Lin Yan, Yuan Yanli, Zhao Xin, Liu Jianmu, Qiu Linxi, He Xiaoxin, Bai Yunlong, Li Bo, Zeng Zhong, Yang Guangxu, Meng Xu, Yuan Chunyu, Zheng Hailun, Kang Wanli, Harries Anthony D
a China Office , International Union Against Tuberculosis and Lung Disease , Beijing , China.
b Director Office , Jilin Provincial Academy of Tuberculosis Control and Prevention , Changchun , China.
Glob Health Action. 2017;10(1):1289737. doi: 10.1080/16549716.2017.1289737.
We aimed to observe (i) changes in fasting blood glucose (FBG) in tuberculosis (TB) patients before and during anti-TB treatment, (ii) whether FBG levels were stable or unstable and (iii) baseline characteristics associated with an unstable FBG.
TB patients consecutively attended six clinics or hospitals. FBG measurements were made at months 0, 2 and 6. Data analysis was performed using the chi-square test and multivariate logistic regression.
Of 232 patients without diabetes mellitus (DM) whose initial FBG < 6.1 mmol/L, over 90% maintained FBG < 6.1 mmol/L during treatment and no patient developed DM. Of 17 patients without DM and initial FBG between 6.1 and 6.9 mmol/L, over half had FBG < 6.1 mmol/L during treatment and no patient had DM at the end of treatment. Eight DM patients with already known DM had their FBG controlled at < 7.0 mmol/L during treatment. There were 13 DM patients newly diagnosed with FBG ≥ 7.0 mmol/L, and 69% continued to have FBG ≥ 7.0 mmol/L. After adjustment for confounding, the odds for an unstable FBG were higher for HIV-positive status, already having DM, smoking and coming to hospitals rather than clinics.
TB patients who do not have DM based on FBG measurements do not develop DM during anti-TB treatment. Those newly diagnosed with DM on screening in general maintain their DM status with high FBG and need to be better managed.
我们旨在观察（i）结核病（TB）患者抗结核治疗前及治疗期间空腹血糖（FBG）的变化，（ii）FBG水平是否稳定，以及（iii）与FBG不稳定相关的基线特征。
连续有结核病患者前往六家诊所或医院就诊。在第0、2和6个月测量FBG。使用卡方检验和多因素逻辑回归进行数据分析。
在232例初始FBG<6.1 mmol/L且无糖尿病（DM）的患者中，超过90%在治疗期间FBG维持在<6.1 mmol/L，且无患者发展为DM。在17例初始FBG在6.1至6.9 mmol/L之间且无DM的患者中，超过一半在治疗期间FBG<6.1 mmol/L，且治疗结束时无患者患DM。8例已知患有DM的糖尿病患者在治疗期间FBG控制在<7.0 mmol/L。有13例新诊断的FBG≥7.0 mmol/L的糖尿病患者，69%继续维持FBG≥7.0 mmol/L。在对混杂因素进行校正后，HIV阳性状态、已患有DM、吸烟以及前往医院而非诊所就诊的患者FBG不稳定的几率更高。
根据FBG测量结果无DM的结核病患者在抗结核治疗期间不会发展为DM。那些在筛查时新诊断为DM的患者总体上维持其高FBG的DM状态，需要更好地管理。
