Qiu Hanbo, Shi Yan, Li Yanyun, Shen Xin, Li Rui, Yang Qundi, Pan Qichao, Yan Fei
Department of Social Medicine, Fudan University, Shanghai, China.
Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Trop Med Int Health. 2017 Jul;22(7):830-838. doi: 10.1111/tmi.12884. Epub 2017 May 19.
To examine the incident rate of tuberculosis (TB) and its associates among adults with type 2 diabetes in Shanghai, China.
We conducted a retrospective cohort study among 170 399 patients with type 2 diabetes aged ≥18 years who were registered in Shanghai community-based diabetes management system between 2004 and 2009. Their TB status was tracked until 31 December 2014. Cox regression was performed to identify the risk factors for TB.
We documented 785 new TB cases during 654 977 person-years of follow-up. The incident rate of TB was 224.20 (206.69, 243.16) per 100 000 person-years among men and 51.34 (44.75, 58.92) per 100 000 person-years among women. A 1-unit increase of BMI was associated with a risk reduction in 16% (P < 0.01) for men and a 14% (P < 0.01) reduction for women. TB cases were more likely to be insulin-dependent [men: hazard ratio = 2.13 (1.29, 3.53); women: 3.28 (1.28, 8.39)] and had a poor glucose level initially [men: 1.21 (1.15, 1.27); women: 1.27 (1.18, 1.37)]. The risk factor for TB specific to men was a young age at diagnosis of diabetes, and the protective factor specific to women was actively engaging in physical activity.
TB incident rate among patients with type 2 diabetes was substantially higher among men than among women. The risk of TB was reversely associated with initial BMI. The severity of poor glucose control among patients with diabetes was also linearly associated with the risk of TB.
研究中国上海2型糖尿病成年患者中结核病（TB）及其相关因素的发病率。
我们对2004年至2009年在上海社区糖尿病管理系统中登记的170399例年龄≥18岁的2型糖尿病患者进行了一项回顾性队列研究。追踪他们的结核病状况直至2014年12月31日。采用Cox回归分析确定结核病的危险因素。
在654977人年的随访期间，我们记录了785例新发结核病病例。男性结核病发病率为每10万人年224.20（206.69，243.16），女性为每10万人年51.34（44.75，58.92）。男性体重指数（BMI）每增加1个单位，风险降低16%（P<0.01），女性降低14%（P<0.01）。结核病患者更可能依赖胰岛素治疗[男性：风险比=2.13（1.29，3.53）；女性：3.28（1.28，8.39）]，且初始血糖水平较差[男性：1.21（1.15，1.27）；女性：1.27（1.18，1.37）]。男性结核病的特定危险因素是糖尿病诊断时年龄较轻，女性的保护因素是积极参加体育活动。
2型糖尿病患者中男性结核病发病率显著高于女性。结核病风险与初始BMI呈负相关。糖尿病患者血糖控制不佳的严重程度也与结核病风险呈线性相关
