代谢相关脂肪性肝病对初治肺结核患者抗结核治疗短期疗效影响因素OA

Objective:To explore the impact and influencing factors of metabolic dysfunction-associated fatty liver disease(MAFLD)on short-term effectiveness of anti-tuberculosis treatment in patients with newly diagnosed pulmonary tuberculosis(PTB),to provide a theoretical basis for individualized treatment of PTB patients.Methods:A case-control study was conducted,enrolling 320 newly diagnosed PTB patients admitted to Nanjing Second Hospital,Jiangsu Province from January to December 2023.According to the effectiveness at the end of the 2nd month of anti-tuberculosis treatment,the patients were divided into a favorable effectiveness group(146 cases)and a poor effectiveness group(174 cases).Demographic characteristics,metabolic indicators(including blood lipids,blood glucose,hepatic steatosis,etc.)and clinical data of the patients were collected.Uni variable analysis was used to screen metabolic indicators related to treatment effectiveness,and multivariable logistic regression analysis was performed to identify factors influencing treatment effectiveness.Results:Univariable analysis revealed that in the poor-response group,42.0％(73/174)of patients had a body mass index(BMI)＞24 kg/m2,54.0％(94/174)had concomitant diabetes,hypertension(52/174,29.9％),and hepatic steatosis(103/174,59.2％).These proportions all were significantly higher than those in the good response group(24.7％(36/146),17.1％(25/146),15.1％(22/146),and 12.3％(18/146),respectively;x2 values:17.739,46.276,9.803,74.155;P＜0.05 for all).Multivariable analysis indicated that abnormal triglycerides(OR=6.179,95％CI:3.159-12.312),abnormal high-density lipoprotein cholesterol(OR=2.134,95％CI:1.233-3.586),and complicated diabetes mellitus(OR=4.412,95％CI:2.464-7.666)were independent risk factors for poor anti-tuberculosis treatment effectiveness.Patients who met the diagnostic criteria for MAFLD had a significantly increased risk of poor treatment effectiveness(OR=11.15,95％CI:6.04-20.57).Conclusion:Abnormal triglycerides,abnormal high-density lipoprotein cholesterol,and concomitant diabetes mellitus are independent risk factors for poor anti-tuberculosis treatment effectiveness.MAFLD is an important factor affecting the prognosis of PTB.Clinically,enhanced monitoring and management should be implemented for PTB patients complicated with MAFLD.