Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 7 (1), 1090

Diabetes Mellitus and the Risk of Multidrug Resistant Tuberculosis: A Meta-Analysis


Diabetes Mellitus and the Risk of Multidrug Resistant Tuberculosis: A Meta-Analysis

Qianqian Liu et al. Sci Rep.


The high prevalence of diabetes mellitus (DM) among multidrug resistant tuberculosis (MDR-TB) patients is a serious cause for concern. We conducted a meta-analysis to determine whether DM is an independent risk factor for MDR-TB. Electronic literature searches of the PubMed, Web of Science and EMBASE databases up to July 12, 2016 were conducted. The pooled adjusted odds ratio (OR) and 95% confidence intervals (CIs) were calculated using the random effects model with STATA 12.0 software. In total 13 studies, including 9289 individuals with TB, were included in this meta-analysis. Significant association between DM and MDR-TB (OR = 1.71; 95% CI = 1.32, 2.22) was identified. Subgroup analyses showed that: 1) Pooled OR was 1.25 (95% CI: 0.82-1.91) for cross-sectional studies, and was 2.14 (95% CI: 1.51-3.02) for longitudinal studies; 2) The pooled OR was 1.69 (95% CI:1.09-2.62) for primary MDR-TB, 1.94 (95% CI:1.42-2.65) for any MDR-TB, and 0.85 for secondary MDR-TB (95% CI: 0.29-2.54); 3) DM was significantly associated with MDR-TB in both Caucasian (OR = 2.26, 95% CI: 1.66-3.07) and Asian (OR = 1.40, 95% CI: 1.01-1.95) subgroups. No evidence of publication bias was identified. In conclusion, the pooling analysis indicated that DM was an independent risk factor for MDR-TB, especially for primary MDR-TB.

Conflict of interest statement

The authors declare that they have no competing interests.


Figure 1
Figure 1
Flow diagram of included studies.
Figure 2
Figure 2
Forest plot of odds ratio (OR) assessing the association between diabetes mellitus and multidrug resistance tuberculosis. CI, confidence interval.
Figure 3
Figure 3
Funnel plots for publication bias.

Similar articles

See all similar articles

Cited by 10 PubMed Central articles

See all "Cited by" articles


    1. WHO. Global tuberculosis report 2015. Geneva, Switzerland: WHO, 2015. (accessed July 1, 2016).
    1. Narayanan, P. R. Evaluation of a non-rifampicin continuation phase (6HE) following thrice-weekly intensive phase for the treatment of new sputum positive pulmonary tuberculosis. The Indian journal of tuberculosis54, 84–90 (2007). - PubMed
    1. Ahuja SD, et al. Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients. PLoS medicine. 2012;9:e1001300. doi: 10.1371/journal.pmed.1001300. - DOI - PMC - PubMed
    1. Faustini A, Hall AJ, Perucci CA. Risk factors for multidrug resistant tuberculosis in Europe: a systematic review. Thorax. 2006;61:158–163. doi: 10.1136/thx.2005.045963. - DOI - PMC - PubMed
    1. Caminero JA. Multidrug-resistant tuberculosis: epidemiology, risk factors and case finding. The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease. 2010;14:382–390. - PubMed

Publication types