Yorke Ernest, Boima Vincent, Dey Ida Dzifa, Amissah-Arthur Maame-Boatemaa, Ganu Vincent, Amaning-Kwarteng Ernest, Tetteh John, Charles Mate-Kole C
University of Ghana, Accra, Greater Accra, Ghana.
Korle-Bu Teaching Hospital, Accra, Greater Accra, Ghana.
Clin Med Insights Circ Respir Pulm Med. 2021 Sep 20;15:11795484211039830. doi: 10.1177/11795484211039830. eCollection 2021.
Apart from increasing the risk of tuberculosis (TB), diabetes may be associated with more severe disease and lower rates of sputum conversion among TB patients.
We conducted a baseline cross-sectional study with a longitudinal follow-up of newly diagnosed smear-positive TB patients for 6 months. Sputum conversion rates between those with dysglycemia and those without were compared at 2 months (end of the intensive phase) and 6 months (end of the treatment). Descriptive statistics and logistic regression were computed to assess factors associated with dysglycemia as well as sputum conversion.
A significantly higher proportion of normoglycemic patients had negative sputum compared with those with dysglycemia (83% vs 67%, -value < .05) at 2 months but not at 6 months (87% vs 77%, -value > .05). After controlling for age group and adjusting for other covariates, patients with dysglycemia were 66% less likely to convert sputum than those with normoglycemia. Females were at least 7 times more likely than males and those with high waist-to-hip ratio (WHR) of 88% were less likely compared with those with low WHR for sputum conversion at 2 months, respectively. At 6 months, females (compared with males) and those with high WHR (compared with those with normal WHR) were at over 9 times increased odds and 89% less likely for sputum conversion, respectively.
A significantly lower proportion of smear-positive TB patients with dysglycemia converted to smear negative after 2 months of treatment but not at the end of the treatment, thus suggesting a transient impact of dysglycemia on sputum conversion.
糖尿病除了会增加患结核病（TB）的风险外，还可能与结核病患者病情更严重以及痰菌转阴率较低有关。
我们对新诊断的涂片阳性结核病患者进行了一项基线横断面研究，并对其进行了为期6个月的纵向随访。比较了血糖异常患者和血糖正常患者在2个月（强化期结束时）和6个月（治疗结束时）的痰菌转阴率。计算描述性统计量和逻辑回归，以评估与血糖异常以及痰菌转阴相关的因素。
在2个月时，血糖正常的患者痰涂片阴性的比例显著高于血糖异常的患者（83%对67%，P值<0.05），但在6个月时并非如此（87%对77%，P值>0.05）。在控制年龄组并对其他协变量进行调整后，血糖异常的患者痰菌转阴的可能性比血糖正常的患者低66%。在2个月时，女性痰菌转阴的可能性至少是男性的7倍，腰围臀围比（WHR）为88%的患者与低WHR患者相比，痰菌转阴的可能性较小。在6个月时，女性（与男性相比）和高WHR患者（与正常WHR患者相比）痰菌转阴的几率分别增加了9倍多和降低了89%。
血糖异常涂片阳性的结核病患者在治疗2个月后痰涂片转阴的比例显著低于血糖正常者，但在治疗结束时并非如此，因此提示血糖异常对痰菌转阴有短暂影响。
