Datasheet2_Tuberculosis survivors and the risk of cardiovascular disease: analysis using a nationwide survey in Korea.zip

BackgroundAlthough the association between tuberculosis (TB) and cardiovascular disease (CVD) has been reported in several studies and is explained by mechanisms related to chronic inflammation, few studies have comprehensively evaluated the association between TB and CVD in Korea.
MethodsUsing the Korea National Health and Nutrition Survey, we classified individuals according to the presence or absence of previous pulmonary TB was defined as the formal reading of a chest radiograph or a previous diagnosis of pulmonary TB by a physician. Using multivariable logistic regression analyses, we evaluated the association between the 10-year atherosclerotic cardiovascular disorder (ASCVD) risk and TB exposure, as well as the 10-year ASCVD risk according to epidemiological characteristics.
ResultsAmong the 69,331 participants, 4% (n = 3,101) had post-TB survivor group. Comparing the 10-year ASCVD risk between the post-TB survivor and control groups, the post-TB survivor group had an increased 10-year ASCVD risk in the high-risk group (40.46% vs. 24.00%, P < 0.001). Compared to the control group, the intermediate- and high-risk groups had also significantly increased 10-year ASCVD risks (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.23 and OR 1.69, 95% CI 1.59–1.78, respectively) in the post-TB survivor group. In the association of CVD among post-TB survivors according to epidemiologic characteristics, age [adjusted OR (aOR) 1.10, 95% CI 1.07–1.12], current smoking (aOR 2.63, 95% CI 1.34–5.14), a high family income (aOR 2.48, 95% CI 1.33–4.62), diabetes mellitus (aOR 1.97, 95% CI 1.23–3.14), and depression (aOR 2.06, 95% CI 1.03–4.10) were associated with CVD in the post-TB survivor group.
ConclusionsOur study findings suggest a higher 10-year ASCVD risk among TB survivors than healthy participants. This warrants long-term cardiovascular monitoring and management of the post-TB population.

背景 尽管多项研究已报道肺结核（Tuberculosis, TB）与心血管疾病（Cardiovascular Disease, CVD）之间存在关联，且该关联可通过与慢性炎症相关的机制加以解释，但目前韩国鲜有研究全面评估肺结核与心血管疾病之间的关联。
方法 本研究以韩国国民健康与营养调查（Korea National Health and Nutrition Survey）为数据来源，根据既往是否罹患肺结核对研究对象进行分组：既往肺结核定义为经正式读片确认的胸部X线异常结果，或经医师确诊的既往肺结核病史。本研究采用多变量logistic回归分析，评估10年动脉粥样硬化性心血管疾病（Atherosclerotic Cardiovascular Disorder, ASCVD）风险与肺结核暴露的关联，并按流行病学特征分析10年ASCVD风险情况。
结果 本研究共纳入69331名研究对象，其中4%（n=3101）为肺结核存活者队列。对比肺结核存活者队列与对照组的10年ASCVD风险可见，肺结核存活者队列的高危人群10年ASCVD风险显著升高（40.46% vs. 24.00%，P<0.001）。与对照组相比，肺结核存活者队列的中危与高危人群10年ASCVD风险同样显著升高（比值比（Odds Ratio, OR）=1.14，95%置信区间（Confidence Interval, CI）：1.04~1.23；OR=1.69，95%CI：1.59~1.78）。在按流行病学特征分析肺结核存活者的心血管疾病关联因素时发现，年龄[校正比值比（adjusted Odds Ratio, aOR）=1.10，95%CI：1.07~1.12]、当前吸烟（aOR=2.63，95%CI：1.34~5.14）、家庭高收入（aOR=2.48，95%CI：1.33~4.62）、糖尿病（Diabetes Mellitus, DM）（aOR=1.97，95%CI：1.23~3.14）及抑郁状态（aOR=2.06，95%CI：1.03~4.10）均与肺结核存活者的心血管疾病发生相关。
结论 本研究结果显示，肺结核存活者的10年ASCVD风险高于健康人群，这提示需对肺结核存活人群开展长期心血管监测与管理。