The role of diabetes mellitus in the higher prevalence of tuberculosis among Hispanics

Am J Public Health. 1997 Apr;87(4):574-9. doi: 10.2105/ajph.87.4.574.


Objectives: This research studied the relative contribution of diabetes mellitus to the increased prevalence of tuberculosis in Hispanics.

Methods: A case-control study was conducted involving all 5290 discharges from civilian hospitals in California during 1991 who had a diagnosis of tuberculosis, and 37,366 control subjects who had a primary discharge diagnosis of deep venous thrombosis, pulmonary embolism, or acute appendicitis. Risk of tuberculosis was estimated as the odds ratio (OR) across race/ethnicity, with adjustment for other factors.

Results: Diabetes mellitus was found to be an independent risk factor for tuberculosis. The association of diabetes and tuberculosis was higher among Hispanics (adjusted OR [ORadj] = 2.95: 95% confidence interval [CI] = 2.61, 3.33) than among non-Hispanic Whites (ORadj = 1.31: 95% CI = 1.19. 1.45): among non-Hispanic Blacks, diabetes was not found to be associated with tuberculosis (ORadj = 0.93: 95% CI = 0.78, 1.09). Among Hispanics aged 25 to 54, the estimated risk of tuberculosis attributable to diabetes (25.2%) was equivalent to that attributable to HIV infection (25.5%).

Conclusions: Diabetes mellitus remains a significant risk factor for tuberculosis in the United States. The association is especially notable in middle-aged Hispanics.

MeSH terms

  • Adult
  • California / epidemiology
  • Case-Control Studies
  • Diabetes Complications*
  • Diabetes Mellitus / epidemiology
  • Female
  • HIV Infections / complications
  • Hispanic or Latino*
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Tuberculosis / epidemiology*
  • Tuberculosis / etiology