The prevalence of diabetes mellitus among the patients with tuberculosis in Qom, Iran, during 2004-2016
DOI:
https://doi.org/10.22122/cdj.v8i2.494Keywords:
Tuberculosis, Risk Factors, Diabetes MellitusAbstract
BACKGROUND: Several studies have indicated the increasing risk of active tuberculosis (TB) due to diabetes mellitus (DM). The increasing prevalence of DM in areas with endemic TB may adversely influence spreading of TB. The current study is undertaken aiming to assess the prevalence of DM in patients with pulmonary TB.
METHODS: This case control study was conducted on 522 participants during a period of 12 years from
2004-2016 in Qom city, central Iran. The control group was symptomatic respiratory patients without preceding history of active pulmonary TB in the same clinic (n = 261). The case and control groups were compared using the Chi-square test. In addition, adjusted odds ratios (OR) and 95% confidence interval for comparison of the DM prevalence among patients with TB across different groups were calculated by multivariate logistic regression.
RESULTS: Mean age of the case and control patients were 51.0 ± 20.5 and 54.0 ± 14.9 years, respectively and 40.4% of all participants were males. The prevalence of DM was higher in patients with TB compared to the control patients and the rate was found to be 26.5% with adjusted OR of 3.54. The DM prevalence was significantly associated with TB in patients with older age (P < 0.001).
CONCLUSION: The prevalence of DM is significantly higher among patients with TB compared to the general population. Moreover, the mean age of patients with TB with DM is significantly higher than expected in patients with TB without DM.
References
World Health Organization. Global tuberculosis report 2019 [Online]. [cited 2019]; Available from: URL; https://www.who.int/tb/global-report-2019
Sadegh Tabrizi J, Fallah Rostami F, Ahmadi Seyed S, Dolatabad S. Socio-demographic factors affecting the prevalence of tuberculosis in Iran. Crescent J Med Biol Sci 2014; 1(3): 80-4.
International Diabets Federation. IDF diabetes atlas. Brussels, Belgium: IDF; 2019.
Esteghamati A, Etemad K, Koohpayehzadeh J, Abbasi M, Meysamie A, Noshad S, et al. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005-2011. Diabetes Res Clin Pract 2014; 103(2): 319-27.
World Health Organization. Collaborative framework for care and control of tuberculosis and diabetes. Geneva, Switzerland: WHO; 2011.
Pan SC, Ku CC, Kao D, Ezzati M, Fang CT, Lin HH. Effect of diabetes on tuberculosis control in 13 countries with high tuberculosis: A modelling study. Lancet Diabetes Endocrinol 2015; 3(5): 323-30.
Restrepo BI. Diabetes and tuberculosis. Microbiol Spectr 2016; 4(6).
Critchley JA, Restrepo BI, Ronacher K, Kapur A, Bremer AA, Schlesinger LS, et al. Defining a research agenda to address the converging epidemics of tuberculosis and diabetes: Part 1: epidemiology and clinical management. Chest 2017; 152(1): 165-73.
World Health Organization. Treatment of tuberculosis: Guidelines. Geneva, Switzerland: WHO; 2010.
Classification and Diagnosis of Diabetes: Standards of medical care in diabetes-2018. Diabetes Care 2018; 41(Suppl 1): S13-S27.
Alebel A, Wondemagegn AT, Tesema C, Kibret GD, Wagnew F, Petrucka P, et al. Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: A systematic review and meta-analysis of observational studies. BMC Infect Dis 2019; 19(1): 254.
Tenaye L, Mengiste B, Baraki N, Mulu E. Diabetes mellitus among adult tuberculosis patients attending tuberculosis clinics in Eastern Ethiopia. Biomed Res Int 2019; 2019: 7640836.
Bukhary ZA. Rediscovering the association between tuberculosis and diabetes mellitus: A perspective. J Taibah Univ Med Sci 2008; 3(1): 1-6.
Yorke E, Atiase Y, Akpalu J, Sarfo-Kantanka O, Boima V, Dey ID. The bidirectional relationship between tuberculosis and diabetes. Tuberc Res Treat 2017; 2017: 1702578.
Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: Convergence of two epidemics. Lancet Infect Dis 2009; 9(12): 737-46.
Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med 2008; 5(7): e152.
Ruslami R, Aarnoutse RE, Alisjahbana B, van der Ven AJ, van CR. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop Med Int Health 2010; 15(11): 1289-99.
Alisjahbana B, Sahiratmadja E, Nelwan EJ, Purwa AM, Ahmad Y, Ottenhoff TH, et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis 2007; 45(4): 428-35.
Restrepo BI, Fisher-Hoch SP, Crespo JG, Whitney E, Perez A, Smith B, et al. Type 2 diabetes and tuberculosis in a dynamic bi-national border population. Epidemiol Infect 2007; 135(3): 483-91.
Chang JT, Dou HY, Yen CL, Wu YH, Huang RM, Lin HJ, et al. Effect of type 2 diabetes mellitus on the clinical severity and treatment outcome in patients with pulmonary tuberculosis: A potential role in the emergence of multidrug-resistance. J Formos Med Assoc 2011; 110(6): 372-81.
Kumar NP, Babu S. Influence of diabetes mellitus on immunity to human tuberculosis. Immunology 2017; 152(1): 13-24.
Ayelign B, Negash M, Genetu M, Wondmagegn T, Shibabaw T. Immunological impacts of diabetes on
the susceptibility of mycobacterium tuberculosis. J Immunol Res 2019; 2019: 6196532.
Martens GW, Arikan MC, Lee J, Ren F, Greiner D, Kornfeld H. Tuberculosis susceptibility of diabetic mice. Am J Respir Cell Mol Biol 2007; 37(5): 518-24.
Wang X, Ma A, Han X, Chan L, Liang H, Litifu A, et al. T cell profile was altered in pulmonary tuberculosis patients with type 2 diabetes. Med Sci Monit 2018; 24: 636-42.
