| With the increased prevalence of diabetes mellitus (DM) , resurgence (developed countries) and bad control (developing countries) of tuberculosis (TB), the amount of diabetics complicated with TB is progressively rising and the issue of concurrence of DM and TB has been drawing global attention in recent years. Although it has been confirmed that diabetics have the higher risk of TB because of metabolic disturbance -. nutritional unbalance and immunological disfunctions, it is still not known which are the potential risk factors for the development of pulmonary tuberculosis among DM patients. Further study on this subject will rebound to the early detect of higher risk population and will help to take efficient measures to prevent the development of TB among diabetics. Objective: To explore risk factors for pulmonary tuberculosis among patients with type 2 diabetes mellitus(DM-PTB).Method: A hospital-based case-control study was conducted at three hospitals in Tianjin during October 2001 to October 2002. 87 newly-diagnosed PTB patients who had had type 2 DM were recruited as cases, and 162 type 2 DM patients were choosen as the control group. Information on risk factors was collected through face-to-face interview. Unconditional logistic regression model was used to explore the risk factors for DM-PTB. New confounding caused by matching on age and sex was excluded by stratified analysis. Multivariate logistic regression modifed by the principal component analysis > factor analysis and K-Mean Cluster analysis were conducted and final main effect functions were built according to different age and sex. Log-linear model was used to explore the potential interactions among risk factors.Results: 31 variates were found to be associated with DM-PTB in the univariate analysis, which were education income occupation history of TB contact duration ofDM, blood sugar controK weight loss, maximal BML diabetic nephropathy, stroke, hypertension, salt 1(1 represented the intake of diet before DM)-, sweetmeat1 , vegetablel , fatl -, eggl -, staple food 2(2 represented the change of diet after DM), vegetable2 milk2N sugar2, fat 2, labor intensity , exercise , smoke , alcohoK tea, exposure to dust, house lighting, house ventilation, environment status and personal character. The modifed multivariate logistic regression analysis found that severe state of DM (OR=1.749 95%CI=1.221 -2.506 X smoke and drink(OR=1.614 95%CI=1.136~2.294X bad contact and introversion (OR=1.778 95%CI=1.248-2.534) and low intake of salt (OR=1.586 95%CI=1.119-2.248) were generally associated with increased risk of DM-PTB in the final model; while beneficial change of diet after DM (OR=0.630 95%CI=0.447 -0.889 X high socioeconomic level (OR=0.508 95%CI=0.346-0.745X good housing condition( OR=0.599 95%CI=0.413 - 0.868 ) ^ good personal habits ( OR=0.333 95%CI=0.218-0.508X hypertension (OR=0.517 95%CI =0.350-0.764) had been shown to be reversely associated with DM-PTB and therefore might prevent the development of DM-PTB.Furthermore, risk factors for different sex and age groups were explored and found that:Men: The risk for DM-PTB among men increased with severe state of DM(OR=3.076 95%CI=1.668-5.671 X bad contact and introversion (OR=2.949 95%CI=1.441- 6.033) and exposure to dust (OR=2.128 95%CI=1.103-4.106) ; while beneficial change of diet after DM (OR=0.404 95%CI=0.238-0.686 X high socioeconomic level (OR^O.356 95%CI=0.170-0.745X good housing condition( OR=0.499 95%CI=0.268 - 0.926 ) x good personal habits ( OR=0.301 95%CI=0.144-0.632) and hypertension (OR=0.228 95%CI=0.103-0.503) might reduced the risk of DM-PTB among male population.Women : The OR for DM-PTB raised among those women who smoked and drinked (OR=7.164 95%CI=1.882-27.267) or those who had low intake of salt(OR=6.757 95%CI=2.395 -19.060) ; while those with good personal habits( OR=0.124 95%CI=0.046 - 0.335 ) or low labor intensity ( OR=0.199 95%CI=0.071 -0.558) had the lower risk of DM-PTB in women.Age less than 60: In younger diabetics...
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