Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.

<h4>Background</h4>Radiographic manifestations of pulmonary tuberculosis (TB) in patients with diabetes mellitus (DM) have previously been reported, with inconsistent results. We conducted a study to investigate whether glycemic control has an impact on radiographic manifestations of pul...

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Main Authors: Chen-Yuan Chiang, Jen-Jyh Lee, Shun-Tien Chien, Donald A Enarson, You-Cheng Chang, Yi-Ting Chen, Ting-Yu Hu, Chih-Bin Lin, Chi-Won Suk, Jui-Ming Tao, Kuan-Jen Bai
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0093397&type=printable
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author Chen-Yuan Chiang
Jen-Jyh Lee
Shun-Tien Chien
Donald A Enarson
You-Cheng Chang
Yi-Ting Chen
Ting-Yu Hu
Chih-Bin Lin
Chi-Won Suk
Jui-Ming Tao
Kuan-Jen Bai
author_facet Chen-Yuan Chiang
Jen-Jyh Lee
Shun-Tien Chien
Donald A Enarson
You-Cheng Chang
Yi-Ting Chen
Ting-Yu Hu
Chih-Bin Lin
Chi-Won Suk
Jui-Ming Tao
Kuan-Jen Bai
author_sort Chen-Yuan Chiang
collection DOAJ
description <h4>Background</h4>Radiographic manifestations of pulmonary tuberculosis (TB) in patients with diabetes mellitus (DM) have previously been reported, with inconsistent results. We conducted a study to investigate whether glycemic control has an impact on radiographic manifestations of pulmonary TB.<h4>Methods</h4>Consecutive patients with culture-positive pulmonary TB who had DM in three tertiary care hospitals from 2005-2010 were selected for review and compared with a similar number without DM. Glycemic control was assessed by glycated haemoglobin A1C (HbA1C). A pre-treatment chest radiograph was read independently by two qualified pulmonologists blinded to patients' diabetic status. Films with any discordant reading were read by a third reader.<h4>Results</h4>1209 culture positive pulmonary TB patients (581 with DM and 628 without DM) were enrolled. Compared with those without DM, TB patients with DM were significantly more likely to have opacity over lower lung fields, extensive parenchymal lesions, any cavity, multiple cavities and large cavities (>3 cm). The relative risk of lower lung field opacities was 0.80 (95% CI 0.46-1.42) for those with DM with A1C<7%, 2.32 (95% CI 1.36 - 3.98) for A1C 7%-9%, and 1.62 (95% CI 1.12-2.36) for A1C>9%; and that of any cavity over no cavity was 0.87 (95% CI 0.46-1.62) for patients with DM with A1C<7%, 1.84 (95% CI 1.20-2.84) for A1C 7%-9%, and 3.71 (95% CI 2.64-5.22) for A1C>9%, relative to patients without DM.<h4>Conclusions</h4>Glycemic control significantly influenced radiographic manifestations of pulmonary TB in patients with DM.
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spelling doaj-art-1c7dfc1bf3874dc486d3483c11ebf58c2025-08-20T03:00:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9339710.1371/journal.pone.0093397Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.Chen-Yuan ChiangJen-Jyh LeeShun-Tien ChienDonald A EnarsonYou-Cheng ChangYi-Ting ChenTing-Yu HuChih-Bin LinChi-Won SukJui-Ming TaoKuan-Jen Bai<h4>Background</h4>Radiographic manifestations of pulmonary tuberculosis (TB) in patients with diabetes mellitus (DM) have previously been reported, with inconsistent results. We conducted a study to investigate whether glycemic control has an impact on radiographic manifestations of pulmonary TB.<h4>Methods</h4>Consecutive patients with culture-positive pulmonary TB who had DM in three tertiary care hospitals from 2005-2010 were selected for review and compared with a similar number without DM. Glycemic control was assessed by glycated haemoglobin A1C (HbA1C). A pre-treatment chest radiograph was read independently by two qualified pulmonologists blinded to patients' diabetic status. Films with any discordant reading were read by a third reader.<h4>Results</h4>1209 culture positive pulmonary TB patients (581 with DM and 628 without DM) were enrolled. Compared with those without DM, TB patients with DM were significantly more likely to have opacity over lower lung fields, extensive parenchymal lesions, any cavity, multiple cavities and large cavities (>3 cm). The relative risk of lower lung field opacities was 0.80 (95% CI 0.46-1.42) for those with DM with A1C<7%, 2.32 (95% CI 1.36 - 3.98) for A1C 7%-9%, and 1.62 (95% CI 1.12-2.36) for A1C>9%; and that of any cavity over no cavity was 0.87 (95% CI 0.46-1.62) for patients with DM with A1C<7%, 1.84 (95% CI 1.20-2.84) for A1C 7%-9%, and 3.71 (95% CI 2.64-5.22) for A1C>9%, relative to patients without DM.<h4>Conclusions</h4>Glycemic control significantly influenced radiographic manifestations of pulmonary TB in patients with DM.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0093397&type=printable
spellingShingle Chen-Yuan Chiang
Jen-Jyh Lee
Shun-Tien Chien
Donald A Enarson
You-Cheng Chang
Yi-Ting Chen
Ting-Yu Hu
Chih-Bin Lin
Chi-Won Suk
Jui-Ming Tao
Kuan-Jen Bai
Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.
PLoS ONE
title Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.
title_full Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.
title_fullStr Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.
title_full_unstemmed Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.
title_short Glycemic control and radiographic manifestations of tuberculosis in diabetic patients.
title_sort glycemic control and radiographic manifestations of tuberculosis in diabetic patients
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0093397&type=printable
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