Diabetes modifies the male:female ratio in pulmonary tuberculosis
C Pérez-Guzmán1, M H Vargas, A Torres-Cruz
1Instituto Nacional de Enfermedades Respiratorias, Hospital General, CMN La Raza, México DF, Mexico.
Summary
Diabetes alters the male predominance typically seen in pulmonary tuberculosis patients. This suggests non-socio-cultural factors influence gender differences in tuberculosis, especially in older adults.
Area of Science:
- Pulmonary Medicine
- Endocrinology
- Epidemiology
Background:
- Male predominance in pulmonary tuberculosis (TB) has been observed, with socio-cultural factors often cited as a cause.
- However, conclusive evidence supporting the role of socio-cultural factors in this male predominance remains limited.
- Understanding factors influencing TB demographics is crucial for targeted public health interventions.
Purpose of the Study:
- To investigate the association between diabetes mellitus and the male predominance in pulmonary tuberculosis.
- To compare the male-to-female ratio in patients with pulmonary tuberculosis and diabetes mellitus (TBDM) versus those with pulmonary tuberculosis alone (TB).
- To analyze how age influences gender distribution in these patient groups.
Main Methods:
- Retrospective review of clinical records for in-patients diagnosed with pulmonary tuberculosis.
- Patients were categorized into two groups: those with (TBDM, n=202) and without (TB, n=226) diabetes mellitus.
- Male percentages were calculated across six defined age groups (15-29 to ≥70 years) for both groups.
Main Results:
- The TB group showed no gender difference in the youngest age group, followed by a male predominance in older age brackets.
- The TBDM group initially mirrored the TB group's pattern but exhibited a significant decline in male percentage after age 50, leading to female predominance.
- Logistic regression confirmed a significant association between age and gender in TBDM patients (P=0.02), but not in TB patients (P=0.19).
Conclusions:
- Diabetes mellitus is associated with a shift away from male predominance in pulmonary tuberculosis, particularly in older individuals.
- The findings indicate that factors beyond socio-cultural influences play a significant role in the gender distribution of pulmonary tuberculosis.
- This highlights the complex interplay between comorbidities like diabetes and the epidemiology of infectious diseases.
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