Study On Risk Factors Of Type 2 Diabetes Mellitus Complicated With Pulmonary Tuberculosis

Objective: To detect environmental risk factors of type 2 diabetes mellitus complicated with pulmonary tuberculosis (T2DM-PTB) .Methods: A hospital-based 1:2 matched case-control study was conducted with 60 type 2 diabetes mellitus patients who developed pulmonary tuberculosis as cases and 120 type 2 diabetes mellitus patients who did not develop pulmonary tuberculosis as controls. Cases and controls were matched by gender and age. Investigator administrated questionnaire was conducted to investigate information including demographic characteristics, disease history, disease family history, living and behavioral pattern, social psychological characteristics and clinical data. Physical and laboratory data were collected through physical examination and laboratory test. Conditional logistic regression was used to explore the risk factors of T2DM-PTB with stratified analysis to exclude the confounding caused by matching factors. Multivariate logistic regression analysis was conducted with factors selected by principal component analysis and factor analysis to detect the main risk factors of T2DM-PTB and main effect model was acquired. Interaction was analyzed among those factors included in the model.Results: Those factors associated with T2DM-PTB found by univariate conditional logistic regression were occupation (OR=0.056 95%CI:0.013-0.253), education (OR=0.377 95%CI:0.251-0.567), income (OR=0.036 95%CI:0.005-0.254), duration of DM (OR=0.543 95%CI:0.391-0.755), testing blood sugar periodically (OR=5.723 95%CI:2.183-15.003), blood sugar control (OR=4.695 95%CI:2.213-9.963), complicated disease of DM (OR=0.137 95%CI:0.060-0.316), weight lossafter DM (OR= 0.611 95%CI:0.423-0.881), family history of DM (OR=2.19695%CI: 1.165-4.142), physical exercise (OR=0.133 95%CI: 0.047-0.270), daily exercise time ( OR=0.316 95%CI: 0.196-0.509 ) , years of exercise (OR=0.410 95%CI:0.254-0.662), drinking tea (OR=0.246 95%CI:0.114-0.530), index of alcohol drinking (OR=0.700 95%CI: 0.510-0.961), daily cereal intake (OR=0.600 95%CI:0.362-0.993), living density (OR=0.365 95%CI:0.232-0.573), house lighting (OR=0.212 95%CI:0.114-0.393), stress (OR=10.986 95%CI:3.806-31.710), highest body mass index (BMI) (OR=0.264 95%CI: 0.152-0.461) .Multivariate logistic regression analysis with factors selected by principal component analysis and factor analysis found factors associated with T2DM-PTB including education (OR=0. 292 95%CI: 0. 082-1. 044), physical exercise index (OR=0. 340 95%CI: 0. 116-0.994), living density (0R=0. 263 95%CI:0. 070-0. 989),which were reversely associated with the development of T2DM-PTB, family history of DM (0R=6. 372 95%CI: 0.979-41.452), not testing blood sugar periodically (OR=5.723 95%CI:2.183-15.003), stress (OR=104.465 95%CI: 4.236-2575.933), which were positively associated with the development of T2DM-PTB. Living density and physical exercise index, family history of DM and stress, family history of DM and testing blood sugar periodically were found having two steps multiple interaction. Conclusion: Education, living density and physical index were found to be protective factors and family history of DM, stress and not testing blood sugar periodically were found to be risk factors of T2DM-PTB. Two steps multiple interaction were found between living density and physical index, family history of DM and stress, family history of DM and not testing blood sugar periodically.