Li Jing, Zhao Yanhong, Jiang Youli, Zhang Ying, Zhang Peize, Shen Lingjun, Chen Zijiao
Department of Pulmonary Medicine and Tuberculosis, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong, People's Republic of China.
Department of Tuberculosis, the Third People's Hospital of Kunming, Kunming, Yunnan, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Mar 2;17:1105-1114. doi: 10.2147/DMSO.S450507. eCollection 2024.
Tuberculosis (TB) and diabetes mellitus (DM) present a dual burden to public health. The screening of DM in TB patients may aid in the early detection and management of diabetes, ultimately improving treatment outcomes for those with the comorbidity of TB-DM. We aim to examine the prevalence and identify risk factors of diabetes in individuals with active pulmonary tuberculosis (PTB) in financially affluent China cities.
A cross-sectional survey was conducted in adult patients with highly suspected TB in two cities of China, spanning from May 9, 2023, to June 30, 2023. We compare the clinical characteristics, nutrition status, fasting blood glucose (FBG) level, living style, and knowledge of TB and DM at admission between patients with and without DM. Univariate and multivariate logistic regression analyses were employed to identify risk factors associated with TB-DM comorbidities.
Of the 322 patients diagnosed with pulmonary tuberculosis (PTB), 54 individuals (16.8%) had comorbid diabetes mellitus (DM). This included 43 males (13.4%) and 11 females (3.4%). The average age was 55.44 ± 12.36 in DM patients and 46.09 ± 16.87 in non-DM patients. A multivariate logistic regression analysis revealed that male (adjusted odds ratio [aOR]=3.29, 95% confidence interval [CI]: 1.05-10.30), age older than 47 years (aOR = 1.04, 95% CI: 1.01-1.07), having a family history of diabetes (aOR = 5.09, 95% CI: 1.28-20.32), and an elevated random blood glucose level (aOR = 1.6, 95% CI: 1.38-1.86) were risk factors for DM in patients with PTB. Furthermore, it was found that diabetes awareness (aOR = 0.07, 95% CI: 0.03-0.21) and zero, light to moderate alcohol consumption were associated with a lower risk of diabetes.
Diabetes is prevalent in patients with active PTB. Screening and raising awareness of DM are recommended, particularly in men after middle age with a family history of diabetes and elevated random blood glucose. Early diagnosis of diabetes and effective diabetes prevention may reduce the dual burden of TB-DM comorbidity.
结核病（TB）和糖尿病（DM）给公共卫生带来双重负担。对结核病患者进行糖尿病筛查有助于早期发现和管理糖尿病，最终改善结核病-糖尿病合并症患者的治疗效果。我们旨在调查中国经济发达城市中活动性肺结核（PTB）患者的糖尿病患病率并确定其危险因素。
于2023年5月9日至2023年6月30日在中国两个城市对高度疑似结核病的成年患者进行了一项横断面调查。我们比较了有糖尿病和无糖尿病患者入院时的临床特征、营养状况、空腹血糖（FBG）水平、生活方式以及对结核病和糖尿病的认知情况。采用单因素和多因素逻辑回归分析来确定与结核病-糖尿病合并症相关的危险因素。
在322例诊断为肺结核（PTB）的患者中，54例（16.8%）患有糖尿病合并症。其中男性43例（13.4%），女性11例（3.4%）。糖尿病患者的平均年龄为55.44±12.36岁，非糖尿病患者为46.09±16.87岁。多因素逻辑回归分析显示，男性（调整后的优势比[aOR]=3.29，95%置信区间[CI]：1.05-10.30）、年龄大于47岁（aOR = 1.04，95% CI：1.01-1.07）、有糖尿病家族史（aOR = 5.09，95% CI：1.28-20.32）以及随机血糖水平升高（aOR = 1.6，95% CI：1.38-1.86）是PTB患者患糖尿病的危险因素。此外，发现糖尿病知晓率（aOR = 0.07，95% CI：0.03-0.21）以及零饮酒、轻度至中度饮酒与较低的糖尿病风险相关。
糖尿病在活动性PTB患者中很常见。建议进行糖尿病筛查并提高对糖尿病的认识，特别是在中年及以上有糖尿病家族史且随机血糖升高的男性中。早期诊断糖尿病并有效预防糖尿病可能会减轻结核病-糖尿病合并症的双重负担。
