Glycemic control and the risk of tuberculosis in patients with diabetes

Background: Diabetes mellitus (DM) is one of the leading chronic diseases globally and one of the most common causes of death, morbidity, and poor quality of life. According to the WHO, DM is also one of the main risk factors for developing active tuberculosis (TB). Subjects with DM are at a higher...

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Autores: Antonio-Arques, Violeta|||0000-0001-7467-0558, Caylà, Joan A.|||0000-0003-3891-111X, Real, Jordi|||0000-0002-5979-8948, Moreno-Martinez, A., Orcau, Àngels|||0000-0001-8109-7614, Mauricio, Didac|||0000-0002-2868-0250, Mata-Cases, Manel|||0000-0003-3693-3622, Julve i Gil, Josep|||0000-0002-6531-2246, Navas, Elena|||0000-0001-5823-5847, Puig Treserra, Ramon|||0000-0003-1224-884X, Millet, Joan Pau|||0000-0003-0200-2459, Del Val García, José Luis|||0000-0002-0391-9368, Vlacho, Bogdan|||0000-0003-3768-8112, Franch-Nadal, Josep|||0000-0002-5175-1555
Formato: artículo
Fecha de publicación:2022
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:275171
Acesso em linha:https://ddd.uab.cat/record/275171
https://dx.doi.org/urn:doi:10.3389/fpubh.2022.1017024
Access Level:acceso abierto
Palavra-chave:Comorbidities
Diabetes mellitus
Diabetes complications
Glycemic control
Primary Health Care
Social determinants of health
Tuberculosis
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spelling Glycemic control and the risk of tuberculosis in patients with diabetesA cohort study in a Mediterranean cityAntonio-Arques, Violeta|||0000-0001-7467-0558Caylà, Joan A.|||0000-0003-3891-111XReal, Jordi|||0000-0002-5979-8948Moreno-Martinez, A.Orcau, Àngels|||0000-0001-8109-7614Mauricio, Didac|||0000-0002-2868-0250Mata-Cases, Manel|||0000-0003-3693-3622Julve i Gil, Josep|||0000-0002-6531-2246Navas, Elena|||0000-0001-5823-5847Puig Treserra, Ramon|||0000-0003-1224-884XMillet, Joan Pau|||0000-0003-0200-2459Del Val García, José Luis|||0000-0002-0391-9368Vlacho, Bogdan|||0000-0003-3768-8112Franch-Nadal, Josep|||0000-0002-5175-1555ComorbiditiesDiabetes mellitusDiabetes complicationsGlycemic controlPrimary Health CareSocial determinants of healthTuberculosisBackground: Diabetes mellitus (DM) is one of the leading chronic diseases globally and one of the most common causes of death, morbidity, and poor quality of life. According to the WHO, DM is also one of the main risk factors for developing active tuberculosis (TB). Subjects with DM are at a higher risk of infections, in addition to frequent micro and macrovascular complications, and therefore sought to determine whether poor glycemic control is linked to a higher risk of developing TB. Methods: We used a retrospective cohort of diabetic subjects to predict the incidence of TB. All DM patients were recruited from Ciutat Vella (the inner-city of Barcelona) from January 2007 until December 2016, with a follow-up period until December 2018 (≥2 years). Data were extracted from Barcelona's Primary Care medical record database - SIDIAP, and linked to the Barcelona TB Control Program. The incidence of TB and the impact of glycemic control were estimated using time-to-event curves analyzed by Cox proportional hazard regression. Hazard ratios (HRs) and 95% confidence intervals (CIs), unadjusted and adjusted by potential confounding variables, were also assessed, which included age, sex, diabetes duration, macrovascular and microvascular signs, BMI, smoking habit, alcohol consumption and geographical origin. Results: Of 8,004 DM patients considered for the study (equating to 68,605 person-years of follow-up), 84 developed TB [incidence rate = 70 (95% CI: 52-93) per 100,000 person-years]. DM subjects with TB were younger (mean: 52.2 vs. 57.7 years old), had higher values of glycosylated hemoglobin (HbA1c) (7.66 vs. 7.41%) and total triglycerides (122 vs. 105 mg/dl), and had twice the frequency of diabetic nephropathy (2.08 vs. 1.18%). The calculated incidence rate increased with increasing HbA1c: 120.5 (95% CI 77.2-179.3) for HbA1c ≥ 7.5%, 143 (95% CI 88.3-218.1) for HbA1c ≥ 8% and 183.8 (95% CI 105-298) for HbA1c ≥ 9%. An increase in the risk of TB was also observed according to a poorer optimization of glycemic control: adjusted HR 1.80 (95% CI 0.60-5.42), 2.06 (95% CI 0.67-6.32), and 2.82 (95% CI 0.88-9.06), respectively. Conclusion: Diabetic subjects with worse glycemic control show a trend toward a higher risk of developing TB. 22022-01-0120222022-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/275171https://dx.doi.org/urn:doi:10.3389/fpubh.2022.1017024reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengMinisterio de Economía y Competitividad https://doi.org/10.13039/501100003329 PI16/01751open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2751712026-06-06T12:50:31Z
dc.title.none.fl_str_mv Glycemic control and the risk of tuberculosis in patients with diabetes
A cohort study in a Mediterranean city
title Glycemic control and the risk of tuberculosis in patients with diabetes
spellingShingle Glycemic control and the risk of tuberculosis in patients with diabetes
Antonio-Arques, Violeta|||0000-0001-7467-0558
Comorbidities
Diabetes mellitus
Diabetes complications
Glycemic control
Primary Health Care
Social determinants of health
Tuberculosis
title_short Glycemic control and the risk of tuberculosis in patients with diabetes
title_full Glycemic control and the risk of tuberculosis in patients with diabetes
title_fullStr Glycemic control and the risk of tuberculosis in patients with diabetes
title_full_unstemmed Glycemic control and the risk of tuberculosis in patients with diabetes
title_sort Glycemic control and the risk of tuberculosis in patients with diabetes
dc.creator.none.fl_str_mv Antonio-Arques, Violeta|||0000-0001-7467-0558
Caylà, Joan A.|||0000-0003-3891-111X
Real, Jordi|||0000-0002-5979-8948
Moreno-Martinez, A.
Orcau, Àngels|||0000-0001-8109-7614
Mauricio, Didac|||0000-0002-2868-0250
Mata-Cases, Manel|||0000-0003-3693-3622
Julve i Gil, Josep|||0000-0002-6531-2246
Navas, Elena|||0000-0001-5823-5847
Puig Treserra, Ramon|||0000-0003-1224-884X
Millet, Joan Pau|||0000-0003-0200-2459
Del Val García, José Luis|||0000-0002-0391-9368
Vlacho, Bogdan|||0000-0003-3768-8112
Franch-Nadal, Josep|||0000-0002-5175-1555
author Antonio-Arques, Violeta|||0000-0001-7467-0558
author_facet Antonio-Arques, Violeta|||0000-0001-7467-0558
Caylà, Joan A.|||0000-0003-3891-111X
Real, Jordi|||0000-0002-5979-8948
Moreno-Martinez, A.
Orcau, Àngels|||0000-0001-8109-7614
Mauricio, Didac|||0000-0002-2868-0250
Mata-Cases, Manel|||0000-0003-3693-3622
Julve i Gil, Josep|||0000-0002-6531-2246
Navas, Elena|||0000-0001-5823-5847
Puig Treserra, Ramon|||0000-0003-1224-884X
Millet, Joan Pau|||0000-0003-0200-2459
Del Val García, José Luis|||0000-0002-0391-9368
Vlacho, Bogdan|||0000-0003-3768-8112
Franch-Nadal, Josep|||0000-0002-5175-1555
author_role author
author2 Caylà, Joan A.|||0000-0003-3891-111X
Real, Jordi|||0000-0002-5979-8948
Moreno-Martinez, A.
Orcau, Àngels|||0000-0001-8109-7614
Mauricio, Didac|||0000-0002-2868-0250
Mata-Cases, Manel|||0000-0003-3693-3622
Julve i Gil, Josep|||0000-0002-6531-2246
Navas, Elena|||0000-0001-5823-5847
Puig Treserra, Ramon|||0000-0003-1224-884X
Millet, Joan Pau|||0000-0003-0200-2459
Del Val García, José Luis|||0000-0002-0391-9368
Vlacho, Bogdan|||0000-0003-3768-8112
Franch-Nadal, Josep|||0000-0002-5175-1555
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Comorbidities
Diabetes mellitus
Diabetes complications
Glycemic control
Primary Health Care
Social determinants of health
Tuberculosis
topic Comorbidities
Diabetes mellitus
Diabetes complications
Glycemic control
Primary Health Care
Social determinants of health
Tuberculosis
description Background: Diabetes mellitus (DM) is one of the leading chronic diseases globally and one of the most common causes of death, morbidity, and poor quality of life. According to the WHO, DM is also one of the main risk factors for developing active tuberculosis (TB). Subjects with DM are at a higher risk of infections, in addition to frequent micro and macrovascular complications, and therefore sought to determine whether poor glycemic control is linked to a higher risk of developing TB. Methods: We used a retrospective cohort of diabetic subjects to predict the incidence of TB. All DM patients were recruited from Ciutat Vella (the inner-city of Barcelona) from January 2007 until December 2016, with a follow-up period until December 2018 (≥2 years). Data were extracted from Barcelona's Primary Care medical record database - SIDIAP, and linked to the Barcelona TB Control Program. The incidence of TB and the impact of glycemic control were estimated using time-to-event curves analyzed by Cox proportional hazard regression. Hazard ratios (HRs) and 95% confidence intervals (CIs), unadjusted and adjusted by potential confounding variables, were also assessed, which included age, sex, diabetes duration, macrovascular and microvascular signs, BMI, smoking habit, alcohol consumption and geographical origin. Results: Of 8,004 DM patients considered for the study (equating to 68,605 person-years of follow-up), 84 developed TB [incidence rate = 70 (95% CI: 52-93) per 100,000 person-years]. DM subjects with TB were younger (mean: 52.2 vs. 57.7 years old), had higher values of glycosylated hemoglobin (HbA1c) (7.66 vs. 7.41%) and total triglycerides (122 vs. 105 mg/dl), and had twice the frequency of diabetic nephropathy (2.08 vs. 1.18%). The calculated incidence rate increased with increasing HbA1c: 120.5 (95% CI 77.2-179.3) for HbA1c ≥ 7.5%, 143 (95% CI 88.3-218.1) for HbA1c ≥ 8% and 183.8 (95% CI 105-298) for HbA1c ≥ 9%. An increase in the risk of TB was also observed according to a poorer optimization of glycemic control: adjusted HR 1.80 (95% CI 0.60-5.42), 2.06 (95% CI 0.67-6.32), and 2.82 (95% CI 0.88-9.06), respectively. Conclusion: Diabetic subjects with worse glycemic control show a trend toward a higher risk of developing TB.
publishDate 2022
dc.date.none.fl_str_mv 2
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/275171
https://dx.doi.org/urn:doi:10.3389/fpubh.2022.1017024
url https://ddd.uab.cat/record/275171
https://dx.doi.org/urn:doi:10.3389/fpubh.2022.1017024
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 PI16/01751
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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