Wuhan Pulmonary Hospital, Wuhan, Hubei, China.
Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
BMC Endocr Disord. 2021 Jun 16;21(1):123. doi: 10.1186/s12902-021-00779-6.
Diabetes is a well-known risk factor for tuberculosis and poorly glycemic control may increase the risk of tuberculosis. We performed a meta-analysis to explore the association of glycemic control in diabetic patients and their tuberculosis prevalence.
We included observational studies that investigated the prevalence of tuberculosis associated with glycemic control. The markers of glycated hemoglobin A1c (HbA1c) and fasting plasma glucose were used to evaluate the exposure of interest in the study. We searched related articles in PubMed, EMBASE and Web of Science through 14 December 2019. The Newcastle-Ottawa scale was used to assess the risk of bias of included studies.
Seventeen studies (four cohort studies, five case-control studies and eight cross-sectional studies) were included, involving 1,027,074 participants. The meta-analysis found the pooled odds ratio of prevalent tuberculosis increased a 2.05-fold (95%CI: 1.65, 2.55) for the patients with HbA1c ≥7.0% compared to those with HbA1c concentration < 7.0%. Furthermore, we found the mean of HbA1c was higher in the diabetes mellitus with tuberculosis group than the diabetes-only group (P = 0.002). In the sensitivity analysis, the finding remains consistent.
Our study provides the evidence that poorly controlled diabetes in diabetics may be associated with increased prevalence of tuberculosis. More efforts should focus on screening tuberculosis in uncontrolled diabetes.
糖尿病是结核病的一个已知危险因素，血糖控制不佳可能会增加结核病的风险。我们进行了一项荟萃分析，以探讨糖尿病患者的血糖控制与结核病患病率之间的关系。
我们纳入了研究血糖控制与结核病患病率之间关联的观察性研究。糖化血红蛋白（HbA1c）和空腹血浆葡萄糖标志物用于评估研究中的暴露因素。我们通过 14 年 12 月 14 日在 PubMed、EMBASE 和 Web of Science 中搜索相关文章。使用纽卡斯尔-渥太华量表评估纳入研究的偏倚风险。
共纳入 17 项研究（4 项队列研究、5 项病例对照研究和 8 项横断面研究），涉及 1027074 名参与者。荟萃分析发现，与 HbA1c 浓度<7.0%的患者相比，HbA1c≥7.0%的患者中结核病的患病率增加了 2.05 倍（95%CI：1.65，2.55）。此外，我们发现合并结核病的糖尿病患者的 HbA1c 平均值高于单纯糖尿病患者（P=0.002）。敏感性分析的结果仍然一致。
本研究提供的证据表明，糖尿病患者血糖控制不佳可能与结核病患病率增加有关。应更加重视对未控制的糖尿病患者进行结核病筛查。
