Article Text
Abstract
Objective Diabetes is a risk factor for active tuberculosis (TB). The purpose of this paper was to estimate the risk of hospitalization for TB with and without a secondary diagnosis of diabetes in groups with different ethnic backgrounds.
Research design and methods We used the Nationwide Inpatient Sample from 1998 to 2011, identifying all patients with a primary diagnosis of TB and/or a secondary diagnosis of diabetes (type 1 or type 2) or HIV. Next, we performed logistic regression to investigate the association of diabetes status, HIV status, and race (and the interaction of diabetes and race) with the risk of hospitalization with a primary diagnosis of TB. We also included a time covariate, to determine whether potential risk factors changed during the study period.
Results Controlling for HIV status, diabetes did not increase the odds of TB in white and black patients. However, in Hispanic and Asian/Pacific Islander patients, diabetes increased the odds of TB by a factor of 1.7 (95% CI 1.51 to 1.83). Asian/Pacific Islanders who had diabetes but not HIV experienced 26.4 (95% CI 23.1 to 30.1) times the odds of TB relative to the white males without diabetes or HIV. In addition, the percent of TB cases that belong to these high-risk groups (Asian/Pacific Islander/Hispanic diabetics) has more than doubled from 4.6% in 1998 to 9.6% in 2011.
Conclusions In specific demographic groups, diabetes was a strong risk factor for hospital admissions for TB.
- Glycemic Control
- Tuberculosis
- Epidemiology
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Footnotes
This work was presented as a poster at the American Diabetes Association 76th Scientific Sessions, 10–14 June 2016, New Orleans, Louisiana.
Contributors RSZ analyzed data and wrote the manuscript. RAP analyzed data and contributed to methods and results. LAP. analyzed data, contributed to discussion and reviewed/edited the manuscript. JEC contributed to methods and results. DBH contributed to discussion and reviewed/edited the manuscript. KLW contributed to discussion and reviewed/edited the manuscript. PMP (guarantor) analyzed data and wrote the manuscript.
Funding This work was supported by the National Heart, Lung, and Blood Institute, grant number K25HL122305; National Institutes of Health, Training in Kidney Disease, Hypertension, Cell Biology, grant number T32DK007690; and University of Iowa Health Venture's Signal Center.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Nationwide Inpatient Sample (NIS) data were used for this study. The NIS is maintained as part of the Healthcare Cost and Utilization Project (HCUP) by the Agency for Healthcare Research and Quality (AHRQ). NIS data can be obtained from AHRQ.