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Meta-Analysis
. 2021 Jun 16;21(1):123.
doi: 10.1186/s12902-021-00779-6.

The association of glycemic level and prevalence of tuberculosis: a meta-analysis

Zhifei Chen  1 , Qi Liu  2 , Ranran Song  3 , Wenxin Zhang  2 , Tingping Wang  4 , Zhan Lian  4 , Xuezhi Sun  4 , Yanli Liu  4
Affiliations
Meta-Analysis

The association of glycemic level and prevalence of tuberculosis: a meta-analysis

Zhifei Chen et al. BMC Endocr Disord. .

Abstract

Background: Diabetes is a well-known risk factor for tuberculosis and poorly glycemic control may increase the risk of tuberculosis. We performed a meta-analysis to explore the association of glycemic control in diabetic patients and their tuberculosis prevalence.

Methods: We included observational studies that investigated the prevalence of tuberculosis associated with glycemic control. The markers of glycated hemoglobin A1c (HbA1c) and fasting plasma glucose were used to evaluate the exposure of interest in the study. We searched related articles in PubMed, EMBASE and Web of Science through 14 December 2019. The Newcastle-Ottawa scale was used to assess the risk of bias of included studies.

Results: Seventeen studies (four cohort studies, five case-control studies and eight cross-sectional studies) were included, involving 1,027,074 participants. The meta-analysis found the pooled odds ratio of prevalent tuberculosis increased a 2.05-fold (95%CI: 1.65, 2.55) for the patients with HbA1c ≥7.0% compared to those with HbA1c concentration < 7.0%. Furthermore, we found the mean of HbA1c was higher in the diabetes mellitus with tuberculosis group than the diabetes-only group (P = 0.002). In the sensitivity analysis, the finding remains consistent.

Conclusion: Our study provides the evidence that poorly controlled diabetes in diabetics may be associated with increased prevalence of tuberculosis. More efforts should focus on screening tuberculosis in uncontrolled diabetes.

Keywords: Diabetes; Glycemic control; Meta-analysis; Tuberculosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of literature search
Fig. 2
Fig. 2
Forest plot of observational studies on poorly controlled diabetes mellitus and tuberculosis infection. Abbreviations: CI: confidence interval, HbA1c: glycated haemoglobin A1c, M-H: Mantel-Haenszel
Fig. 3
Fig. 3
Funnel plot of observational studies on poorly controlled diabetes mellitus and tuberculosis infection
Fig. 4
Fig. 4
Forest plot of observational studies on glycated haemoglobin A1c and tuberculosis infection. Abbreviations: CI: confidence interval, IV: inverse variance
Fig. 5
Fig. 5
Forest plot of observational studies on fasting plasma glucose and tuberculosis infection. Abbreviations: CI: confidence interval, IV: inverse variance
See this image and copyright information in PMC

References

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