{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T03:48:42Z","timestamp":1774496922128,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aimed to examine whether D\u2010dimer and lymphocyte counts predict the risk of concurrent pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) and to identify critical thresholds for clinical use. We also investigated whether D\u2010dimer mediates the protective effect of lymphocytes against tuberculosis (TB) dissemination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One thousand nine hundred (1318 PTB and 582 PTB\u2009+\u2009EPTB) patients diagnosed between 2022 and 2024 were analyzed. Multiple regression analysis, smooth curve fitting, threshold effect analysis, and causal mediation analysis were conducted using EasyStat and R software to evaluate the association between lymphocyte counts (exposure), D\u2010dimer (mediator), and PTB\u2009+\u2009EPTB risk (outcome) and to determine the critical value of lymphocyte counts and D\u2010dimer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PTB\u2009+\u2009EPTB patients had higher D\u2010dimer and lower lymphocyte counts. Elevated D\u2010dimer increased the risk of PTB\u2009+\u2009EPTB (adjusted OR\u2009=\u20092.28, 95% CI: 1.99\u20132.60). High lymphocyte counts reduced the risk (adjusted OR\u2009=\u20090.25, 95% CI: 0.13\u20130.46). Threshold effects showed increased risk when D\u2010dimer exceeded 0.170\u2009mg\/L (OR\u2009=\u20092.35, 95% CI: 2.05\u20132.70) and reduced risk when lymphocyte counts exceeded 750 cells\/\u03bcL (OR\u2009=\u20090.15, 95% CI: 0.07\u20130.32). D\u2010dimer mediated 36.473% (95% CI: 25.469\u201353.168) of the protective effect of lymphocytes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>D\u2010dimer is an independent risk factor and lymphocyte counts a protective factor for PTB\u2009+\u2009EPTB, with D\u2010dimer mediating 36.473% of the lymphocyte effect. Clinically actionable thresholds (D\u2010dimer &gt;\u20090.170\u2009mg\/L and lymphocytes &lt;\u2009750 cells\/\u03bcL) provide concrete targets for early intervention to prevent TB dissemination and improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/crj.70175","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:07:56Z","timestamp":1773767276000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["D\u2010Dimer: A Mediator of the Association Between Lymphocyte and Dissemination of Pulmonary Tuberculosis: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8937-1259","authenticated-orcid":false,"given":"Yujun","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital Fujian Medical University  Quanzhou City Fujian 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