Glycemic Control and Radiographic Manifestations of Tuberculosis in Diabetic Patients

Radiographic manifestations of pulmonary tuberculosis (TB) in patients with diabetes mellitus (DM) have previously been reported, with inconsistent results. We conducted a study to investigate whether glycemic control has an impact on radiographic manifestations of pulmonary TB. Consecutive patients...

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Vydáno v:PloS one Ročník 9; číslo 4; s. e93397
Hlavní autoři: Chiang, Chen-Yuan, Lee, Jen-Jyh, Chien, Shun-Tien, Enarson, Donald A., Chang, You-Cheng, Chen, Yi-Ting, Hu, Ting-Yu, Lin, Chih-Bin, Suk, Chi-Won, Tao, Jui-Ming, Bai, Kuan-Jen
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Public Library of Science 03.04.2014
Public Library of Science (PLoS)
Témata:
Adult
Age
Aged
Blood Glucose - metabolism
Cavitation
Cavities
Diabetes
Diabetes mellitus
Diabetes Mellitus - diagnostic imaging
Diabetes Mellitus - metabolism
Female
Glucose
Glycated Hemoglobin A - metabolism
Glycemic Index - physiology
Hemoglobin
Holes
Hospitals
Humans
Hyperglycemia
Internal medicine
Lesions
Lung - diagnostic imaging
Lung - metabolism
Lung diseases
Lungs
Male
Medicine
Medicine and Health Sciences
Middle Aged
Mycobacterium tuberculosis
Opacity
Patients
Radiography
Studies
Tuberculosis
Tuberculosis, Pulmonary - diagnostic imaging
Tuberculosis, Pulmonary - metabolism
France
Taiwan
ISSN:1932-6203, 1932-6203
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Shrnutí:Radiographic manifestations of pulmonary tuberculosis (TB) in patients with diabetes mellitus (DM) have previously been reported, with inconsistent results. We conducted a study to investigate whether glycemic control has an impact on radiographic manifestations of pulmonary TB. Consecutive patients with culture-positive pulmonary TB who had DM in three tertiary care hospitals from 2005-2010 were selected for review and compared with a similar number without DM. Glycemic control was assessed by glycated haemoglobin A1C (HbA1C). A pre-treatment chest radiograph was read independently by two qualified pulmonologists blinded to patients' diabetic status. Films with any discordant reading were read by a third reader. 1209 culture positive pulmonary TB patients (581 with DM and 628 without DM) were enrolled. Compared with those without DM, TB patients with DM were significantly more likely to have opacity over lower lung fields, extensive parenchymal lesions, any cavity, multiple cavities and large cavities (>3 cm). The relative risk of lower lung field opacities was 0.80 (95% CI 0.46-1.42) for those with DM with A1C<7%, 2.32 (95% CI 1.36 - 3.98) for A1C 7%-9%, and 1.62 (95% CI 1.12-2.36) for A1C>9%; and that of any cavity over no cavity was 0.87 (95% CI 0.46-1.62) for patients with DM with A1C<7%, 1.84 (95% CI 1.20-2.84) for A1C 7%-9%, and 3.71 (95% CI 2.64-5.22) for A1C>9%, relative to patients without DM. Glycemic control significantly influenced radiographic manifestations of pulmonary TB in patients with DM.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Designed the study: CYC JJL STC KJB. Read chest radiographs: JJL STC YCC YTC TYH CBL CWS JMT KJB. Conducted data analysis: CYC. Interpreted findings and wrote the first draft of the manuscript: CYC DAE. Contributed to the revision of the manuscript and gave approval to the final version of the manuscript: CYC JJL STC DAE YCC YTC TYH CBL CWS JMT KJB.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0093397