Pablos-Méndez A, Blustein J, Knirsch C A
Division of General Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Am J Public Health. 1997 Apr;87(4):574-9. doi: 10.2105/ajph.87.4.574.
This research studied the relative contribution of diabetes mellitus to the increased prevalence of tuberculosis in Hispanics.
A case-control study was conducted involving all 5290 discharges from civilian hospitals in California during 1991 who had a diagnosis of tuberculosis, and 37,366 control subjects who had a primary discharge diagnosis of deep venous thrombosis, pulmonary embolism, or acute appendicitis. Risk of tuberculosis was estimated as the odds ratio (OR) across race/ethnicity, with adjustment for other factors.
Diabetes mellitus was found to be an independent risk factor for tuberculosis. The association of diabetes and tuberculosis was higher among Hispanics (adjusted OR [ORadj] = 2.95: 95% confidence interval [CI] = 2.61, 3.33) than among non-Hispanic Whites (ORadj = 1.31: 95% CI = 1.19. 1.45): among non-Hispanic Blacks, diabetes was not found to be associated with tuberculosis (ORadj = 0.93: 95% CI = 0.78, 1.09). Among Hispanics aged 25 to 54, the estimated risk of tuberculosis attributable to diabetes (25.2%) was equivalent to that attributable to HIV infection (25.5%).
Diabetes mellitus remains a significant risk factor for tuberculosis in the United States. The association is especially notable in middle-aged Hispanics.
本研究探讨糖尿病对西班牙裔人群结核病患病率上升的相对影响。
开展一项病例对照研究，纳入1991年加利福尼亚州所有5290例诊断为结核病的公立医院出院患者，以及37366例主要出院诊断为深静脉血栓形成、肺栓塞或急性阑尾炎的对照对象。通过种族/族裔计算结核病风险比（OR），并对其他因素进行调整。
糖尿病被发现是结核病的独立危险因素。西班牙裔人群中糖尿病与结核病的关联程度高于非西班牙裔白人（校正OR[ORadj]=2.95；95%置信区间[CI]=2.61，3.33），而在非西班牙裔黑人中未发现糖尿病与结核病有关联（ORadj=0.93；95%CI=0.78，1.09）。在25至54岁的西班牙裔人群中，糖尿病导致的结核病估计风险（25.2%）与HIV感染导致的风险（25.5%）相当。
在美国，糖尿病仍然是结核病的重要危险因素。这种关联在中年西班牙裔人群中尤为显著。
