Objectives: The public health system faces major challenges due to the double burden of diabetes mellitus (DM) and tuberculosis (TB) in China. We aimed to investigate the prevalence and impact of diabetes on patients with TB.
Methods: Stratified cluster sampling was used to select 13 counties as study sites in the Zhejiang province. Patients who visited designated TB hospitals in these areas participated in this study between 1 January 2017 and 28 February 2019. Multiple logistic regression models were performed to investigate the association between DM and bacteriological and imaging results. A decision tree was used to predict the bacteriology and imaging results under the influence of DM.
Results: Of 5920 patients with newly diagnosed pulmonary tuberculosis, 643 (12.16%) had DM. Patients with pulmonary TB and DM were more likely to have pulmonary cavities (adjusted odds ratio [aOR], 2.81; 95% confidence intervals [95% CI]: 2.35-3.37) and higher rates of positive bacteriological tests (aOR, 2.32; 95% CI:1.87-2.87). Decision-tree analysis showed similar results.
Conclusions: Concurrence of DM and pulmonary TB makes patients more likely to have positive bacteriological results and pulmonary cavities. Therefore, appropriate measures are necessary to promptly identify and manage patients with TB and DM.
目的:由于糖尿病(DM)和肺结核(TB)在中国的双重负担, 公共卫生系统面临着重大挑战。我们旨在调查糖尿病患者中肺结核的患病率和影响。 方法:在浙江省选择了13个县作为研究地点, 采用分层集群抽样的方法。在这些地区指定的肺结核医院就诊的患者参与了这项研究, 研究时间为2017年1月1日至2019年2月28日。进行多项逻辑回归模型研究DM与细菌学和影像学结果之间的关联性。使用决策树预测在DM影响下的细菌学和影像学结果。 结果:在5920例新诊断的肺结核患者中, 有643例(12.16%)患有DM。同时患有肺结核和DM的患者更可能出现肺空洞(调整后的比值比[aOR]为2.81；95%置信区间[95% CI]为2.35-3.37), 并且细菌学检测阳性率更高(aOR为2.32；95% CI为1.87-2.87)。决策树分析显示出类似结果。 结论:同时患有肺结核和DM的患者更容易出现细菌学检测结果阳性和肺空洞。有必要采取适当措施及时识别和管理同时患有TB和DM的患者。.
Keywords: comorbidity; decision trees; diabetes mellitus; pulmonary; tuberculosis; 共病; 决策树; 糖尿病; 肺结核.
© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.