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

摘要

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.