Work

Clinical Characteristics of Patients with Diabetes and Pulmonary Tuberculosis with Additional Extrapulmonary Involvement: A Retrospective Comparative Analysis

Year: 2026

Type: article

Abstract: Background: Diabetes mellitus (DM) increases the risk of tuberculosis (TB), but clinical characteristics associated with extrapulmonary tuberculosis (EPTB) among patients with DM and pulmonary tuberculosis (PTB) remain insufficiently characterized. This study investigated the clinical features and factors associated with concomitant EPTB in patients with DM and PTB. Methods: This retrospective comparative study included 146 patients with DM and confirmed PTB who were admitted to Shenzhen Third People's Hospital between April 2017 and October 2022. Patients were classified into a DM-EPTB group (PTB with concomitant EPTB; n = 56) and a DM-PTB group (PTB without EPTB; n = 90). Demographic characteristics, clinical features, laboratory and immunological indices, microbiological and pathological findings, chest computed tomography findings, glycemic management, and drug-resistance profiles were compared between groups. Multivariable logistic regression was used to identify factors associated with concomitant EPTB. Results: Among patients in the DM-EPTB group, 91.1% had extrapulmonary organ or site manifestations. The most frequently involved sites were the pericardium (23.4%), meninges (17.2%), and cervical lymph nodes (15.6%). Compared with patients in the DM-PTB group, those in the DM-EPTB group had lower body mass index, HbA1c, fasting plasma glucose, LDL-C, lymphocyte count, monocyte count, hemoglobin level, T-lymphocyte count, and helper T-lymphocyte count, but a higher monocyte-to-lymphocyte ratio (all P < 0.05). They also had longer hospital stays and more frequent readmissions. In multivariable logistic regression analysis, multiple hospitalizations (odds ratio [OR] = 2.300, 95% confidence interval [CI]: 1.134-4.664; P = 0.021) and multiple pulmonary cavities (OR = 4.405, 95% CI: 1.349-14.382; P = 0.014) were independently associated with concomitant EPTB. Conclusion: In patients with DM and PTB, concomitant EPTB was associated with poorer nutritional and immunological status, longer hospitalization, and greater disease complexity. Multiple hospitalizations and multiple pulmonary cavities were independently associated with concomitant EPTB. These findings support increased clinical vigilance and targeted assessment for EPTB in high-risk patients with DM and PTB.

Source: Diabetes Metabolic Syndrome and Obesity

DOI: 10.2147/dmso.s612100

Authors: Pengyan Yang, Caimao Huang, Yongcong Nie, Shilai Su, Xiaoyan Chen

Institutions: First Affiliated Hospital of Guangzhou Medical University, Shenzhen Third People’s Hospital, Shenzhen Second People's Hospital

Language: English

Topic: Tuberculosis Research and Epidemiology

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836