Effects Of Diet And Behavior Habits On The Risk Of Pulmonary Tuberculosis In Middle-aged And Elderly Patients With Diabetes Mellitus

Objective:Diabetes mellitus is a risk factor for tuberculosis.It is reported that diabetes mellitus can lead to a threefold increase in the risk of tuberculosis.When two diseases are complicated,diabetes occurs before the tuberculosis.Old age is a risk factor for diabetes,therefore,diabetes complicated with pulmonary tuberculosis are easily occurred in the middle-aged and elderly population.In recent years,with the aging population,urbanization,socio-economic development and lifestyle changes,the burden of diabetes in developing countries such as China and India has increased significantly.At the same time,the TB burden in these countries is still serious.Studies have found that malnutrition,smoking,drinking and other bad behavior habits are significantly related to the increased risk of diabetes complicated with pulmonary tuberculosis.Therefore,this study intends to use the method of group case-control study to investigate the past dietary situation and behavior habits of middle-aged and elderly patients with diabetes mellitus complicated with pulmonary tuberculosis,and compare with simple pulmonary tuberculosis patients.To explore the dietary and behavioral risk factors that may lead to middle-aged and elderly diabetes complicated with pulmonary tuberculosis,and to provide scientific basis for prevention and control of tuberculosis.Methods:Epidemiological group case-control study was used in this study.From January 2018 to February 2019,middle-aged and elderly patients(40-75 years old)with diabetes complicated with pulmonary tuberculosis(DM-PTB)and patients with simple pulmonary tuberculosis(PTB)diagnosed in a municipal thoracic hospital were selected as case group and control group respectively.There was no significant difference in age and sex between the two groups(p < 0.05).Questionnaires were used to collect the general demographic characteristics,nutrient intake and dietary information of the subjects,and a 3-day,24-hour dietary review method was used to investigate the nutrient intake of the patients.The food frequency table(FFQ)was used to investigate the dietary status of patients.The height, weight and blood pressure of the two groups were measured.Collect biochemical serum indexes examined by the patient’s laboratory;Logistics regression was used to analyze the data by univariate and multivariate analysis.The 95% confidence interval(CI)of odds ratio(OR)and OR were calculated.Results:Two hundred and fifty six middle-aged and elderly tuberculosis patients were recruited in this study,including 126 cases in PTB group and 130 cases in DM-PTB group.The basic characteristics and main biochemical indexes of the two groups were compared.The results showed that the levels of systolic blood pressure,diastolic blood pressure,fasting blood glucose,triglyceride and cholesterol in the middle-aged and elderly DM-PTB group were significantly higher than those in the simple PTB group.Univariate analysis showed that previous smoking,previous drinking,frequent staying up late and insufficient magnesium intake may be risk factors for DM-PTB among the middle-aged and elderly,while high frequency of vegetable consumption,high frequency of potato consumption and high consumption of potato may be protective factors for DM-PTB among the middle-aged and elderly.Multivariate Logistics regression analysis showed that among dietary factors,those with high frequency of vegetables(daily consumption of vegetables)(OR=0.23,95%CI:0.09-0.38),and those with high frequency of potatoes(daily consumption of potatoes and weekly consumption of potatoes)(OR = 0.22,95% CI: 0.08-0.37);Compared with the potato consumption < 50g/d,the potato consumption of 50-100g/d(OR = 0.34,95% CI:0.26-0.56)and the potato consumption > 100 g/d(OR=0.20,95%CI: 0.13-0.38)may be related to the risk reduction of pulmonary tuberculosis in middle-aged and elderly diabetes patients.While insufficient intake of magnesium(OR=2.86,95%CI: 1.53-5.36)and insufficient intake of manganese(OR=3.93,95%CI:1.83-8.45)may be related to the increased risk of diabetes complicated with pulmonary tuberculosis in the middle-aged and elderly.Among behavioral factors,frequent staying up late(OR=5.85,95%CI: 1.77-19.33),previous smoking(OR=3.42,95%CI: 1.29-9.04),and previous drinking(OR=3.07,95%CI:1.34-6.99)may be related to the increased risk of pulmonary tuberculosis in middle-aged and elderly diabetes patients.Conclusion:Dietary and behavioral habits are significantly related to DM-PTB in middle-aged and elderly people.The high frequency of vegetable consumption,high frequency of potato consumption and high consumption of potato may be related to the reduction of risk of diabetes complicated with pulmonary tuberculosis in middle-aged and elderly people.However,frequent staying up late,previous smoking,previous drinking and insufficient intake of magnesium and manganese in food may be related to the increased risk of diabetes complicated with pulmonary tuberculosis in middle-aged and elderly people.