted Wilcoxon rank-sum and weighted chi-square tests were used to compare group differences. A multivariable logistic regression model was constructed to assess the association between serum globulin and DM, with subgroup analyses and evaluations of nonlinear relationships. Receiver operating characteristic curves were used to assess the predictive power of the models. A total of 694 participants (512 DM and 182 nonDM) were included in our study and the incidence of DM was 22%. Higher serum globulin levels were significantly associated with an increased risk of DM, with a 21% increase in risk for each unit increase in serum globulin (odds ratio = 1.21, 95% confidence interval [1.03, 1.43], P < .001). The relationship between serum globulin and DM was linear, and higher serum globulin levels were associated with a higher risk of DM, particularly in males (P = .043) and obese individuals (P = .019). The area under the curve for serum globulin predicting DM was 0.795, with an optimal cutoff value of 2.9. Elevated serum globulin levels are significantly associated with an increased risk of DM among individuals with LTBI, highlighting the potential role of serum globulin as a predictive biomarker for DM in this population. However, the specific mechanism between globulin and LTBI-DM needs to be further investigated.

摘要

糖尿病(DM)易导致潜伏性结核感染(LTBI)。了解 LTBI-DM 的潜在因素对于结核病的预防和控制至关重要。本研究旨在评估美国非住院平民人群中 LTBI 与 DM 之间的关联,重点关注血清球蛋白的影响。我们使用 2011 年至 2012 年全国健康与营养调查的公共数据进行了横断面研究设计,重点关注年龄在 20 岁及以上被诊断为 LTBI 的参与者。使用加权 Wilcoxon 秩和检验和加权卡方检验来比较组间差异。构建多变量逻辑回归模型来评估血清球蛋白与 DM 之间的关联,并进行亚组分析和非线性关系评估。使用受试者工作特征曲线来评估模型的预测能力。共纳入 694 名参与者(512 名 DM 和 182 名非 DM),DM 的发病率为 22%。较高的血清球蛋白水平与 DM 的风险增加显著相关,血清球蛋白每增加一个单位,风险增加 21%(优势比=1.21,95%置信区间[1.03, 1.43],P<0.001)。血清球蛋白与 DM 之间的关系呈线性,较高的血清球蛋白水平与 DM 的风险增加相关,尤其是在男性(P=0.043)和肥胖个体中(P=0.019)。血清球蛋白预测 DM 的曲线下面积为 0.795,最佳截断值为 2.9。在 LTBI 个体中,较高的血清球蛋白水平与 DM 的风险增加显著相关,这突出了血清球蛋白作为该人群中 DM 的预测生物标志物的潜在作用。然而,球蛋白与 LTBI-DM 之间的确切机制仍需进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fc1/11460894/b8a3e283cf49/medi-103-e39949-g001.jpg

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