Prevalence and Associated Factors of Urinary Tract Infection in Patients with Diabetic Neuropathy: A Hospital-Based Cross-Sectional Study

Figures & data

Table 1 Association Between Demographic Characteristics and Urinary Tract Infections in Patients with Diabetic Neuropathy

Demographic Characteristics	Total	UTI	Non-UTI	P
Sex, n (%)				<0.001
Male	395 (68.2)	47 (11.9)	348 (88.1)
Female	184 (31.8)	86 (46.7)	98 (53.3)
Total	579 (100)	133 (23.0)	446 (77.0)
Age, year, means (SD)	57.89 (11.64)	56.63 (11.36)	62.12 (11.61)	<0.001
Age group, n (%)				<0.001
<45 year	63 (10.9)	5 (7.9)	58 (92.1)
45–54 year~	173 (29.9)	36 (20.8)	137 (79.2)
55–64 year~	182 (31.4)	35 (19.2)	147 (80.8)
≥65 year	181 (27.8)	57 (35.4)	104 (64.6)
Education level, n (%)				0.001
1~6 year	162 (29.5)	55 (34.0)	107 (66.0)
7~9 year	143 (26.0)	27 (18.9)	116 (81.1)
10~12 year	200 (36.4)	37 (18.5)	163 (81.5)
>12 year	44 (8.0)	7 (15.9)	37 (84.1)
Types of medical insurance, n (%)				0.218
Workers medical insurance	130 (22.6)	25 (19.2)	105 (80.8)
Resident medical insurance	356 (61.8)	80 (22.5)	276 (77.5)
Self-paying	51 (8.9)	16 (31.4)	35 (68.6)
Other	39 (6.8)	12 (30.8)	27 (69.2)
BMI, kg/m^2, means (SD)	24.05 (3.46)	24.56 (3.95)	23.90 (3.29)	0.070
BMI group, n (%)				0.781
Normal weight group	271 (52.8)	59 (21.8)	212 (78.2)
Overweight group	177 (34.5)	43 (24.3)	134 (75.7)
Obesity group	65 (12.7)	16 (24.6)	49 (75.4)
History of diabetes, n (%)				0.444
< 10 year	289 (54.8)	63 (21.8)	226 (78.2)
10 year~	169 (32.1)	40 (23.7)	129 (76.3)
≥ 20 year	69 (13.1)	20 (29.0)	49 (71.0)
Mode of insulin administration, n (%)				0.008
Oral medicine	164 (28.3)	27 (16.5)	137 (83.5)
Oral and intravenous medicine	237 (40.9)	28 (22.0)	99 (78.0)
Without medicine	127 (21.9)	12 (23.5)	39 (76.5)
Intravenous medicine	51 (8.8)	66 (27.8)	171 (72.2)

Abbreviations: UTI, urinary tract infections; Non-UTI, non-urinary tract infections; BMI, body mass index.

Table 2 Association Between Clinical Characteristics and Urinary Tract Infections in Patients with Diabetic Neuropathy

Clinical Characteristics	Total	UTI	Non-UTI	P
Complication, n (%)
Peripheral vascular disease				0.226
Yes	235 (40.6)	60 (25.5)	175 (39.2)
No	344 (59.4)	73 (21.2)	271 (78.8)
Retinopathy				0.513
Yes	223 (38.5)	48 (21.5)	175 (78.5)
No	356 (61.5)	85 (23.9)	271 (76.1)
Diabetic nephropathy				0.859
Yes	136 (23.5)	32 (23.5)	104 (76.5)
No	443 (76.5)	101 (22.8)	342 (77.2)
Ketoacidosis				0.208
Yes	14 (2.4)	1 (7.1)	13 (92.9)
No	565 (97.6)	132 (23.4)	433 (76.6)
Hypertension				0.386
Yes	290 (50.1)	71 (24.5)	219 (75.5)
No	289 (49.9)	62 (21.5)	227 (78.5)
Coronary heart disease				0.858
Yes	80 (13.8)	19 (23.8)	61 (76.3)
No	499 (86.2)	114 (22.8)	385 (77.2)
Cataract				0.002
Yes	158 (27.3)	50 (31.6)	108 (68.4)
No	421 (72.7)	83 (19.7)	338 (80.3)
Pulmonary infection				0.069
Yes	37 (6.4)	13 (35.1)	24 (64.9)
No	542 (93.6)	120 (22.1)	422 (77.9)
Electrolyte disturbance				0.082
Yes	5 (0.9)	3 (60.0)	2 (40.0)
No	574 (99.1)	130 (22.6)	444 (77.4)
Hypoproteinemia				0.138
Yes	11 (1.9)	5 (45.5)	6 (54.5)
No	568 (98.1)	128 (22.5)	440 (77.5)
Chronic kidney disease				0.006
Yes	39 (6.7)	16 (41.0)	23 (59.0)
No	540 (93.3)	117 (21.7)	423 (78.3)
History of urinary tract infection				<0.001
Yes	22 (3.8)	19 (86.4)	3 (13.6)
No	557 (96.2)	114 (20.5)	443 (79.5)
Hemoglobin A1c level, n (%)				0.058
< 6.5%	50 (10.7)	17 (34.0)	33 (66.0)
6.5%~	28 (6.0)	3 (10.7)	25 (89.3)
7.0%~	108 (23.2)	30 (27.8)	78 (72.2)
≥8.5%	280 (60.1)	54 (19.3)	226 (80.7)
Fasting plasma glucose level—no (%)				0.461
≤7.0mmol/L	197 (60.6)	42 (21.3)	155 (78.7)
>7.0mmol/L	128 (39.4)	23 (18.0)	105 (82.0)
2-hour postprandial blood glucose, n (%)				0.689
< 10 mmol/L	34 (10.0)	8 (23.5)	26 (76.5)
≥ 10 mmol/L	306 (90.0)	63 (20.6)	243 (79.4)
Urine nitrite, n (%)				<0.001
Positive	34 (6.1)	31 (91.2)	3 (8.8)
Negative	523 (93.9)	102 (19.5)	421 (80.5)
Residual urine volume, n (%)				<0.001
Normal group	431 (74.4)	75 (17.4)	356 (82.6)
High group	148 (25.6)	58 (39.2)	90 (60.8)

Abbreviations: UTI, urinary tract infections; Non-UTI, non-urinary tract infections.

Table 3 Univariate Analysis of Associated Factors with Urinary Tract Infections in Patients with Diabetic Neuropathy

Index	UTI		Non-UTI		P
	N	Means (SD)	N	Means (SD)
Glycated hemoglobin level, mmol/L	104	9.22 (2.68)	362	9.89 (2.84)	0.034
Fasting plasma glucose level, mmol/L	65	6.69 (2.01)	260	6.87 (2.30)	0.323
2-hour postprandial plasma glucose level, mmol/L	71	16.16 (4.70)	269	15.76 (4.26)	0.571
Urine specific gravity	131	1.02 (0.01)	416	1.05 (0.36)	0.292
Urine PH	132	5.70 (0.73)	416	5.76 (0.63)	0.352
Residual urine volume, mL	133	42.07 (85.96)	446	25.51 (61.95)	0.040

Abbreviations: UTI, urinary tract infections; Non-UTI, non-urinary tract infections.

Table 4 Multivariate Analysis of Associated Factors with Urinary Tract Infections in Patients with Diabetic Neuropathy

Influence Factors	Reference Group	OR (95% CI)	P
Age group:	<45 years
45 years~		3.91 (1.02, 15.03)	0.047
55 years~		2.31 (0.59, 9.03)	0.228
≥65 years		4.87 (1.23, 19.25)	0.024
Female sex	Male sex	4.12 (2.24, 7.60)	<0.001
Education level:	1~6 years
7~9 years		0.58 (0.26, 1.30)	0.184
10~12 years		0.92 (0.45, 1.89)	0.821
>12 years		1.12 (0.32, 3.84)	0.863
Mode of insulin administration:	Oral medicine
Oral and intravenous medicine		1.05 (0.44, 2.52)	0.910
Without medicine		1.95 (0.66, 5.73)	0.225
Intravenous medicine		2.10 (1.02, 4.35)	0.045
Cataract	No	1.17 (0.59, 2.30)	0.657
Electrolyte disturbance	No	2.32 (0.03, 215.08)	0.716
Chronic kidney disease	Without chronic kidney disease	3.12 (1.11, 8.80)	0.032
History of urine tract infection	No	45.92 (8.62, 244.76)	<0.001
Glycated hemoglobin level	—	0.96 (0.86, 1.08)	0.494
Positive urine nitrite	Negative	32.87 (7.37, 146.70)	<0.001
High residual urine volume	Normal	2.19 (1.17, 4.10)	0.014

Figure 1 Associated factors of UTI among patients with diabetic neuropathy showed that older age, female sex, hypodermic injection mode of treatment administration, CKD, history of UTI, and positive urinary nitrite were associated with UTI in patients with diabetic neuropathy in the multivariate analysis.