Incidence of Pulmonary Tuberculosis in Chinese Adults with Type 2 Diabetes: a Retrospective Cohort Study in Shanghai

Overview

Journal Sci Rep

Specialty Science

Date 2020 May 24

PMID 32444672

Citations 6

Authors

Yanyun Li

Juntao Guo

Tian Xia

Fei Wu

Jingyan Tian

Minna Cheng

Wanghong Xu

Qinping Yang

Jing Chen

Zheyuan Wu

Qinghua Yan

Yan Shi

Fan Wu

Affiliations

Soon will be listed here.

Abstract

To estimate the incidence of pulmonary tuberculosis (PTB) in Chinese diabetes patients and to evaluate the effect of blood glucose on PTB risk, a retrospective cohort study was built based on the diabetes management system in Shanghai and included 240,692 adults aged 35 or above. Incidences of PTB in all diabetes patients and by subgroups were calculated and compared. Multivariable Cox regression models with restricted cubic splines were used to evaluate the association of fasting plasma glucose (FPG) with the risk of PTB. A total of 439 incident PTB cases were identified in the cohort after an average of 3.83 years of follow-up. The overall PTB incidence rate was 51.3/100,000 in diabetes patients, and annual incidence remained higher than that in general population. The PTB incidence rate of diabetes patients was higher in men than in women (86.2 vs. 22.1 per 100,000) and was highest in patients with body mass index (BMI) < 18.5 kg/m (215.2/100,000) or FPG ≥ 10 mmol/L (143.2/100,000). Our results suggest that the risk of tuberculosis may be greater at higher levels of FPG in diabetes patients of normal weight. Specific tuberculosis screening strategies for different characteristic diabetes population should be provided to prevent and control tuberculosis in China.

Citing Articles

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References

Marks S . Diabetes and tuberculosis, US National Health Interview Survey, 2000-2005. Int J Tuberc Lung Dis. 2011; 15(7):982-4. PMC: 5451099. DOI: 10.5588/ijtld.10.0637. View

Baker M, Lin H, Chang H, Murray M . The risk of tuberculosis disease among persons with diabetes mellitus: a prospective cohort study. Clin Infect Dis. 2012; 54(6):818-25. DOI: 10.1093/cid/cir939. View

Delgado-Sanchez G, Garcia-Garcia L, Castellanos-Joya M, Cruz-Hervert P, Ferreyra-Reyes L, Ferreira-Guerrero E . Association of Pulmonary Tuberculosis and Diabetes in Mexico: Analysis of the National Tuberculosis Registry 2000-2012. PLoS One. 2015; 10(6):e0129312. PMC: 4468212. DOI: 10.1371/journal.pone.0129312. View

Hongguang C, Min L, Shiwen J, Fanghui G, Shaoping H, Tiejie G . Impact of diabetes on clinical presentation and treatment outcome of pulmonary tuberculosis in Beijing. Epidemiol Infect. 2014; 143(1):150-6. PMC: 9206788. DOI: 10.1017/S095026881400079X. View

Jimenez-Corona M, Cruz-Hervert L, Garcia-Garcia L, Ferreyra-Reyes L, Delgado-Sanchez G, Bobadilla-Del-Valle M . Association of diabetes and tuberculosis: impact on treatment and post-treatment outcomes. Thorax. 2012; 68(3):214-20. PMC: 3585483. DOI: 10.1136/thoraxjnl-2012-201756. View

Lonnroth K, Roglic G, Harries A . Improving tuberculosis prevention and care through addressing the global diabetes epidemic: from evidence to policy and practice. Lancet Diabetes Endocrinol. 2014; 2(9):730-9. DOI: 10.1016/S2213-8587(14)70109-3. View

Al-Rifai R, Pearson F, Critchley J, Abu-Raddad L . Association between diabetes mellitus and active tuberculosis: A systematic review and meta-analysis. PLoS One. 2017; 12(11):e0187967. PMC: 5697825. DOI: 10.1371/journal.pone.0187967. View

Lin Y, Innes A, Xu L, Li L, Chen J, Hou J . Screening of patients with diabetes mellitus for tuberculosis in community health settings in China. Trop Med Int Health. 2015; 20(8):1073-80. DOI: 10.1111/tmi.12519. View

Niazi A, Kalra S . Diabetes and tuberculosis: a review of the role of optimal glycemic control. J Diabetes Metab Disord. 2013; 11(1):28. PMC: 3598170. DOI: 10.1186/2251-6581-11-28. View

10.

Alisjahbana B, Sahiratmadja E, Nelwan E, Purwa A, Ahmad Y, Ottenhoff T . The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis. 2007; 45(4):428-35. DOI: 10.1086/519841. View

11.

Dooley K, Chaisson R . Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis. 2009; 9(12):737-46. PMC: 2945809. DOI: 10.1016/S1473-3099(09)70282-8. View

12.

Pealing L, Wing K, Mathur R, Prieto-Merino D, Smeeth L, Moore D . Risk of tuberculosis in patients with diabetes: population based cohort study using the UK Clinical Practice Research Datalink. BMC Med. 2015; 13:135. PMC: 4470065. DOI: 10.1186/s12916-015-0381-9. View

13.

Leegaard A, Riis A, Kornum J, Prahl J, Thomsen V, Sorensen H . Diabetes, glycemic control, and risk of tuberculosis: a population-based case-control study. Diabetes Care. 2011; 34(12):2530-5. PMC: 3220855. DOI: 10.2337/dc11-0902. View

14.

Lee P, Fu H, Lai T, Chiang C, Chan C, Lin H . Glycemic Control and the Risk of Tuberculosis: A Cohort Study. PLoS Med. 2016; 13(8):e1002072. PMC: 4978445. DOI: 10.1371/journal.pmed.1002072. View

15.

Li X, Lu J, Hu S, Cheng K, De Maeseneer J, Meng Q . The primary health-care system in China. Lancet. 2017; 390(10112):2584-2594. DOI: 10.1016/S0140-6736(17)33109-4. View

16.

Lonnroth K, Williams B, Cegielski P, Dye C . A consistent log-linear relationship between tuberculosis incidence and body mass index. Int J Epidemiol. 2009; 39(1):149-55. DOI: 10.1093/ije/dyp308. View

17.

Desquilbet L, Mariotti F . Dose-response analyses using restricted cubic spline functions in public health research. Stat Med. 2010; 29(9):1037-57. DOI: 10.1002/sim.3841. View

18.

Martinez L, Zhu L, Castellanos M, Liu Q, Chen C, Hallowell B . Glycemic Control and the Prevalence of Tuberculosis Infection: A Population-based Observational Study. Clin Infect Dis. 2017; 65(12):2060-2068. PMC: 5848314. DOI: 10.1093/cid/cix632. View

19.

Rahim Z, Banu Momi M, Saha S, Zaman K, Uddin K, Jamil S . Pulmonary tuberculosis in patients with diabetes mellitus in Bangladesh. Int J Tuberc Lung Dis. 2012; 16(8):1132-3. DOI: 10.5588/ijtld.11.0846. View

20.

Young F, Wotton C, Critchley J, Unwin N, Goldacre M . Increased risk of tuberculosis disease in people with diabetes mellitus: record-linkage study in a UK population. J Epidemiol Community Health. 2010; 66(6):519-23. DOI: 10.1136/jech.2010.114595. View