Tuberculosis and diabetes mellitus: convergence of two epidemics

被引:590
作者
Dooley, Kelly E. [1 ,2 ,3 ]
Chaisson, Richard E. [1 ,2 ]
机构
[1] Johns Hopkins Univ, Ctr TB Res, Sch Med, Baltimore, MD 21231 USA
[2] Johns Hopkins Univ, Div Infect Dis, Sch Med, Baltimore, MD 21231 USA
[3] Johns Hopkins Univ, Div Clin Pharmacol, Sch Med, Baltimore, MD 21231 USA
基金
美国国家卫生研究院;
关键词
MULTIDRUG-RESISTANT TUBERCULOSIS; PULMONARY TUBERCULOSIS; RISK-FACTORS; HEALTHY-SUBJECTS; SOUTH-INDIA; LIFE-STYLE; PHARMACOKINETICS; ASSOCIATION; RIFAMPICIN; PHARMACODYNAMICS;
D O I
10.1016/S1473-3099(09)70282-8
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The link between diabetes mellitus and tuberculosis has been recognised for centuries. In recent decades, tuberculosis incidence has declined in bigh-income countries, but incidence remains high in countries that have high rates of infection with HIV, high prevalence of malnutrition and crowded living conditions, or poor tuberculosis control infrastructure. At the same time, diabetes mellitus prevalence is soaring globally, fuelled by obesity. There is growing evidence that diabetes mellitus is an important risk factor for tuberculosis and might affect disease presentation and treatment response. Furthermore, tuberculosis might induce glucose intolerance and worsen glycaemic control in people with diabetes. We review the epidemiology of the tuberculosis and diabetes epidemics, and provide a synopsis of the evidence for the role of diabetes mellitus in susceptibility to, clinical presentation of, and response to treatment for tuberculosis. In addition, we review potential mechanisms by which diabetes mellitus can cause tuberculosis, the effects of tuberculosis on diabetic control, and pharmacokinetic issues related to the co-management of diabetes and tuberculosis.
引用
收藏
页码:737 / 746
页数:10
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