成人身體質量指數與特定社區型感染症相關性之文獻回顧

Review of the Association between Body Mass Index and Site-specific Community-acquired Infections in Adults

肥胖增加心血管疾病及代謝性疾病的風險已為人所知，是近幾年全球公共衛生的重要議題。當各國將健康議題放在非傳染性疾病(noncommunicable disease, NCD)的當下，不可否認的是感染症仍是造成全球死亡原因的前十名，包括下呼道感染症、感染性腹瀉以及肺結核。有不少研究指出肥胖是術後感染和院內感染的危險因子，相較之下肥胖跟社區型感染症的相關文獻較少，值得注意。其背後機轉可能跟過多的脂肪細胞長期分泌發炎前驅因子進而影響人體免疫細胞的調控有關。成人體重不足的議題比起嬰幼兒跟老人族群比較不常被討論，體重不足背後可能象徵著營養不良或是未被發現的慢性疾病問題，導致這群人可能相較於正常體重族群在對抗病原體入侵時，無法有效地啟動體內的發炎過程對抗致病菌，為易感受族群。身體質量數(body mass index, BMI)是臨床上與流行病學上最常被用來代表身體密度的指標。本篇文獻回顧的目的在探討異常的BMI是否在面對不同的社區型感染症時，為不同的易感受族群，而有不同的結果。

 

Obesity, known to increase the risk of cardiovascular and metabolic diseases, has been an important global public health issue. In spite of the focus of the global medical community on noncommunicable diseases, infectious diseases like lower respiratory infections, infectious diarrhea, and tuberculosis, continue to make their ways into the list of top ten causes of death worldwide. Studies have identified obesity as a risk factor for postoperative infections and nosocomial infections. However, there is only limited literature on the association between obesity and the risk of community-acquired infection. An underlying mechanism may be related to immune dysregulation caused by long-term secretion of proinflammatory factors by excessive adipocytes. The issue of underweight in adults has attracted less attention than those in children and the elderly. Compared to those with normal weight, underweight people may experience malnutrition or undetected chronic diseases, which can cause deficits in the innate and adaptive immune systems when fighting pathogens. Body Mass Index (BMI) is the most used indicator of body density. The purpose of this review is to investigate whether people marked with abnormal BMI are more susceptible to different community-acquired infections.