基线肺功能与结核病发病风险：一项基于全国人口的队列研究。
Baseline lung function and risk of incident tuberculosis: a nationwide population-based cohort study.
作者信息
Kim Kyu Yean, Park Yong-Moon, Ko Seung Hyun, Han Kyungdo, Kim Seung Hoon, Kim Shin Young, Kim Sung Kyoung
机构信息
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America.
出版信息
PLoS One. 2025 Apr 29;20(4):e0322616. doi: 10.1371/journal.pone.0322616. eCollection 2025.
BACKGROUND
While lung function is known to decrease after suffering from pulmonary tuberculosis (TB), little is known about whether baseline lung function is associated with the occurrence of TB in the general population. This study aimed to evaluate the risk of incident TB according to baseline lung function.
METHODS
A nationwide population-based cohort study was conducted using a database derived by cross-referencing Korea National Health and Nutrition Examination Survey and National Health Insurance Service between 2010 and 2016. Of 29,524 subjects, 16,594 participants aged over 40 years who had spirometry results without a previous TB history were enrolled. The primary endpoint was newly developed TB.
RESULTS
Among 16,457 participants, 72 were newly diagnosed with TB during the follow-up period (median: 5.5 years). TB risk was higher in participants with obstructive lung function impairment (aHR: 2.033, 95% CI: 1.123-3.679) or restrictive lung function impairment (aHR: 2.193, 95% CI: 1.120-4.294) than in those with normal lung function. Low forced expiratory volume in one second (FEV1) was associated with increased TB risk (aHR [lowest quartile vs. highest quartile]: 1.91, 95% CI: 1.05-3.50; aHR [lowest decile vs. highest decile]: 2.76, 95% CI: 1.14-6.70; both p for trends < 0.0001).
CONCLUSION
Our findings suggest that impaired lung function might increase TB risk and that TB risk might be inversely associated with FEV1.
背景
虽然已知肺结核（TB）患者的肺功能会下降，但对于普通人群中基线肺功能是否与结核病的发生有关却知之甚少。本研究旨在根据基线肺功能评估新发结核病的风险。
方法
利用2010年至2016年间韩国国家健康与营养检查调查和国民健康保险服务交叉引用得出的数据库进行了一项全国性的基于人群的队列研究。在29524名受试者中，纳入了16594名年龄超过40岁且有肺量计测量结果且无既往结核病史的参与者。主要终点是新发结核病。
结果
在16457名参与者中，72人在随访期间（中位数：5.5年）被新诊断为结核病。阻塞性肺功能损害（调整后风险比：2.033，95%置信区间：1.123 - 3.679）或限制性肺功能损害（调整后风险比：2.193，95%置信区间：1.120 - 4.294）的参与者患结核病的风险高于肺功能正常的参与者。一秒用力呼气量（FEV1）低与结核病风险增加相关（调整后风险比[最低四分位数与最高四分位数比较]：1.91，95%置信区间：1.05 - 3.50；调整后风险比[最低十分位数与最高十分位数比较]：2.76，95%置信区间：1.14 - 6.70；趋势p值均<0.0001）。
结论
我们的研究结果表明，肺功能受损可能会增加结核病风险，且结核病风险可能与FEV1呈负相关。
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