Poor sleep quality is associated with higher risk of pulmonary tuberculosis among patients with type 2 diabetes mellitus course more than 5 years

Abstract

A case-control study was conducted in Shandong from January to December 2017 to explore the relationship between sleep quality and risk of active pulmonary tuberculosis (PTB). 79 Type 2 diabetes mellitus coincident with newly diagnosed pulmonary tuberculosis (DM-PTB) and age-, sex-, and DM course- frequency-matched 169 controls (DM alone) were enrolled. Univariate and multivariable unconditional logistic regression analysis were used. We further conducted subgroup analyses to explore the relationship between sleep quality and PTB risk, including DM course (≤5, >5 years), age, sex, the present of overweight/obesity (BMI >24). Multivariate logistic regression demonstrated poor sleep quality had a borderline negative association with the odds of PTB (P = 0.065). Subgroup multivariate analyses showed poor sleep quality increased the risk of PTB to more than 3 times among patients with DM course >5 years (OR 3.31, 95%CI: 1.08-10.13; P =0.036) after adjusted for the potential confounding factors including residential area, educational level, BMI, history of contact with TB patients, smoking, alcohol consumption, physical exercise, immune status and the frequency of blood glucose monitoring. In conclusion, poor sleep quality is an independent risk factor of PTB among DM patients with course >5 years, which indicates significant epidemiological implications for PTB control.