Effect of complicated, untreated and uncontrolled diabetes and pre-diabetes on treatment outcome among patients with pulmonary tuberculosis.

IF 6.6 2区医学 Q1 RESPIRATORY SYSTEM

Respirology Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI:10.1111/resp.14714

Kyung Hoon Kim, Hyung Woo Kim, Yong Hyun Kim, Yeonhee Park, Sung Soo Jung, Jin Woo Kim, Jee Youn Oh, Heayon Lee, Sung Kyoung Kim, Sun-Hyung Kim, Jiwon Lyu, Yousang Ko, Sun Jung Kwon, Yun-Jeong Jeong, Do Jin Kim, Hyeon-Kyoung Koo, Yangjin Jegal, Sun Young Kyung, Sung Soon Lee, Jae Seuk Park, Ju Sang Kim, Jinsoo Min

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引用次数: 0

Abstract

Background and objective: Patients with tuberculosis and diabetes have a higher risk of unfavourable anti-tuberculosis treatment outcomes. In the present study, we aimed to evaluate the effects of various diabetes statuses on the outcomes of patients with pulmonary tuberculosis.

Methods: Among the patients with pulmonary tuberculosis enrolled in the Korea Tuberculosis Cohort (KTBC) registry and the multicentre prospective cohort study of pulmonary tuberculosis (COSMOTB), those with diabetes and complicated diabetes were identified. The primary and secondary outcomes were unfavourable outcomes and mortality, respectively. The effect of diabetes and complicated diabetes on the outcomes was assessed using multivariable logistic regression analysis. Using COSMOTB, subgroup analyses were performed to assess the association between various diabetes statuses and outcomes.

Results: In the KTBC, diabetes (adjusted odds ratio [aOR] = 1.93, 95% CI = 1.64-2.26) and complicated diabetes (aOR = 1.96, 95% CI = 1.67-2.30) were significantly associated with unfavourable outcomes, consistent with the COSMOTB data analysis. Based on subgroup analysis, untreated diabetes at baseline was an independent risk factor for unfavourable outcomes (aOR = 2.72, 95% CI = 1.26-5.61). Prediabetes and uncontrolled diabetes increased unfavourable outcomes and mortality without statistical significance.

Conclusion: Untreated and complicated diabetes at the time of tuberculosis diagnosis increases the risk of unfavourable outcomes and mortality.

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复杂、未治疗和未控制的糖尿病及糖尿病前期对肺结核患者治疗效果的影响。

背景和目的：肺结核合并糖尿病的患者抗结核治疗效果不佳的风险较高。本研究旨在评估各种糖尿病状态对肺结核患者治疗结果的影响：在韩国肺结核队列（KTBC）登记处和肺结核多中心前瞻性队列研究（COSMOTB）中登记的肺结核患者中，确定了糖尿病患者和复杂性糖尿病患者。主要和次要结果分别为不利结果和死亡率。采用多变量逻辑回归分析评估了糖尿病和复杂性糖尿病对结果的影响。利用 COSMOTB 进行了亚组分析，以评估各种糖尿病状态与结果之间的关联：在 KTBC 中，糖尿病（调整后比值比 [aOR] = 1.93，95% CI = 1.64-2.26）和并发糖尿病（aOR = 1.96，95% CI = 1.67-2.30）与不良预后显著相关，这与 COSMOTB 数据分析结果一致。根据亚组分析，基线时未经治疗的糖尿病是不利预后的独立风险因素（aOR = 2.72，95% CI = 1.26-5.61）。糖尿病前期和未控制的糖尿病会增加不良预后和死亡率，但无统计学意义：结论：肺结核确诊时未治疗的糖尿病和并发症会增加不良预后和死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respirology 医学-呼吸系统

CiteScore

10.60

自引率

5.80%

发文量

225

审稿时长

1 months

期刊介绍： Respirology is a journal of international standing, publishing peer-reviewed articles of scientific excellence in clinical and clinically-relevant experimental respiratory biology and disease. Fields of research include immunology, intensive and critical care, epidemiology, cell and molecular biology, pathology, pharmacology, physiology, paediatric respiratory medicine, clinical trials, interventional pulmonology and thoracic surgery. The Journal aims to encourage the international exchange of results and publishes papers in the following categories: Original Articles, Editorials, Reviews, and Correspondences. Respirology is the preferred journal of the Thoracic Society of Australia and New Zealand, has been adopted as the preferred English journal of the Japanese Respiratory Society and the Taiwan Society of Pulmonary and Critical Care Medicine and is an official journal of the World Association for Bronchology and Interventional Pulmonology.