Diabetes as an increasingly common comorbidity among patient hospitalizations for tuberculosis in the USA

Roula Zahr, Ryan A. Peterson, Linnea A. Polgreen, Joseph E. Cavanaugh, Douglas B. Hornick, Kevin Winthrop, Philip M. Polgreen

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: Diabetes is a risk factor for active tuberculosis (TB). The purpose of this paper was to estimate the risk of hospitalization for TB with and without a secondary diagnosis of diabetes in groups with different ethnic backgrounds. Research design and methods: We used the Nationwide Inpatient Sample from 1998 to 2011, identifying all patients with a primary diagnosis of TB and/or a secondary diagnosis of diabetes (type 1 or type 2) or HIV. Next, we performed logistic regression to investigate the association of diabetes status, HIV status, and race (and the interaction of diabetes and race) with the risk of hospitalization with a primary diagnosis of TB. We also included a time covariate, to determine whether potential risk factors changed during the study period. Results: Controlling for HIV status, diabetes did not increase the odds of TB in white and black patients. However, in Hispanic and Asian/Pacific Islander patients, diabetes increased the odds of TB by a factor of 1.7 (95% CI 1.51 to 1.83). Asian/Pacific Islanders who had diabetes but not HIV experienced 26.4 (95% CI 23.1 to 30.1) times the odds of TB relative to the white males without diabetes or HIV. In addition, the percent of TB cases that belong to these high-risk groups (Asian/Pacific Islander/Hispanic diabetics) has more than doubled from 4.6% in 1998 to 9.6% in 2011. Conclusions: In specific demographic groups, diabetes was a strong risk factor for hospital admissions for TB.

Original languageEnglish (US)
Article numbere000268
JournalBMJ Open Diabetes Research and Care
Volume4
Issue number1
DOIs
StatePublished - Jan 1 2016

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Comorbidity
Tuberculosis
Hospitalization
HIV
Hispanic Americans
Chronic Disease Hospitals
HIV-2
Type 1 Diabetes Mellitus
Inpatients
Research Design
Logistic Models
Odds Ratio
Demography

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Diabetes as an increasingly common comorbidity among patient hospitalizations for tuberculosis in the USA. / Zahr, Roula; Peterson, Ryan A.; Polgreen, Linnea A.; Cavanaugh, Joseph E.; Hornick, Douglas B.; Winthrop, Kevin; Polgreen, Philip M.

In: BMJ Open Diabetes Research and Care, Vol. 4, No. 1, e000268, 01.01.2016.

Research output: Contribution to journalArticle

Zahr, Roula ; Peterson, Ryan A. ; Polgreen, Linnea A. ; Cavanaugh, Joseph E. ; Hornick, Douglas B. ; Winthrop, Kevin ; Polgreen, Philip M. / Diabetes as an increasingly common comorbidity among patient hospitalizations for tuberculosis in the USA. In: BMJ Open Diabetes Research and Care. 2016 ; Vol. 4, No. 1.
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abstract = "Objective: Diabetes is a risk factor for active tuberculosis (TB). The purpose of this paper was to estimate the risk of hospitalization for TB with and without a secondary diagnosis of diabetes in groups with different ethnic backgrounds. Research design and methods: We used the Nationwide Inpatient Sample from 1998 to 2011, identifying all patients with a primary diagnosis of TB and/or a secondary diagnosis of diabetes (type 1 or type 2) or HIV. Next, we performed logistic regression to investigate the association of diabetes status, HIV status, and race (and the interaction of diabetes and race) with the risk of hospitalization with a primary diagnosis of TB. We also included a time covariate, to determine whether potential risk factors changed during the study period. Results: Controlling for HIV status, diabetes did not increase the odds of TB in white and black patients. However, in Hispanic and Asian/Pacific Islander patients, diabetes increased the odds of TB by a factor of 1.7 (95{\%} CI 1.51 to 1.83). Asian/Pacific Islanders who had diabetes but not HIV experienced 26.4 (95{\%} CI 23.1 to 30.1) times the odds of TB relative to the white males without diabetes or HIV. In addition, the percent of TB cases that belong to these high-risk groups (Asian/Pacific Islander/Hispanic diabetics) has more than doubled from 4.6{\%} in 1998 to 9.6{\%} in 2011. Conclusions: In specific demographic groups, diabetes was a strong risk factor for hospital admissions for TB.",
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