Prevalence and Risk Factors of Diabetes in Patients with Active Pulmonary Tuberculosis: A Cross-Sectional Study in Two Financially Affluent China Cities

Jing Li; Yanhong Zhao; Youli Jiang; Ying Zhang; Peize Zhang; Lingjun Shen; Zijiao Chen

doi:10.2147/DMSO.S450507

Prevalence and Risk Factors of Diabetes in Patients with Active Pulmonary Tuberculosis: A Cross-Sectional Study in Two Financially Affluent China Cities

Diabetes Metab Syndr Obes. 2024 Mar 2:17:1105-1114. doi: 10.2147/DMSO.S450507. eCollection 2024.

Authors

Jing Li^#¹, Yanhong Zhao^#², Youli Jiang³, Ying Zhang⁴, Peize Zhang¹, Lingjun Shen², Zijiao Chen¹

Affiliations

¹ Department of Pulmonary Medicine and Tuberculosis, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong, People's Republic of China.
² Department of Tuberculosis, the Third People's Hospital of Kunming, Kunming, Yunnan, People's Republic of China.
³ Department of Neurology, People's Hospital of Longhua, Shenzhen, 518109, People's Republic of China.
⁴ Department of Endocrinology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong, People's Republic of China.

^# Contributed equally.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: alcohol consumption; diabetes; diabetes awareness; risk factors; tuberculosis; waist-to-hip ratio.

Grants and funding

This work was supported by the Shenzhen Science and Technology Plan Project (No. JCYJ20210324132012035), Technology Project of Guangdong Province (No.2020B1111170014) and Technology Project of Health commission of Kunming Municipality (No. 2023-03-02-019, No. 2023-03-08-012). All these fund are from government for tuberculosis treatment and control.