Diabetes Mellitus Increases the Risk of Active Tuberculosis A Systematic Review of 13 Observational Studies 英文参考文献.docVIP

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Diabetes Mellitus Increases the Risk of Active Tuberculosis A Systematic Review of 13 Observational Studies 英文参考文献.doc

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Diabetes Mellitus Increases the Risk of Active Tuberculosis A Systematic Review of 13 Observational Studies 英文参考文献

o PL SMEDICINE DiabetesMellitusIncreasestheRiskofActive Tuberculosis:ASystematicReviewof13 ObservationalStudies Christie Y.Jeon*,Megan B.Murray DepartmentofEpidemiology,HarvardSchoolofPublicHealth,Boston,Massachusetts,UnitedStatesofAmerica Funding:CYJissupportedbya departmentalgrantfromthe DepartmentofEpidemiologyat HarvardSchoolofPublicHealth.The departmenthadnoroleinstudy design,datacollectionandanalysis, decisiontopublish,orpreparation ofthemanuscript. ABSTRACT Background Several studies have suggested that diabetes mellitus (DM) increases the risk of active tuberculosis (TB). The rising prevalence of DM in TB-endemic areas may adversely affect TB control. We conducted a systematic review and a meta-analysis of observational studies assessing the association of DM and TB in order to summarize the existing evidence and to assessmethodologicalqualityofthestudies. CompetingInterests:Theauthors havedeclaredthatnocompeting interestsexist. AcademicEditor:BrianWilliams, WorldHealthOrganization, Switzerland MethodsandFindings WesearchedthePubMedandEMBASEdatabasestoidentifyobservationalstudiesthathad reportedanage-adjustedquantitativeestimateoftheassociationbetweenDMandactiveTB disease.Thesearchyielded13observationalstudies(n?1,786,212participants)with17,698TB cases.Randomeffectsmeta-analysisofcohortstudiesshowedthatDMwasassociatedwithan increased risk of TB (relative risk ? 3.11, 95% CI 2.27–4.26). Case-control studies were heterogeneous and odds ratios ranged from 1.16 to 7.83. Subgroup analyses showed that effectestimateswerehigherinnon-NorthAmericanstudies. Citation:JeonCY,MurrayMB(2008) Diabetesmellitusincreasestherisk ofactivetuberculosis:Asystematic reviewof13observationalstudies. PLoSMed5(7):e152.doi:10.1371/ journal.pmed.0050152 Received:March18,2008 Accepted:June3,2008 Published:July15,2008 Copyright:ó2008JeonandMurray. Thisisanopen-accessarticle distributedunderthetermsofthe CreativeCommonsAttribution License,whichpermitsunrestricted use,distribution,andrepr