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However, little has discussed the impact of different BMI status on the emergence of TB drug resistance. We aimed to explore the drug-resistant profiles of DR-TB and its clinical predictors among underweight, overweight or obesity population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>8957 newly diagnosed TB cases with drug susceptibility results and BMI data in Shandong China, from 2004 to 2019 were enrolled. Multivariable and univariable logistic regression models were applied to investigate the impact of BMI on different drug-resistance. Clinical predicators and drug-resistant profiles of DR-TB among obesity, underweight, normal TB group were also described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 8957\u00a0TB cases, 6417 (71.64%) were normal weight, 2121 (23.68%) were underweight, 373 (4.16%) were overweight, and 46 (0.51%) were obese. The proportion of drug resistance and co-morbidity among normal weight, underweight, overweight, obese TB groups were 18.86%\/18.25%\/20.38%\/23.91% (DR-TB), 11.19%\/11.74%\/9.65%\/17.39% (mono-resistant tuberculosis, MR-TB), 3.41%\/3.06%\/5.36%\/0.00% (multidrug resistant tuberculosis, MDR-TB), 4.21%\/3.39%\/5.36%\/6.52% (polydrug resistant tuberculosis, PDR-TB), 10.57%\/8.44%\/19.57%\/23.91% (co-morbidity), respectively. Compared with normal weight group, underweight were associated with lower risk of streptomycin-related resistance (OR 0.844, 95% CI 0.726\u20130.982), but contributed to a higher risk of MR-TB (isoniazid) (odds ratio (OR) 1.347, 95% CI 1.049\u20131.730; adjusted OR (aOR) 1.31, 95% CI 1.017\u20131.686), P\u2009&lt;\u20090.05. In addition, overweight were positively associated with MDR-TB (OR 1.603, 95% CI 1.002\u20132.566; aOR 1.639, 95% CI 1.02\u20132.633), isoniazid\u2009+\u2009rifampicin\u2009+\u2009streptomycin resistance (OR 1.948, 95% confidence interval (CI): 1.061\u20133.577; aOR 2.113, 95% CI 1.141\u20133.912), Any isoniazid\u2009+\u2009streptomycin resistance (OR 1.472, 95% CI 1.013\u20132.14; aOR 1.483, 95% CI 1.017\u20132.164),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The higher risk of MDR-TB, isoniazid\u2009+\u2009rifampicin\u2009+\u2009streptomycin resistance, Any isoniazid\u2009+\u2009streptomycin resistance, and co-morbidity among overweight population implies that routine screening for drug sensitivity and more attention on co-morbidity among overweight TB cases may be necessary. In addition, underweight TB cases have a higher risk of isoniazid resistance. Our study suggests that an in-depth study of the interaction between host metabolic activity and infection of DR-TB may contribute more to novel treatment options or preventive measures, and accelerate the implementation of the STOP TB strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12890-021-01774-2","type":"journal-article","created":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T01:02:43Z","timestamp":1638752563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Association between body mass index and newly diagnosed drug-resistant pulmonary tuberculosis in Shandong, China from 2004 to 2019"],"prefix":"10.1186","volume":"21","author":[{"given":"Wan-mei","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-ting","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-jin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-yue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning-ning","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian-yun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-qi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-qi","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-fan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-bao","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-hua","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huai-chen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,6]]},"reference":[{"key":"1774_CR1","unstructured":"WHO Global tuberculosis report. https:\/\/www.who.int\/tb\/publications\/global_report\/en\/"},{"issue":"1","key":"1774_CR2","doi-asserted-by":"publisher","first-page":"6","DOI":"10.5588\/ijtld.16.0110","volume":"21","author":"S Nourzad","year":"2017","unstructured":"Nourzad S, Jenkins HE, Milstein M, Mitnick CD. 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Eur J Clin Nutr. 2013;67(6):620\u20134.","journal-title":"Eur J Clin Nutr"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-021-01774-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-021-01774-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-021-01774-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T02:06:00Z","timestamp":1675994760000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/s12890-021-01774-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,6]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["1774"],"URL":"https:\/\/doi.org\/10.1186\/s12890-021-01774-2","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,6]]},"assertion":[{"value":"30 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The protocols applied in this study were approved by the Ethics Committee of Shandong Provincial Hospital, affiliated with Shandong University (SPH) and the Ethic Committee of Shandong Provincial Chest Hospital (SPCH), China. Personal identifiers of TB patients were removed before data analysis and reporting. Informed consent was obtained from all participants or, if participants are under 18, from a parent and\/or legal guardian. All methods were performed in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"399"}}