A novel risk factor for predicting anti-tuberculosis drug resistance in patients with tuberculosis complicated with type 2 diabetes mellitus.

Abstract Objectives This work aimed to explore the relationship between glycosylated hemoglobin (HbA1c) and the risk of anti-tuberculosis (TB) drug resistance for TB-type 2 diabetes mellitus (T2DM) patients. Methods From March 2014 to June 2019, medical records from multi-centers were searched. Logistic regression analyses were performed. Predictive model for multidrug resistance (MDR) was developed and validated. Calibration and discrimination of the model were assessed. Results Inconsistent results were found in a systemic review. A multi-center chart review with 657 records was thus conducted. HbA1c https://mengyuan.shinyapps.io/Shinyapp/ ) showed excellent capacity with AUC of 75.4% in training set and 73.9% in internal validation set. The performance in calibration, prediction probabilities and net clinical benefit were significantly improved by HbA1c grading. Conclusions HbA1c grading was an independent risk factor for isoniazid resistance and MDR in TB-T2DM patients.