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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/m2 (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.
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Details
1 Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China (GRID:grid.430328.e)
2 Division of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China (GRID:grid.430328.e)
3 Division of Public Health Informatics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China (GRID:grid.430328.e)
4 Department of Endocrinology and Metabolism, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (GRID:grid.16821.3c) (ISNI:0000 0004 0368 8293)
5 School of Public Health, Shanghai Medical College, Fudan University, Shanghai, China (GRID:grid.11841.3d) (ISNI:0000 0004 0619 8943)
6 Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China (GRID:grid.430328.e); National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China (GRID:grid.430328.e)
7 Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China (GRID:grid.430328.e); Shanghai Medical College, Fudan University, Shanghai, China (GRID:grid.11841.3d) (ISNI:0000 0004 0619 8943)