Abstract
Purpose: The previous studies of extrapulmonary tuberculosis (EPTB) have not focused on the
impacts of diabetes mellitus. We conducted a retrospective study to explore the difference
between EPTB patients with and without diabetes.
Methods: The EPTB patients receiving initial treatments from Taipei Medical University Hospital
between January 2003 and March 2008 were recruited. They were divided into with-diabetes
(WD) group or non-diabetes (ND) group according to coexistence of diabetes mellitus
or not, respectively. All characteristics of these two groups were compared.
Results: Seventy-five patients were enrolled into our study. Fifteen patients and 60 patients
were recruited into WD and ND groups, respectively. The basic characteristics and
tuberculosis sites of the two groups were compared. The prevalence of hypertension
(66.7% vs. 38.3%, p=0.048) and chronic liver diseases (33.3% vs. 3.3%, p=0.003) in
WD group were higher than in ND group. The incidence of tuberculous peritonitis in
WD group was higher than in ND group (26.7% vs. 6.7%, p=0.046). The odds ratio of
tuberculous peritonitis for WD group was 5 091 (95% CI 1.103–23.493, p=0.037). The
random glucose level (10.9±5.8 vs. 6.8±1.6 mmol/L, p=0.025), the fasting glucose level
(8.6±4.4 vs. 5.6±0.9 mmol/L, p=0.038), and the hemoglobin A1c level (7.4±1.1 vs. 5.6±0.4%,
p=0.037) were higher in WD group than in ND group. The total bilirubin level was higher
in WD group than in ND group (18.4±6.2 vs. 13±7.2 μmol/L, p=0.042). Presenting symptoms
and other laboratory data were not different statistically between these two groups.
Conclusions: This is the first study about the impacts of diabetes on EPTB. The prevalence of
hypertension and chronic liver diseases, the incidence of tuberculous peritonitis,
and the total bilirubin level were higher in EPTB patients with diabetes than those
without diabetes.
Key words
diabetes mellitus - extrapulmonary tuberculosis - hypertension - liver disease - tuberculous
peritonitis
References
- 1
Bell DS, Allbright E.
The multifaceted associations of hepatobiliary disease and diabetes.
Endocr Pract.
2007;
13
300-312
- 2
Kim SJ, Hong YP, Lew WJ. et al .
Incidence of pulmonary tuberculosis among diabetics.
Tuber Lung Dis.
1995;
76
529-533
- 3
Koziel H, Koziel MJ.
Pulmonary complications of diabetes mellitus.
Pneumonia. Infect Dis Clin North Am.
1995;
9
65-96
- 4
Leung CC, Lam TH, Chan WM. et al .
Diabetic control and risk of tuberculosis: a cohort study.
Am J Epidemiol.
2008;
167
1486-1494
- 5
Morris JT, Seaworth BJ, MacAllister CK.
Pulmonary tuberculosis in diabetics.
Chest.
1992;
102
539-541
- 6
Pablos-Mendez A, Blustein J, Knirsch CA.
The role of diabetes mellitus in the higher prevalence of tuberculosis among Hispanics.
Am J Public Health.
1997;
87
574-579
- 7
Perez-Guzman C, Torres-Cruz A, Villarreal-Velarde H. et al .
Atypical radiological images of pulmonary tuberculosis in 192 diabetic patients: a
comparative study.
Int J Tuberc Lung Dis.
2001;
5
455-461
- 8
Perez-Guzman C, Torres-Cruz A, Villarreal-Velarde H. et al .
Progressive age-related changes in pulmonary tuberculosis images and the effect of
diabetes.
Am J Respir Crit Care Med.
2000;
162
1738-1740
- 9
Perez-Guzman C, Vargas MH, Torres-Cruz A. et al .
Diabetes modifies the male:female ratio in pulmonary tuberculosis.
Int J Tuberc Lung Dis.
2003;
7
354-358
- 10
Ponce-De-Leon A, Garcia-Garcia MML, Garcia-Sancho MC. et al .
Tuberculosis and diabetes in southern Mexico.
Diabetes Care.
2004;
27
1584-1590
- 11
Romero-Gomez M.
Hepatitis C and insulin resistance: steatosis, fibrosis and non-response.
Rev Esp Enferm Dig.
2006;
98
605-615
- 12
Shaikh MA, Singla R, Khan NB. et al .
Does diabetes alter the radiolog-ical presentation of pulmonary tuberculosis.
Saudi Med J.
2003;
24
278-281
- 13
Stevenson CR, Critchley JA, Forouhi NG. et al .
Diabetes and the risk of tuberculosis: a neglected threat to public health?.
Chronic Illn.
2007;
3
228-245
- 14
Tolman KG, Fonseca V, Tan MH. et al .
Narrative review: hepatobiliary disease in type 2 diabetes mellitus.
Ann Intern Med.
2004;
141
946-956
- 15
Zein CO, Levy C, Basu A. et al .
Chronic hepatitis C and type II diabetes mellitus: a prospective cross-sectional study.
Am J Gastroenterol.
2005;
100
48-55
Correspondence
Dr. C.-L. Huang
Department of Internal Medicine
Taipei Medical University Hospital
No. 252, Wuxing Street
Xinyi District
Taipei City 110
Taiwan
Phone: +886/2/2737 21 81 ext. 39 03
Fax: +886/2/2736 30 51
Email: sfweng@ntu.edu.tw
