目的:高空腹血糖(HFPG)已被确定为耐药结核病发病率和死亡率的危险因素。然而,HFPG-归因耐多药结核病(MDR-TB)和广泛耐药结核病(XDR-TB)的流行特征仍不清楚.我们旨在分析1990年至2019年HFPG可归因于耐多药结核病和广泛耐药结核病的全球空间格局和时间趋势。
方法:利用2019年全球疾病负担项目的数据,从1990年至2019年,我们对HFPG归因MDR-TB和XDR-TB的年度死亡和残疾调整寿命年(DALYs)进行了分析.采用Joinpoint回归来量化随时间的趋势。
结果:从1990年到2019年,全球由HFPG引起的MDR-TB和XDR-TB引起的死亡和DALYs呈现总体上升趋势,在2003年至2004年之前大幅增加,随后逐渐下降或稳定。在过去30年中,低社会人口指数(SDI)地区的增长最为明显。区域,撒哈拉以南非洲,中亚和大洋洲仍然是最大的负担。此外,HFPG引起的耐多药结核病和广泛耐药结核病的负担存在性别和年龄差异,25-34岁年龄段的年轻男性死亡率更高,DALY的负担和比女性更快的增长趋势。有趣的是,随着SDI的增加,可归因于HFPG的MDR-TB和XDR-TB的ASMR和ASDR呈增加趋势,随后呈稳定或降低模式.
结论:从1990年到2019年,全球范围内HFPG归因MDR-TB和XDR-TB的负担上升。这些发现强调了常规双向筛查和综合管理对耐药结核病和糖尿病的重要性。
OBJECTIVE: High fasting plasma glucose (HFPG) has been identified as a risk factor for drug-resistant tuberculosis incidence and mortality. However, the epidemic characteristics of HFPG-attributable multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) remain unclear. We aimed to analyze the global spatial patterns and temporal trends of HFPG-attributable MDR-TB and XDR-TB from 1990 to 2019.
METHODS: Utilizing data from the Global Burden of Disease 2019 project, annual deaths and disability-adjusted life years (DALYs) of HFPG-attributable MDR-TB and XDR-TB were conducted from 1990 to 2019. Joinpoint regression was employed to quantify trends over time.
RESULTS: From 1990 to 2019, the deaths and DALYs due to HFPG-attributable MDR-TB and XDR-TB globally showed an overall increasing trend, with a significant increase until 2003 to 2004, followed by a gradual decline or stability thereafter. The low sociodemographic index (SDI) region experienced the most significant increase over the past 30 years. Regionally, Sub-Saharan Africa, Central Asia and Oceania remained the highest burden. Furthermore, there was a sex and age disparity in the burden of HFPG-attributable MDR-TB and XDR-TB, with young males in the 25-34 age group experiencing higher mortality, DALYs burden and a faster increasing trend than females. Interestingly, an increasing trend followed by a stable or decreasing pattern was observed in the ASMR and ASDR of HFPG-attributable MDR-TB and XDR-TB with SDI increasing.
CONCLUSIONS: The burden of HFPG-attributable MDR-TB and XDR-TB rose worldwide from 1990 to 2019. These findings emphasize the importance of routine bi-directional screening and integrated management for drug-resistant TB and diabetes.