Prediabetes and risk of active tuberculosis

Ko, T.H., Chang, Y.C., Chang, C.H., Liao, K.C.W., Magee, M.J. and Lin, H.H., 2023. Prediabetes and risk of active tuberculosis: a cohort study from Northern Taiwan. International Journal of Epidemiology, 52(3), pp.932-941.

- Numerous studies and systematic reviews confirm diabetes mellitus (DM) as a major risk factor for active TB disease and latent TB infection.
- Incident cases of active TB were identified from the National Tuberculosis Registry in Taiwan.
- TB is a notifiable disease in Taiwan; presumptive TB cases must undergo sputum smear examinations at least twice and sputum cultures.
- All confirmed TB cases are registered in the National Tuberculosis Registry and receive standardized and free treatment.
- In this study, patients with smear-positive or culture-positive results are defined as active TB cases.
-  Prediabetes is associated with a 27% reduced risk of active TB disease compared to normoglycaemia.
- The biological mechanism of this inverse association and its implications for global nutrition transition and TB control require further investigation.
- This is the first longitudinal study investigating the association between prediabetes and the risk of TB.
- The novel finding has critical implications for the dual epidemic of diabetes and tuberculosis.
- Given the protective association of obesity and prediabetes with tuberculosis, the global nutrition transition may represent a double-edged sword for global TB control.

- More research is needed to fully understand the biological mechanism and public health implications of the relationship between prediabetes and TB. 

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