title: Prevalence of type 2 diabetes among newly detected pulmonary tuberculosis patients in China: a community based cohort study.
abstract: BACKGROUND
  Patients with type 2 diabetes (DM) have a higher risk of developing pulmonary tuberculosis (PTB); moreover, DM co-morbidity in PTB is associated with poor PTB treatment outcomes. Community based prevalence data on DM and prediabetes (pre-DM) among TB patients is lacking, particularly from the developing world. Therefore we conducted a prospective study to investigate the prevalence of DM and pre-DM and evaluated the risk factors for the presence of DM among newly detected PTB patients in rural areas of China.
  
  
  RESULTS
  In a prospective community based study carried out from 2010 to 2012, a representative sample of 6382 newly detected PTB patients from 7 TB clinics in Linyi were tested for DM. A population of 6674 non-TB controls from the same community was similarly tested as well. The prevalence of DM in TB patients (6.3%) was higher than that in non-TB controls (4.7%, p<0.05). PTB patients had a higher odds of DM than non-TB controls (adjusted OR 3.17, 95% CI 1.14-8.84). The prevalence of DM increased with age and was significantly higher in TB patients in the age categories above 30 years (p<0.05). Among TB patients, those with normal weight (BMI 18.5-23.9) had the lowest prevalence of DM (5.8%). Increasing age, family history of DM, positive sputum smear, cavity on chest X-ray and higher yearly income (≥10000 RMB yuan) were positively associated and frequent outdoor activity was negatively associated with DM in PTB patients.
  
  
  CONCLUSIONS
  The prevalence of DM in PTB patients was higher than in non-TB controls with a 3 fold higher adjusted odds ratio of having DM. Given the increasing DM prevalence and still high burden of TB in China, this association may represent a new public health challenge concerning the prevention and treatment of both diseases.
authors.affiliation: Nutrition Institute, Qingdao University, Qingdao, China.
authors.forename: Qiuzhen
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Nutrition Institute, Qingdao University, Qingdao, China.
authors.forename: Aiguo
authors.initials: A
authors.lastname: Ma
authors.affiliation: Nutrition Institute, Qingdao University, Qingdao, China.
authors.forename: Xiuxia
authors.initials: X
authors.lastname: Han
authors.affiliation: Linyi Chest Hospital, Linyi, China.
authors.forename: Shanliang
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Nutrition Institute, Qingdao University, Qingdao, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Cai
authors.affiliation: Linyi Chest Hospital, Linyi, China.
authors.forename: Yunbo
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Yishui Tuberculosis Clinic, Linyi, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Tancheng Tuberculosis Clinic, Linyi, China.
authors.forename: Yuwen
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Yinan Tuberculosis Clinic, Linyi, China.
authors.forename: Huaifeng
authors.initials: H
authors.lastname: Dong
authors.affiliation: Lanshan Tuberculosis Clinic, Linyi, China.
authors.forename: Zhenlei
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Feixian Tuberculosis Clinic, Linyi, China.
authors.forename: Lai
authors.initials: L
authors.lastname: Wei
authors.affiliation: Pingyi Tuberculosis Clinic, Linyi, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Yu
authors.affiliation: Cangshan Tuberculosis Clinic, Linyi, China.
authors.forename: Peixue
authors.initials: P
authors.lastname: Chen
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Evert G
authors.initials: EG
authors.lastname: Schouten
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Kok
authors.affiliation: World Diabetes Foundation, Gentofte, Denmark.
authors.forename: Anil
authors.initials: A
authors.lastname: Kapur
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*