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The risk factors for tuberculosis patients with diabetes mellitus living in Western China: a retrospective study conducted from 2014 to 2018

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

To study risk factors for tuberculosis (TB) patients with diabetes mellitus (DM) living in Western China and analyze the baseline characteristics and clinical data of those patients for developing an effective screening strategy.

Methods

We enrolled 3548 TB patients who were admitted to our hospital from 2014 to 2018. The baseline characteristics and clinical data of TB patients with and without DM were compared. Besides, risk factors were presented, and their effects on TB patients with and without DM were analyzed.

Results

The prevalence of DM among TB patients was 7.7%, which increased with elevation of the patients’ age, and 63.1% of TB patients with DM had hemoglobin A1c (HbA1c) ≥ 7.0%. The prevalence of DM in the Han patients with TB was the highest (8.8%), which was roughly three times higher than that in the Tibetan patients with TB (3.0%). In the multivariate logistic regression analysis, elevated values of the patients’ age (odds ratio (OR), 1.047 (1.033–1.062, p < 0.01), blood pressure (OR, 1.735 (1.101–2.734), p = 0.04), proportion of cavity in pulmonary TB (PTB) (OR, 2.167 (1.272–3.656), p = 0.004), fasting blood glucose (OR, 2.248 (1.997–2.555), p < 0.001), erythrocyte sedimentation rate (ESR) (OR, 1.007 (1.001–1.012), p = 0.027), and proportion of patients with PTB (OR, 2.426 (1.425–4.104), p < 0.001) were significantly associated with increased prevalence of DM in TB patients. For evaluation of the model, the receiver operating characteristic (ROC) curve was plotted, in which the area under the curve (AUC) value of 0.924 was obtained for an optimal cutoff value of 0.052. The re-sampling method was utilized to verify the regression model, and the mean squared error (MSE) was 0.00026.

Conclusions

The prevalence of DM in TB patients is high and is associated with severe clinical symptoms. Therefore, early screening of DM for TB patients is highly recommended.

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Acknowledgment

We highly appreciate participation of all subjects in this study and assistance of clinicians who contributed to blood sampling and data collection.

Funding

This study was financially supported by the National Natural Science Foundation of China (Grant Nos. 81902142, 81672095, and 81501800).

Author information

Author notes

  1. He He and Mei Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China

    He He, Mei Zhang, Xingbo Song, Zhenzhen Zhao, Li Xiong, Hao Bai & Binwu Ying

Authors
  1. He He
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  2. Mei Zhang
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  3. Xingbo Song
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  4. Zhenzhen Zhao
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  7. Binwu Ying
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Corresponding author

Correspondence to Binwu Ying.

Ethics declarations

The study received approval from the Ethics Committee of West China Hospital, Sichuan University (Approval No. 198 (2014)).

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The authors declare that there are no conflicts of interest.

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Electronic supplementary material

Fig. S1a

Lifestyle and TB-related clinical symptoms of the different ethnics. a. The percentage of patients with smoking history was around 30%; the lowest rate was 16.5% for is Tibetan patients. b. The percentage of patients with alcohol intake was about 20%; c. Except for the Han patients, the percentage of rural residents in minority ethnic groups was higher than that of urban dwellers; d. & g. The percentages of cough and anorexia were the highest in the Tibetan patients; e. The Tibetan patients had the highest proportion of weight loss; f. The Yi patients had the highest proportion of night sweats; h. The proportion of the Han patients with fever was the highest and that of Qiang patients was the lowest. (PNG 206 kb)

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Fig. S1b

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ESM 1

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He, H., Zhang, M., Song, X. et al. The risk factors for tuberculosis patients with diabetes mellitus living in Western China: a retrospective study conducted from 2014 to 2018. Int J Diabetes Dev Ctries 40, 538–546 (2020). https://doi.org/10.1007/s13410-020-00834-3

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  • DOI: https://doi.org/10.1007/s13410-020-00834-3

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