Association of Body Mass Index with the Tuberculosis Infection: a Population-based Study among 17796 Adults in Rural China

Abstract

Body mass index (BMI) has been shown to be associated with host susceptibility to several infections. However, the link between BMI and the risk of tuberculosis (TB) infection has been sparsely studied in China and in worldwide. Based on the baseline survey of a population-based, prospective study in rural China, the association between BMI and TB infection among adults was estimated by means of cross-sectional analysis. TB infection status was tested using QuantiFERON-TB Gold In-Tube (QFT), a commercial of interferon-γ release assay (IGRA). Totally, 17796 eligible participants aged ≥18 years from 4 study sites, were included in the analysis. 21.76% (3873/17796) were observed to be QFT positive. Age and gender standardized prevalence ranged from 16.49% to 23.81% across the study sites. 42.19% study participants were obese/overweight with BMI ≥ 24.0 kg/m2. BMI ≥ 28.0 kg/m2 was observed to be independently associated with QFT positivity (adjusted odds ratio: 1.17, 95% confidence interval: 1.04–1.33). The strength of the association was found to be geographically diversity, which might be explained, at least partly, by the varied local TB epidemic status. Our results suggest that individuals with obesity might be one important target population for TB infection control in rural China.

Sex influences the association between haemostasis and the extent of lung lesions in tuberculosis

“…Our result is consistent with a recent report that in those cases without cavitation, the radiological severity of disease on chest X-ray prior to treatment in smear-positive pulmonary TB patients has no association with the bacterial burden [ 40 ]. It may therefore explain the seemingly paradox association of BMI [ 41 – 43 ] and anti-TB antibody [ 26 , 44 , 45 ] response with the bacterial counts and cavity in TB patients, in our data and previous reports.…”

Association of body mass index with incident tuberculosis in Korea

“…Furthermore, adipose tissue participates in inflammation and immunity, producing and releasing a variety of pro-inflammatory and anti-inflammatory factors that might influence susceptibility to infections [ 7 ]. In one study, BMI above 28 kg/m 2 was independently associated with host susceptibility of TB in rural China [ 8 ]. Additionally, although an inverse logarithmic relationship between TB incidence and BMI was showed in another study, the relationship was uncertain at a BMI above 30 kg/m 2 [ 3 ].…”

<p>Incidence and Predictors of Tuberculosis among Adult Diabetic Patients, Debre Markos Referral Hospital, Northwest Ethiopia, 2018: A Retrospective Cohort Study</p>

“…22 However, this study contradicts findings reported from US, 23 UK 24 and China. 25 Variations among studies could be attributable to differences in sample size, study settings, follow-up periods, and sociodemographic characteristics of study participants. Furthermore, one of the most significant predictors of TB among diabetic patients was a history of TB.…”