Risk of having pulmonary tuberculosis in type 2 diabetes: A hospital-based matched case-control study

Yukang Wang, Mei Dou, Tingyan Kou, Yufeng Liu, Wenshan Lv, Lei Han, Na Wang, Aiguo Ma, Frans J. Kok, Evert G. Schouten, Qiuzhen Wang*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and Objectives: Diabetes mellitus (DM) leads to nearly 3-fold higher risk of pulmonary tuberculosis (TB), indicating an increasing challenge to public health in low-to-middle income countries. Till now, the risk factor is still uncertain. We carried out this study with the main purpose to identify the risk factors of having TB in DM patients. Methods and Study Design: A hospital-based matched case-control study was conducted in Qingdao, China from March, 2016 to January, 2018. Cases were DM patients with concurrent TB (DM-TB). Each case was matched with two controls, patients with DM only of similar age, sex and DM course. Cox regression of conditional logistic analysis was used to define the risk factors for having TB in DM, and then sensitivity analysis was carried out. Results: We identified 315 patients, including 105 cases and 210 controls. Smokers had a higher risk of having TB with a multivariable adjusted odds ratio (aOR) of 12.45 than non-smokers. Poor glycemic control (aOR=2.66), frequency of DM re-examination <1 time/year (aOR=3.39), as well as TB contact history was also independently related with higher risk, while BMI ≥24 (aOR=0.42), education level ≥ college (aOR=0.11) showed a negative association. Conclusions: Poor glycemic control, smoking, low frequency of reexamination was associated with higher risk of having TB in DM, while overweight and obesity, high education levels showed a negative association. These findings provide clues to target DM populations prone to TB, which may be of help to halt the epidemic of TB in high burden countries.

Original languageEnglish
Pages (from-to)303-310
Number of pages8
JournalAsia Pacific Journal of Clinical Nutrition
Issue number2
Publication statusPublished - 30 Jun 2021


  • clinical epidemiology
  • diabetes
  • poor glycemic control
  • smoking
  • tuberculosis


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