| Background and Objectives In recent years,the incidence of diabetes mellitus(DM)is increasing annually,especially in developing countries which are still with a high burden of tuberculosis.The combination of two diseases increase the difficulty of prevention,prognosis and treatment of disease and brings new challenges to global public health.There are some existing studies on the dietary nutrient,oxidative stress and quality of life of patients with PTB,but there are few studies aimed at the effect of diabetes mellitus on dietary intake,level of oxidative stress and quality of life after intensive treatment in patients with PTB.PTB and DM are nutritional wasting diseases and patients’ nutritional status and dietary minerals play important roles in the occurrence and prognosis of the disease on the disease progression.Besides,diabetes can induce metabolic disturbances of glycolipids,immune injury,etc.But there are few studies on the relationship of dietary minerals and the effect of diabetes mellitus on the level of oxidative stress in patients with two diseases.Therefore,in order to understand the effects of diabetes mellitus on diet and oxidative stress in PTB patients,we investigated the dietary intake,biochemical indicators and symptoms of clinical symptoms in a subset of PTB and PTB-DM patients,and explored the effect of diabetes on the nutritional and oxidative stress levels of tuberculosis patients and observed the changes of quality of life after one-month intensive treatment and the risk factors of quality of life.Methods: This study is divided into two parts.In the first part,we used cross-sectional method to investigate the effect of diabetes on the nutrition,oxidative stress level and the proliferation activity of lymphocyte.A total of 48 patients with PTB-DM diagnosed in Chest Hospital from January 2014 to March 2015 were included in this part.We chose other 48 PTB patients matched by age and gender,measured heights and weights and evaluated nutritional intake level of subjects by the 3-days-24-hour dietary recall method.We also collect serum biochemical markers and clinical signs.We collected patients’ whole blood and measured glutathione(GSH)content in red plasma by colorimetric method,plasma superoxide dismutase(SOD)activity by hydroxylamine method,plasma paraoxonase1(PON1)activity by double antibody sandwich ELISA method,plasma malondialdehyde(MDA)content by thiobarbituric acid method,plasma human oxidized low density lipoprotein(ox-LDL)content by competitive ELISA method,DNA damage of peripheral lymphocyte by single-cell gel electrophoresis assay and proliferation activity of lymphocytes by MTT method,then we compared the results of two groups and observed whether there were statistically significant differences between two groups.The second part is to study the quality of life and its influencing factors in PTB-DM before and after intensive treatment for one month.We selected 118 patients treated in the Chest Hospital from March 2015 to April 2016.The Chinese SF-36v2 scale was used to investigate the quality of life of the patients.We acquired the demographic characteristics and symptoms and physical signs of the patients by questionnaires and case records respectively.Multiple regression analysis was used to analyze the influencing factors of health scores.Results The proportion of overweight / obesity(30.8% vs 16.7%,P<0.05)in PTB-DM group were higher than that in PTB group.Results of 3-days-24-hour dietary review showed that various nutrients intake of patients in two groups were generally lower than the recommended intake(RNI).The intake of fat,retinol,thiamine and potassium in the PTB-DM group were higher than that in the PTB group,and the other nutrients were lower than that in the PTB group,and the intake of sodium was significantly lower than that in the PTB group(63.12% vs 43.01%,P<0.05).There was no significant difference in the nutritional level of the patient.The analysis of oxidative stress level showed that plasma antioxidant enzymes such as SOD and reducing substances such as glutathione(GSH)index in PTB-DM group were significantly lower than in PTB group(P<0.05);the content of MDA in PTB-DM group was higher than PTB group,but the difference was not statistically significant(P=0.84).The analysis also showed that the plasma ox-LDL content was significantly higher than that in group PTB(P<0.05).Results of single-cell gel electrophoresis showed that spontaneous injury and induced injury conditions of DNA in PTB-DM group were severer than that in PTB group(AU values 158.333 vs 138.400,P<0.05),and cell proliferation activity of patients in PTB-DM group was significantly lower than that of PTB group(P<0.05).Quality of life of the results of the study showed that patients with PTB before the quality of life is significantly reduced,and all items scores were significantly lower than the healthy population Chinese norm(P<0.05),especially the physiological function(RP)and social function(SF)are just more than half of the norm.By comparing the quality of life between the PTB group and the PTB-DM group,there was no significant difference between the every dimensions.After one month of intensive treatment,the quality of life of the two groups increased.In addition to physical pain(BP)scores(P>0.05),the scores of other dimensions were significantly increased in the PTB group.Multiple linear regression analysis showed that age is the influence factors of patients before treatment reduced the total health(β=-0.031,P<0.05).The higher score indicates the worse quality of life of patients;the female is to strengthen the risk factors of physical health score decreased after one month of treatment(β =-5.989,P<0.05).Conclusions: Both groups were in poor nutrition status and patients in PTB-DM group were easily suffered from overweight/obesity.Patients in both were deficient in energy,dietary fiber,vitamin B2 and Na and the PTB-DM group had poorer nutritional status.Diabetes mellitus can increase oxidative stress level,advance DNA damage and reduce lymphocyte proliferation activity in patients with tuberculosis.Quality of life of PTB patients before treatment was significantly lower than that in normal population,and it improved significantly after one month of intensive treatment,but the quality of life of PTB group didn’t improve well. |
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