Girishbhai Patel Divya, Baral Tejaswini, Jacob Kurian Shilia, Malakapogu Pravachana, Saravu Kavitha, Sekhar Miraj Sonal
Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
J Clin Tuberc Other Mycobact Dis. 2024 Mar 12;35:100428. doi: 10.1016/j.jctube.2024.100428. eCollection 2024 May.
India has been estimated to have 14 % of malnourished population and a high TB incidence burden with a 26.9 lakh cases. Malnutrition and diabetes mellitus are major risk factors for tuberculosis infection. Malnutrition in patients with both tuberculosis and diabetes (TB-DM) population worsens the disease severity, treatment outcomes and increases morbidity and mortality risk.
To assess the nutritional status in patients with TB-DM compared with patients with TB and DM alone.
Records from January 2016 to November 2020 for patients admitted to Kasturba Hospital, Manipal were assessed. Data pertaining to glycemic parameters, nutritional parameters, and other relevant laboratory parameters were extracted for assessment. The study population were divided into three groups i.e. patients with TB-DM, TB and DM. The statistical association was carried out with one-way ANOVA method, considering p < 0.05 as statistically significant.
A total of 291 patients were included, with 97 patients in each group; among those, male and female were 86.27 % and 13.73 % respectively. Cardiovascular co-morbidity was predominant in the DM (68.04 %) and TB-DM (26.8 %) group. The mean value of HbA1c (10.47 %) was found to be highest for the TB-DM group. Low levels of albumin were reported by 71.91 % of patients of the TB group, whereas 73.68 % patients in TB-DM group had vitamin D deficiency. Moreover, higher prevalence of low MCV and MCH in the TB-DM group suggest an increased risk of iron-deficiency anemia.
The findings of our study reflect the need for implementation of nutritional support in patients with TB-DM.
据估计，印度有14%的人口营养不良，结核病发病负担较高，病例达269万例。营养不良和糖尿病是结核病感染的主要危险因素。结核病合并糖尿病（TB-DM）患者的营养不良会加重疾病严重程度、影响治疗效果，并增加发病和死亡风险。
评估TB-DM患者与单纯结核病患者及糖尿病患者相比的营养状况。
评估了2016年1月至2020年11月在马尼帕尔卡斯图尔巴医院住院患者的记录。提取了血糖参数、营养参数和其他相关实验室参数的数据进行评估。研究人群分为三组，即TB-DM患者、结核病患者和糖尿病患者。采用单因素方差分析方法进行统计关联分析，将p < 0.05视为具有统计学意义。
共纳入291例患者，每组97例；其中男性和女性分别占86.27%和13.73%。糖尿病组（68.04%）和TB-DM组（26.8%）中心血管合并症最为常见。TB-DM组的糖化血红蛋白平均值（10.47%）最高。结核病组71.91%的患者白蛋白水平较低，而TB-DM组73.68%的患者维生素D缺乏。此外，TB-DM组低平均红细胞体积和低平均红细胞血红蛋白的患病率较高，提示缺铁性贫血风险增加。
我们的研究结果表明，TB-DM患者需要实施营养支持。
