医学
肺结核
优势比
内科学
糖尿病
逻辑回归
人类免疫缺陷病毒(HIV)
人口
活动性肺结核
免疫学
结核分枝杆菌
环境卫生
内分泌学
病理
作者
Susan Bailey,Sian Floyd,Maina Cheeba-Lengwe,Kwitaka Maluzi,Kasanda Chiwele-Kangololo,Deborah Kaluba-Milimo,Modupe Amofa-Sekyi,John Yudkin,Peter Godfrey‐Faussett,Helen Ayles
标识
DOI:10.1007/s44197-024-00236-2
摘要
Abstract Objectives To determine if HIV modifies the association between hyperglycaemia and active tuberculosis in Lusaka, Zambia. Methods A case–control study among newly—diagnosed adult tuberculosis cases and population controls in three areas of Lusaka. Hyperglycaemia is determined by random blood glucose (RBG) concentration measured at the time of recruitment; active tuberculosis disease by clinical diagnosis, and HIV status by serological result. Multivariable logistic regression is used to explore the primary association and effect modification by HIV. Results The prevalence of RBG concentration ≥ 11.1 mmol/L among 3843 tuberculosis cases was 1.4% and among 6977 controls was 1.5%. Overall, the adjusted odds ratio of active tuberculosis was 1.60 (95% CI 0.91–2.82) comparing those with RBG concentration ≥ 11.1– < 11.1 mmol/L. The corresponding adjusted odds ratio among those with and without HIV was 5.47 (95% CI 1.29–23.21) and 1.17 (95% CI 0.61–2.27) respectively; p -value for effect modification by HIV = 0.042. On subgroup analysis, the adjusted odds ratio of smear/Xpert-positive tuberculosis was 2.97 (95% CI 1.49–5.90) comparing RBG concentration ≥ 11.1– < 11.1 mmol/L. Conclusions Overall, no evidence of association between hyperglycaemia and active tuberculosis was found, though among those with HIV and/or smear/Xpert-positive tuberculosis there was evidence of association. Differentiation of hyperglycaemia caused by diabetes mellitus and stress-induced hyperglycaemia secondary to tuberculosis infection is important for a better understanding of these findings.
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