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Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study
OBJECTIVES: This study aimed to describe and quantify the relationship between body mass index (BMI) and tuberculosis (TB) incidence. DESIGN: A population-based prospective cohort study. SETTING: Ten randomly selected communities in the southwestern mountainous region of China. PARTICIPANTS: Partici...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928331/ https://www.ncbi.nlm.nih.gov/pubmed/35296472 http://dx.doi.org/10.1136/bmjopen-2021-050928 |
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author | Chen, Jinou Zha, Shun Hou, Jinglong Lu, Kunyun Qiu, Yubing Yang, Rui Li, Ling Yang, Yunbin Xu, Lin |
author_facet | Chen, Jinou Zha, Shun Hou, Jinglong Lu, Kunyun Qiu, Yubing Yang, Rui Li, Ling Yang, Yunbin Xu, Lin |
author_sort | Chen, Jinou |
collection | PubMed |
description | OBJECTIVES: This study aimed to describe and quantify the relationship between body mass index (BMI) and tuberculosis (TB) incidence. DESIGN: A population-based prospective cohort study. SETTING: Ten randomly selected communities in the southwestern mountainous region of China. PARTICIPANTS: Participants who had resided in study sites before screening for at least 6 months were eligible. Those who refused to participate or were temporary residents (who resided less than 6 months during three waves of screening) were excluded. The present research included 26 022 participants aged over 15 years for analyses. INTERVENTIONS: The cohort study conducted three rounds of TB screening from 2013 to 2015. Face-to-face surveys for participants were carried out. TB symptoms positivity suspects underwent chest X-ray and sputum smear test for diagnosis. PRIMARY OUTCOME MEASURES: The study outcome was the diagnosed active TB in the second and third rounds of screening. RESULTS: During the follow-up of 2.25 years, 43 cases developed TB in 44 574.4 person-years. The negative log-linear relationship between BMI and TB incidence was fitted (adjusted R(2)=0.76). Overweight or obese was associated with a lower risk of TB compared with normal weight (adjusted HR (aHR) 0.34, 95% CI 0.14 to 0.82). The inverse log-linear associations between continuous BMI and individual TB risk were evaluated. In subgroup analysis, the risk of TB reduced 78% in overweight or obese women (aHR 0.22, 95% CI 0.05 to 0.97), and a 64% reduction in the elderly (aHR 0.36, 95% CI 0.12 to 1.00) compared with those with normal weight, respectively. CONCLUSIONS: The study provided evidence for a negative association between BMI and TB development in Chinese adults. It suggests the inverse dose–response relationship between BMI and TB incidence, and implies an optimal cut-off point of BMI for screening strategy. |
format | Online Article Text |
id | pubmed-8928331 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-89283312022-04-01 Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study Chen, Jinou Zha, Shun Hou, Jinglong Lu, Kunyun Qiu, Yubing Yang, Rui Li, Ling Yang, Yunbin Xu, Lin BMJ Open Epidemiology OBJECTIVES: This study aimed to describe and quantify the relationship between body mass index (BMI) and tuberculosis (TB) incidence. DESIGN: A population-based prospective cohort study. SETTING: Ten randomly selected communities in the southwestern mountainous region of China. PARTICIPANTS: Participants who had resided in study sites before screening for at least 6 months were eligible. Those who refused to participate or were temporary residents (who resided less than 6 months during three waves of screening) were excluded. The present research included 26 022 participants aged over 15 years for analyses. INTERVENTIONS: The cohort study conducted three rounds of TB screening from 2013 to 2015. Face-to-face surveys for participants were carried out. TB symptoms positivity suspects underwent chest X-ray and sputum smear test for diagnosis. PRIMARY OUTCOME MEASURES: The study outcome was the diagnosed active TB in the second and third rounds of screening. RESULTS: During the follow-up of 2.25 years, 43 cases developed TB in 44 574.4 person-years. The negative log-linear relationship between BMI and TB incidence was fitted (adjusted R(2)=0.76). Overweight or obese was associated with a lower risk of TB compared with normal weight (adjusted HR (aHR) 0.34, 95% CI 0.14 to 0.82). The inverse log-linear associations between continuous BMI and individual TB risk were evaluated. In subgroup analysis, the risk of TB reduced 78% in overweight or obese women (aHR 0.22, 95% CI 0.05 to 0.97), and a 64% reduction in the elderly (aHR 0.36, 95% CI 0.12 to 1.00) compared with those with normal weight, respectively. CONCLUSIONS: The study provided evidence for a negative association between BMI and TB development in Chinese adults. It suggests the inverse dose–response relationship between BMI and TB incidence, and implies an optimal cut-off point of BMI for screening strategy. BMJ Publishing Group 2022-03-16 /pmc/articles/PMC8928331/ /pubmed/35296472 http://dx.doi.org/10.1136/bmjopen-2021-050928 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Epidemiology Chen, Jinou Zha, Shun Hou, Jinglong Lu, Kunyun Qiu, Yubing Yang, Rui Li, Ling Yang, Yunbin Xu, Lin Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study |
title | Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study |
title_full | Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study |
title_fullStr | Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study |
title_full_unstemmed | Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study |
title_short | Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study |
title_sort | dose–response relationship between body mass index and tuberculosis in china: a population-based cohort study |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928331/ https://www.ncbi.nlm.nih.gov/pubmed/35296472 http://dx.doi.org/10.1136/bmjopen-2021-050928 |
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