Is resistance to anti-tuberculosis drugs associated with type 2 diabetes mellitus? A register review in Beijing, China.
BACKGROUND
China has a high burden of drug-resistant tuberculosis (TB) and diabetes mellitus (DM).


OBJECTIVE
The objectives of this study were to determine the following in patients with culture-confirmed TB: 1) demographic characteristics and disease patterns in relation to the presence or absence of type 2 diabetes and 2) presence or absence of drug resistance to isoniazid (INH), rifampicin (RMP) or both in relation to duration of diabetes and control of diabetes.


METHODS
This is a cross-sectional and retrospective study involving record reviews.


RESULTS
There were 621 patients with culture-positive TB, of whom 187 (30%) had previously known or new type 2 diabetes. In those with diabetes, there was a significantly higher proportion of males, persons aged ≥35 years and patients registered with new TB (p<0.05). Prevalence of multidrug-resistant TB (MDR-TB) was 6.2% in new patients (N=422) and 62.3% in previously treated patients (N=199), with no significant differences between those with and without diabetes. In patients with diabetes, there was no association of drug resistance with diabetes duration or disease control [assessed by fasting blood glucose (FBG) at 1 week].


CONCLUSIONS
A high proportion of patients with TB in a tertiary health facility, Beijing, China, had diabetes, but there was no association between type 2 diabetes and drug-resistant TB. Further prospective studies are needed to confirm these findings.
Department of Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China; MFL667@163.com.
Fengling
F
Mi
National Tuberculosis Clinical Laboratory, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
Guanglu
G
Jiang
Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
Jian
J
Du
Administration Office, Clinical Center on Tuberculosis, China CDC, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
Liang
L
Li
Department of Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
Wentao
W
Yue
Department of Research, International Union Against Tuberculosis and Lung Disease, Paris, France; Department of Infectious Diseases and Tropical Medicine, London School of Hygiene and Tropical Medicine, London, UK.
Anthony D
AD
Harries
Center for International Health, University of Bergen, Bergen, Norway.
Sven
S
Gudmund Hinderaker
International Union Against Tuberculosis and Lung Disease, Beijing, China.
Yan
Y
Lin
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
D000995:Antitubercular Agents
China; diabetes control; diabetes duration; diabetes mellitus; multidrug-resistant tuberculosis; tuberculosis