Incidence and risk factors of asymptomatic bacteriuria in patients with type 2 diabetes mellitus: a meta-analysis

BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) is increasing each year and has become one of the most prominent health concerns worldwide. Patients with T2DM are prone to infectious diseases, and urinary tract infections are also widespread. Despite a comprehensive understanding of urinary tract infection (UTI), there is a lack of research regarding primary prevention strategies for asymptomatic bacteriuria (ASB). OBJECTIVE: To clarify the incidence and risk factors of asymptomatic urinary tract infection in patients with T2DM by meta-analysis to provide evidence for preventing UTI. Help patients, their families, and caregivers to identify the risk factors of patients in time and intervene to reduce the incidence of ASB in patients with T2DM. Fill in the gaps in existing research. STUDY DESIGN: Meta-analyses were conducted in line with PRISMA guidelines. METHODS: Eleven databases were systematically searched for articles about ASB in T2DM, and the retrieval time was selected from the establishment of the database to February 5, 2023. Literature screening, quality evaluation, and meta-analysis were independently performed by two researchers according to the inclusion and exclusion criteria, and a meta-analysis was performed using Stata 17.0. RESULTS: Fourteen articles were included, including cohort and case–control studies. A meta-analysis of 4044 patients with T2DM was included. The incidence of ASB in patients with T2DM was 23.7%(95% CI (0.183, 0.291); P < 0.001). After controlling for confounding variables, the following risk factors were associated with ASB in patients with T2DM: age (WMD = 3.18, 95% CI (1.91, 4.45), I(2) = 75.5%, P < 0.001), female sex (OR = 1.07, 95% CI(1.02, 1.12), I(2) = 79.3%, P = 0.002), duration of type 2 diabetes (WMD = 2.54, 95% CI (1.53, 5.43), I(2) = 80.7%, P < 0.001), HbA1c (WMD = 0.63, 95% CI (0.43, 0.84), I(2) = 62.6,%. P < 0.001), hypertension (OR = 1.59, 95% CI (1.24, 2.04), I(2) = 0%, <0.001), hyperlipidemia (OR = 1.66, 95% CI (1.27, 2.18), I(2) = 0%, P < 0.001), Neuropathy (OR = 1.81, 95% CI (1.38, 2.37), I(2) = 0%, P < 0.001), proteinuria (OR = 3.00, 95% CI (1.82, 4.95), I(2) = 62.7%, P < 0.001). CONCLUSION: The overall prevalence of ASB in T2DM is 23.7%. Age, female sex, course of T2DM, HbA1C, hypertension, hyperlipidemia, neuropathy, and proteinuria were identified as related risk factors for ASB in T2DM. These findings can provide a robust theoretical basis for preventing and managing ASB in T2DM.