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Abstract：
BACKGROUND: Adipokines are emerging mediators of immune response, and may affect susceptibility to active TB.OBJECTIVE: To examine the associations between adipokines and the risk of active TB.METHODS: In a case-control study nested within a prospective cohort of middle-aged and older adults in Singapore, 280 incident active TB cases who donated blood for research before diagnosis were matched with 280 controls. Serum levels of adiponectin, resistin, leptin and ghrelin were measured. Multivariable logistic regression models were used to compute the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between adipokines and the risk of active TB.RESULTS: Higher levels of leptin and resistin were associated with reduced risk of TB in a dose-dependent manner. Compared to those in the lowest quartile of leptin levels, those in the highest quartile had an OR of 0.46 (95%CI 0.26-0.82; P for trend = 0.009). Similarly, compared to those in the lowest quartile of resistin levels, those in the highest quartile had an OR of 0.46 (95%CI 0.24-0.90; P for trend = 0.03). Adiponectin and ghrelin levels were not associated with TB risk.CONCLUSION: Increased serum levels of leptin and resistin may be associated with reduced susceptibility to active TB infection.
摘要：
背景：脂肪因子是免疫反应的新兴介质，并可能影响对活动性结核病的易感性。目的：研究脂肪因子与活动性结核病风险之间的关系。方法：在一项病例对照研究中，嵌套在新加坡中老年人的前瞻性队列中，在诊断前捐献血液进行研究的280例活动性结核病病例与280例对照相匹配。血清脂联素水平，抵抗素,测量瘦素和生长素释放肽。使用多变量逻辑回归模型来计算脂肪因子与活动性TB风险之间的关联的调整比值比（OR）和95％置信区间（CI）。结果：较高水平的瘦素和抵抗素以剂量依赖的方式与结核病风险降低相关。与瘦素水平最低四分位数的人相比，最高四分位数的OR为0.46(95CI0.26-0.82;趋势P=0.009).同样，与抵抗素水平最低四分位数的相比，最高四分位数的OR为0.46(95CI0.24-0.90;趋势P=0.03).脂联素和ghrelin水平与结核病风险无关。结论：血清瘦素和抵抗素水平升高可能与活动性结核感染易感性降低有关。
