糖尿病患者血清矿物质水平与其并发肺结核风险的关系研究

ASSOCIATION BETWEEN SERUM MINERAL LEVELS AND RISK OF PULMONARY TUBERCULOSIS IN DIABETIC PATIENTS

目的探讨糖尿病(DM)患者血清矿物元素含量与并发肺结核风险的关系。方法采用病例对照研究方法,以糖尿病并发肺结核(DM-PTB)患者为病例组,单纯DM患者为对照组,并设健康对照组。通过问卷调查收集研究对象的一般人口学信息,测量其身高、体重,计算BMI,采用电感耦合等离子体质谱法(ICP-MS)检测血清矿物元素水平。运用多因素logistics回归法分析DM患者血清矿物元素水平与并发PTB风险的关系。结果本研究共纳入286例研究对象,其中DM-PTB患者67例,DM患者128例,健康对照91例。与DM组相比,DM-PTB组患者血清Cu、Ni含量显著升高,而Fe、Mn、Se含量分别降低14.29%、37.74%、5.65%。经调整年龄、性别和BMI后,多因素回归分析结果显示,低Na(OR=3.11,95%CI:1.47-6.57)、低Se(OR=2.26,95%CI:1.08-4.72)、低Mn(OR=3.10,95%CI:1.41-6.79)与DM患者并发PTB的风险增加有关,而血清低Cu(OR=0.03,95%CI:0.01-0.10)、低Ni(OR=0.22,95%CI:0.09-0.52)是其保护因素。结论DM患者体内Na、Mn、Cu、Se、Ni等矿物元素水平的改变可能与其活动性肺结核发生风险关联,提示血清元素谱变化对DM患者发生活动性肺结核可能具有预测作用。

Objective To investigate the association between serum mineral levels and the risk of pulmonary tuberculosis in diabetic patients.Methods A case-control study design was used.Patients with concurrent diabetes mellitus and pulmonary tuberculosis(DM-PTB)were recruited in the case group,and patients with diabetes mellitus(DM)only as the control group.Also,healthy individuals were recruited as the healthy control group.The general demographic information of the subjects was collected by using structured questionnaires,and height and weight were measured for the calculation of BMI.Serum mineral concentrations were measured using inductively coupled plasma mass spectrometry(ICP-MS).Multivariate logistic regression analysis was used to analyze the correlation between serum mineral concentrations and risk of concurrent PTB in DM patients.Results A total of 286 subjects were included in this study,including 67 patients with DM-PTB,128 patients with DM,and 91 healthy controls.Compared with DM group,serum Fe,Mn and Se concentrations in DM-PTB patients were lower by 14.29%,37.74%and 5.65%,respectively.After adjusting for age,sex and BMI,the multivariate regression analysis showed that low Na(OR=3.11;95%CI:1.47-6.57),low Se(OR=2.26;95%CI:1.08-4.72),low Mn(OR=3.10;95%CI:1.41-6.79)were associated with an increased risk of PTB in DM patients,while low Cu(OR=0.03;95%CI:0.01-0.10),low Ni(OR=0.22;95%CI:0.09-0.52)were associated a protective effect.Conclusion Altered serum mineral levels including Na,Mn,Cu,Se and Ni in DM patients may be associated with increased risk of active tuberculosis,indicating that serum mineral changes may predict the risk of active tuberculosis in DM patients.