PMID- 28237037
OWN - NLM
STAT- MEDLINE
DCOM- 20171121
LR  - 20220409
IS  - 1873-281X (Electronic)
IS  - 1472-9792 (Linking)
VI  - 103
DP  - 2017 Mar
TI  - The effect size of type 2 diabetes mellitus on tuberculosis drug resistance and 
      adverse treatment outcomes.
PG  - 83-91
LID - S1472-9792(16)30430-9 [pii]
LID - 10.1016/j.tube.2017.01.006 [doi]
AB  - OBJECTIVE: To evaluate the effect size of type 2 diabetes mellitus (T2DM) on 
      tuberculosis (TB) treatment outcomes and multi drug resistance (MDR). METHODS: A 
      cohort with 507 individuals with diagnosed TB included 183 with coexistence of 
      T2DM and TB (TB-T2DM). Participants were identified at the time of TB diagnosis 
      and followed during the course of TB treatment. Then we computed relative risks 
      and adjustments by Cox proportional hazards for outcome variables (drug 
      resistance, death, relapse, treatment failure), and the size of their effect as 
      Cohen's-d. RESULTS: Patients with TB-T2DM were more likely to remain positive for 
      acid-fast bacilli after two months of anti-TB treatment RR = [2.01 (95% CI: 1.3, 
      3.1)], to have drug resistant (DR) [OR 3.5 (95% CI: 1.8, 6.7)] and multi-drug 
      resistant (MDR) TB [OR 3.5 (95% CI: 1.8, 7.1)]. The Cohen's-d for DR or MDR in 
      T2DM was 0.69 when compared with non-DM subjects. The T2DM patients had higher 
      odds of resistance to isoniazid (OR 3.9, 95% CI: 2.01, 7.9), rifampicin (OR 3.4, 
      95% CI: 1.6, 7.2) and pyrazinamide (OR 9.4, 95% CI: 2.8, 25.6), and their effect 
      sizes were >/=0.67. Patients with TB-T2DM (versus no DM) were more likely to 
      present with MDR TB (HR 3.1; 95% CI: 1.7, 5.8; p < 0.001), treatment failure (HR 
      2.04; 95% CI: 1.07, 3.8; p = 0.02) and relapse (HR 1.86; 95% CI: 1.09, 3.1; p = 
      0.02), with effect size >/=0.34. CONCLUSION: T2DM showed a substantial contribution 
      to the presence of DR or MDR-TB and to adverse clinical outcomes during and after 
      TB treatment. Our findings support the importance for routine screening of T2DM 
      among newly-diagnosed TB patients in order to stratify them for immediate DR 
      assessment, and highlight the need for clinical trials to evaluate variations to 
      the standard TB treatment in TB-T2DM to prevent adverse treatment outcomes.
CI  - Copyright (c) 2017 Elsevier Ltd. All rights reserved.
FAU - Perez-Navarro, Lucia Monserrat
AU  - Perez-Navarro LM
AD  - Nephrology Service, Research Division, Hospital General de Mexico "Dr. Eduardo 
      Liceaga", Mexico; Public Health Institute, University of Veracruz, Veracruz, 
      Mexico.
FAU - Restrepo, Blanca I
AU  - Restrepo BI
AD  - University of Texas Health Science Center Houston, Brownsville Campus, 
      Brownsville, TX, USA.
FAU - Fuentes-Dominguez, Francisco Javier
AU  - Fuentes-Dominguez FJ
AD  - Mycobacteriosis State Program, Veracruz Health Services, Mexico.
FAU - Duggirala, Ravindranath
AU  - Duggirala R
AD  - South Texas Diabetes and Obesity Institute, University of Texas Rio Grande 
      Valley, Edinburg, TX, USA.
FAU - Morales-Romero, Jaime
AU  - Morales-Romero J
AD  - Public Health Institute, University of Veracruz, Veracruz, Mexico.
FAU - Lopez-Alvarenga, Juan Carlos
AU  - Lopez-Alvarenga JC
AD  - South Texas Diabetes and Obesity Institute, University of Texas Rio Grande 
      Valley, Edinburg, TX, USA.
FAU - Comas, Inaki
AU  - Comas I
AD  - Unidad de Genomica de la Tuberculosis, Instituto de Biomedicina de Valencia, 
      Consejo Superior de Investigaciones Cientificas, Valencia, Spain.
FAU - Zenteno-Cuevas, Roberto
AU  - Zenteno-Cuevas R
AD  - Public Health Institute, University of Veracruz, Veracruz, Mexico; Red 
      multidisciplinaria de Investigacion en tuberculosis, Mexico. Electronic address: 
      robzencue@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20170124
PL  - Scotland
TA  - Tuberculosis (Edinb)
JT  - Tuberculosis (Edinburgh, Scotland)
JID - 100971555
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Adult
MH  - Antitubercular Agents/adverse effects/*therapeutic use
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 2/diagnosis/*epidemiology/mortality
MH  - *Drug Resistance, Multiple, Bacterial
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Mexico/epidemiology
MH  - Odds Ratio
MH  - Proportional Hazards Models
MH  - Recurrence
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Failure
MH  - Tuberculosis, Multidrug-Resistant/diagnosis/*drug therapy/mortality
OTO - NOTNLM
OT  - Effect
OT  - Size
OT  - Tuberculosis
OT  - Type 2 diabetes mellitus
EDAT- 2017/02/27 06:00
MHDA- 2017/11/29 06:00
CRDT- 2017/02/27 06:00
PHST- 2016/10/10 00:00 [received]
PHST- 2017/01/19 00:00 [revised]
PHST- 2017/01/21 00:00 [accepted]
PHST- 2017/02/27 06:00 [entrez]
PHST- 2017/02/27 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
AID - S1472-9792(16)30430-9 [pii]
AID - 10.1016/j.tube.2017.01.006 [doi]
PST - ppublish
SO  - Tuberculosis (Edinb). 2017 Mar;103:83-91. doi: 10.1016/j.tube.2017.01.006. Epub 
      2017 Jan 24.