Prevalence and risk factors of diabetes mellitus among retreatment pulmonary tuberculosis patients
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摘要:
目的 探讨复治肺结核合并糖尿病患者的影响因素,为制定肺结核合并糖尿病防治政策提供相关依据。 方法 2009年10月 — 2012年12月选择我国22家结核病定点医疗机构确诊并进行治疗的复治肺结核患者395例进行调查,按照是否合并糖尿病分为单纯复治肺结核组及合并糖尿病组,运用χ2检验比较两组患者在社会学特征等方面的差异,运用多因素非条件logistic回归分析肺结核合并糖尿病的危险因素。 结果 共纳入395例患者,其中合并糖尿病60例,占15.2 %;单纯肺结核患者335例,占84.8 %。两组患者在年龄(χ2 = 10.459,P = 0.005 3),体质指数(BMI)(χ2 = 15.070,P = 0.000 5),职业(χ2 = 11.620,P = 0.002 9),婚姻状况(χ2 = 9.999,P = 0.006 7)差异具有显著性。复治肺结核患者40~59岁年龄组和 ≥ 60岁年龄组,BMI < 18.5(kg/m2)及BMI ≥ 24.0(kg/m2),已婚是复治肺结核合并糖尿病的危险因素,OR(95 % CI)值分别为2.159(1.050~4.439),5.017(1.485~16.951)、4.946(1.279~8.705)、5.732(1.918~17.133)及4.476(1.248~10.504)。 结论 复治肺结核合并糖尿病与患者的年龄、体重指数、婚姻状态有关。 Abstract:Objective To explore tuberculosis – diabetes mellitus (DM) comorbidity and its risk factors among retreat-ment pulmonary tuberculosis patients (PTB) and to provide references for prevention and treatment of PTB-DM comorbidity. Methods We recruited 395 retreatment PTB patients at 22 medical institutions designated for PTB treatment across China and divided the patients into a PTB and a PTB-DM group according to the comorbidity of DM; then we carried out a questionnaire survey among all the patients from October 2009 to December 2012. Chi-square test was used to compare differences in demographics and other characteristics between the patients of the two groups; multivariate logistic regression analysis was used to explore risk factors of DM comorbidity. Results Of all the patients, 15.2% (60) were PTB-DM and 84.8% (335) were simple PTB; there were significant differences between the two groups in age (χ2 = 10.459, P = 0.005 3), body mass index (BMI) (χ2 = 15.070, P = 0.000 5), occupation (χ2 = 11.620, P = 0.002 9) and marital status (χ2 = 9.999, P = 0.006 7). Aged 40 – 59 years (odds ratio [OR] = 2.159, 95% confidence interval [95% CI]: 1.050 – 4.439), aged 60 years and above (OR = 5.017, 95% CI: 1.485 – 16.951), with a BMI of < 18.5 kg/m2 (OR = 4.946, 95% CI: 1.279 – 8.705), with a BMI of ≥ 24 kg/m2 (OR = 5.732, 95% CI: 1.918 – 17.133), and being married (OR = 4.476, 95% CI: 1.248 – 10.504) were significant risk factors of PTB-DM comorbidity. Conclusion The complication of diabetes mellitus is associated with age, body mass index, and marital status among retreatment pulmonary tuberculosis patients. -
Key words:
- pulmonary tuberculosis /
- diabetes mellitus /
- risk factor
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表 1 单纯复治肺结核和复治肺结核合并糖尿病两组患者单因素分析
特征 合计 单纯肺结核组(n = 335) 肺结核并发糖尿病组(n = 60) χ2 值 P 值 n % n % n % 性别 2.112 0.146 3 男性 300 75.9 250 74.6 50 83.3 女性 95 24.1 85 25.4 10 16.7 年龄(岁) 10.459 0.005 3 18~39 167 42.3 153 45.6 14 23.3 40~59 191 48.3 152 45.4 39 65.0 ≥ 60 37 9.4 30 9.0 7 11.7 BMI(kg/m2) 15.07 0.000 5 < 18.5 106 26.9 101 30.1 5 8.3 18.5~ 245 62.0 202 60.3 43 71.7 ≥ 24.0 44 11.1 32 9.6 12 20.0 职业 11.620 0.002 9 农民及外来务工人员 200 50.6 179 53.5 21 35.0 企事业单位职工 69 17.5 50 14.9 19 31.7 其他 a 126 31.9 106 31.6 20 33.3 户籍 2.539 0.111 1 本地户籍人口 275 69.6 228 68.1 47 78.3 非本地户籍人口 120 30.4 107 31.9 13 21.7 婚姻 9.999 0.006 7 未婚 77 19.5 74 22.1 3 5.0 已婚 301 76.2 246 73.4 55 91.7 其他 b 17 4.3 15 4.5 2 3.3 吸烟 2.334 0.311 3 从来不 168 42.5 145 43.3 23 38.3 过去吸现在不吸 167 42.3 143 42.7 24 40.0 现在吸 60 15.2 47 14.0 13 21.7 饮酒 5.122 0.077 2 从来不 216 54.7 191 57.0 25 41.7 过去饮酒现在不 154 39.0 123 36.7 31 51.6 现在饮酒 25 6.3 21 6.3 4 6.7 注: a 交通运输业人员及商业服务人员等;b离异或丧偶。 表 2 肺结核合并糖尿病的logistic多因素回归分析
变量 对照组 β $ {S_{\bar x}}$ Wald χ2 值 P 值 OR 值 95 % CI 年龄(岁) 40~59 18~39 0.769 0.368 4.376 0.036 2.159 1.050~4.439 ≥ 60 1.613 0.621 6.74 0.009 5.017 1.485~16.951 BMI(kg/m2) < 18.5 18.5~< 24.0 2.073 0.637 8.578 0.005 4.946 1.279~8.705 ≥ 24.0 1.346 0.559 9.769 0.002 5.732 1.918~17.133 婚姻 已婚 未婚和其他 b 1.499 0.652 5.291 0.021 4.476 1.248~10.504 注:b 离异或丧偶。 -
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