Impact of diabetes and smoking on mortality in tuberculosis.
Diabetes mellitus is a risk factor for tuberculosis (TB) disease. There is evidence that diabetes also influences TB severity and treatment outcomes but information is incomplete and some published results have been inconsistent.A longitudinal cohort study was conducted at the National Masan Tubercu...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3585219?pdf=render |
| _version_ | 1819163030266576896 |
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| author | George W Reed Hongjo Choi So Young Lee Myungsun Lee Youngran Kim Hyemi Park Jongseok Lee Xin Zhan Hyeungseok Kang SooHee Hwang Matthew Carroll Ying Cai Sang-Nae Cho Clifton E Barry Laura E Via Hardy Kornfeld |
| author_facet | George W Reed Hongjo Choi So Young Lee Myungsun Lee Youngran Kim Hyemi Park Jongseok Lee Xin Zhan Hyeungseok Kang SooHee Hwang Matthew Carroll Ying Cai Sang-Nae Cho Clifton E Barry Laura E Via Hardy Kornfeld |
| author_sort | George W Reed |
| collection | DOAJ |
| description | Diabetes mellitus is a risk factor for tuberculosis (TB) disease. There is evidence that diabetes also influences TB severity and treatment outcomes but information is incomplete and some published results have been inconsistent.A longitudinal cohort study was conducted at the National Masan Tuberculosis Hospital in the Republic of Korea. Subjects presenting with a first episode of TB or for retreatment of TB were followed from enrollment through completion of treatment. Demographic, clinical, and microbiological variables were recorded, along with assessment of outcomes. Results were compared in TB patients with and without diabetes or smoking history. Data were adjusted for gender, age, cohort, educational level and alcohol consumption.The combined cohorts comprised 657 subjects. Diabetes was present in 25% and was associated with greater radiographic severity and with recurrent or relapsed TB. Diabetes and cigarette smoking independently increased the risk of death in the first 12 months after enrollment. Estimating the combined impact of diabetes and smoking yielded a hazard ratio of 5.78. Only 20% of diabetic subjects were non-smokers; 54% smoked ≥1 pack daily. In this cohort, the impact of diabetes on mortality was greater in patients younger than 50 years, compared to older patients.In this cohort of Korean patients, diabetes exacerbated the severity of TB disease. Diabetic subjects who smoked ≥1 pack of cigarettes daily were at particularly high risk of death from TB. Strategies to improve TB outcomes could productively focus resources for patient education and TB prevention on the vulnerable population of younger diabetics, particularly those who also smoke. |
| first_indexed | 2024-12-22T17:37:39Z |
| format | Article |
| id | doaj.art-73374be761894054a111c03ee8bac9a8 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T17:37:39Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-73374be761894054a111c03ee8bac9a82022-12-21T18:18:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0182e5804410.1371/journal.pone.0058044Impact of diabetes and smoking on mortality in tuberculosis.George W ReedHongjo ChoiSo Young LeeMyungsun LeeYoungran KimHyemi ParkJongseok LeeXin ZhanHyeungseok KangSooHee HwangMatthew CarrollYing CaiSang-Nae ChoClifton E BarryLaura E ViaHardy KornfeldDiabetes mellitus is a risk factor for tuberculosis (TB) disease. There is evidence that diabetes also influences TB severity and treatment outcomes but information is incomplete and some published results have been inconsistent.A longitudinal cohort study was conducted at the National Masan Tuberculosis Hospital in the Republic of Korea. Subjects presenting with a first episode of TB or for retreatment of TB were followed from enrollment through completion of treatment. Demographic, clinical, and microbiological variables were recorded, along with assessment of outcomes. Results were compared in TB patients with and without diabetes or smoking history. Data were adjusted for gender, age, cohort, educational level and alcohol consumption.The combined cohorts comprised 657 subjects. Diabetes was present in 25% and was associated with greater radiographic severity and with recurrent or relapsed TB. Diabetes and cigarette smoking independently increased the risk of death in the first 12 months after enrollment. Estimating the combined impact of diabetes and smoking yielded a hazard ratio of 5.78. Only 20% of diabetic subjects were non-smokers; 54% smoked ≥1 pack daily. In this cohort, the impact of diabetes on mortality was greater in patients younger than 50 years, compared to older patients.In this cohort of Korean patients, diabetes exacerbated the severity of TB disease. Diabetic subjects who smoked ≥1 pack of cigarettes daily were at particularly high risk of death from TB. Strategies to improve TB outcomes could productively focus resources for patient education and TB prevention on the vulnerable population of younger diabetics, particularly those who also smoke.http://europepmc.org/articles/PMC3585219?pdf=render |
| spellingShingle | George W Reed Hongjo Choi So Young Lee Myungsun Lee Youngran Kim Hyemi Park Jongseok Lee Xin Zhan Hyeungseok Kang SooHee Hwang Matthew Carroll Ying Cai Sang-Nae Cho Clifton E Barry Laura E Via Hardy Kornfeld Impact of diabetes and smoking on mortality in tuberculosis. PLoS ONE |
| title | Impact of diabetes and smoking on mortality in tuberculosis. |
| title_full | Impact of diabetes and smoking on mortality in tuberculosis. |
| title_fullStr | Impact of diabetes and smoking on mortality in tuberculosis. |
| title_full_unstemmed | Impact of diabetes and smoking on mortality in tuberculosis. |
| title_short | Impact of diabetes and smoking on mortality in tuberculosis. |
| title_sort | impact of diabetes and smoking on mortality in tuberculosis |
| url | http://europepmc.org/articles/PMC3585219?pdf=render |
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