BMI, diabetes, and risk of tuberculosis

A population-based cohort study in Eastern China (2013–2021) followed 27,807 individuals to examine tuberculosis (TB) incidence and risk factors. The median age was 50 years, with 18.3% over 65 years old. About half were female, and 34.8% were overweight or obese. Smoking and alcohol consumption were reported by 20.9% and 17.4%, respectively, while 58.8% had BCG vaccination. Diabetes prevalence was 6%.[1] See also: https://tbreadingnotes.blogspot.com/2024/08/assessing-spatiotemporal-patterns-of.html

Over seven years, 108 individuals developed TB (incidence rate: 50.4 per 100,000 person-years). Diabetes was linked to a higher TB incidence (131.2 vs. 47.1 per 100,000 person-years, P = 0.008). Among those with a BMI ≤24 kg/m², diabetics had a 3.4 times higher TB incidence than non-diabetics, whereas no difference was seen among those with a BMI >24 kg/m².[1] See also: https://tbreadingnotes.blogspot.com/2024/08/a-modelling-framework-to-support.html

Males had a higher TB incidence than females, while BCG scars were associated with lower TB rates. Risk factors in a multivariable model included male sex, older age, and diabetes. Higher BMI was protective against TB. Among those with BMI ≤24 kg/m², diabetes significantly increased TB risk, but not in those with BMI >24 kg/m². BCG scars reduced TB risk in individuals with low BMI.[1]

A study using data from Korea's National Health Insurance Service analyzed 4.4 million adults and found that diabetes increases TB risk by 48%, with a 57% higher risk in those diabetic for 5+ years. The association is stronger in men and younger adults, and new diabetics with the highest fasting plasma glucose levels face a 79% increased TB risk.[2]

A Taiwan NHIRD study (2002–2013) found that adults face a higher risk of diabetes, AMI, and stroke after TB treatment, particularly if treatment lasts 7–12 months. Age, gender, and pre-existing NCDs are key predictors, highlighting the need for vigilant post-TB monitoring.[3]

References:

1. Lu, P., Zhang, Y., Liu, Q., Ding, X., Kong, W., Zhu, L. and Lu, W., 2021. Association of BMI, diabetes, and risk of tuberculosis: a population-based prospective cohort. International Journal of Infectious Diseases, 109, pp.168-173.

2. Yoo JE, Kim D, Han K, Rhee SY, Shin DW, Lee H. Diabetes status and association with risk of tuberculosis among Korean adults. JAMA network open. 2021 Sep 1;4(9):e2126099.

3. Salindri, A.D., Wang, J.Y., Lin, H.H. and Magee, M.J., 2019. Post-tuberculosis incidence of diabetes, myocardial infarction, and stroke: retrospective cohort analysis of patients formerly treated for tuberculosis in Taiwan, 2002–2013. International Journal of Infectious Diseases, 84, pp.127-130.