结核病(TB)及其危险因素与心血管疾病(CVD)独立相关。我们确定了乌干达耐药结核病(DRTB)人群中CVD危险因素的患病率和相关性。
在这项横断面研究中,我们在2021年7月至12月期间在乌干达的4个治疗地点招募了微生物学证实的DRTB患者.研究的CVD危险因素是任何吸烟史,糖尿病(DM)高血压,高体重指数(BMI),中心性肥胖和血脂异常。我们使用具有稳健标准误差的改良泊松回归模型来确定与每种血脂异常独立相关的因素。高血压,和中心性肥胖。
在212名参与者中,118人(55.7%)感染了艾滋病毒。总的来说,196(92.5%,95%置信区间(CI)88.0-95.3)具有≥1个CVD危险因素。个体CVD危险因素的患病率;95%CI为:血脂异常(62.5%;55.4-69.1),高血压(40.6%;33.8-47.9),中心性肥胖(39.3%;32.9-46.1),吸烟(36.3%;30.1-43.1),高BMI(8.0%;5.0-12.8)和DM(6.5%;3.7-11.1)。血脂异常与糖化血红蛋白增加相关(校正患病率(aPR)1.14,95CI1.06-1.22)。高血压与农村居民(aPR1.89,95%CI1.14-3.14)和既往吸烟史(aPR0.46,95%CI0.21-0.98)有关。中心性肥胖与年龄增长相关(aPR1.02,95CI1.00-1.03),舒张压升高(aPR1.0395CI1.00-1.06)。
乌干达的DRTB患者中CVD危险因素的患病率很高,其中血脂异常是最常见的。我们建议使用综合服务来识别和管理DRTB中的CVD危险因素。
Tuberculosis (TB) and its risk factors are independently associated with cardiovascular disease (CVD). We determined the prevalence and associations of CVD risk factors among people with drug-resistant tuberculosis (DRTB) in Uganda.
In this cross-sectional study, we enrolled people with microbiologically confirmed DRTB at four treatment sites in Uganda between July to December 2021. The studied CVD risk factors were any history of cigarette smoking, diabetes mellitus (DM) hypertension, high body mass index (BMI), central obesity and dyslipidaemia. We used modified Poisson regression models with robust standard errors to determine factors independently associated with each of dyslipidaemia, hypertension, and central obesity.
Among 212 participants, 118 (55.7%) had HIV. Overall, 196 (92.5%, 95% confidence interval (CI) 88.0-95.3) had ≥ 1 CVD risk factor. The prevalence; 95% CI of individual CVD risk factors was: dyslipidaemia (62.5%; 55.4-69.1), hypertension (40.6%; 33.8-47.9), central obesity (39.3%; 32.9-46.1), smoking (36.3%; 30.1-43.1), high BMI (8.0%; 5.0-12.8) and DM (6.5%; 3.7-11.1). Dyslipidaemia was associated with an increase in glycated haemoglobin (adjusted prevalence ratio (aPR) 1.14, 95%CI 1.06-1.22). Hypertension was associated with rural residence (aPR 1.89, 95% CI 1.14-3.14) and previous history of smoking (aPR 0.46, 95% CI 0.21-0.98). Central obesity was associated with increasing age (aPR 1.02, 95%CI 1.00-1.03), and elevated diastolic blood pressure (aPR 1.03 95%CI 1.00-1.06).
There is a high prevalence of CVD risk factors among people with DRTB in Uganda, of which dyslipidaemia is the commonest. We recommend integrated services for identification and management of CVD risk factors in DRTB.