Sex-Specific Differences in the Clinical Profile Among Patients with Tracheobronchial Tuberculosis: A Hospital-Based Cross-Sectional Study in Shenzhen, China

Abstract

Jiapeng Fu,1– 3,* Jian Li,1– 3,* Zhi Liu,1– 3 Shasha Zheng,1– 3 Xue Li,1– 3 Xianjia Ning,4,5 Jinghua Wang,4,5 Wenying Gao,1– 3 Guobao Li1– 3 1Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 2The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 3National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong, People’s Republic of China; 4Center of Clinical Epidemiology, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 5Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guobao Li; Wenying Gao, Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel [phone], Fax [phone], Email [email protected]; [email protected]: Tracheobronchial tuberculosis (TBTB) has been proposed to occur more commonly in female patients. However, to date, studies that systematically delineate differences between female and male patients with TB infection are lacking. We aimed to comprehensively assess the sex-specific differences in clinical manifestation, bronchoscopy performance, bacteriological examination, and imaging of TBTB in Shenzhen, China.Methods: All patients with diagnosed TBTB from August 1, 2018 to July 31, 2021 at The Third People’s Hospital of Shenzhen were enrolled in the present study. Demographic information, clinical manifestations, blood tests, chest computed tomography, and bronchoscopic findings were collected, and assessed their sex-specific differences.Results: Of these 331 patients, 238 patients (71.9%) were female, and 93 patients (28.1%) were male, with an overall average age of 37.3 years. The average age of male patients with TBTB was more than 5 years older than that of female patients. The prevalence of lymph fistula and diabetes mellitus was significantly higher in male patients than female patients (8.6% vs 1.7%, P = 0.005; 17.2% vs 2.1%, P < 0.001). The positive proportion of sputum smear was higher in male patients (27.9%) than in female patients (16.7%, P = 0.026). Moreover, the mean monocyte-to-lymphocyte ratio, serum CRP, and IL-6 levels were significantly higher in male patients than in female patients (P < 0.05).Conclusion: In summary, in patients with TBTB diagnosis, male sex was associated with a high prevalence of diabetes mellitus, lymph fistula, and smear-positive ratio, as well as high inflammation levels. The management of young female and male patients with diabetes mellitus and high inflammation levels should be strengthened. Furthermore, to reduce the burden of TBTB, we must pay attention to the risk of TBTB in past tuberculosis patients, especially male patients under 45 years old and female patients over 45 years old.Keywords: sex difference, tracheobronchial tuberculosis, inflammation

Keywords

• sex difference
• tracheobronchial tuberculosis
• inflammation.