Alcohol consumption and risk of developing tuberculosis

In individuals with type 2 diabetes mellitus (T2DM), heavy alcohol consumption was associated with an increased risk of developing tuberculosis (TB). Conversely, mild-to-moderate alcohol consumption was linked to a decreased risk of TB development. Notably, an alcohol intake of 20 grams per day or more was identified as a threshold beyond which the risk of TB substantially increased. Interestingly, even mild-to-moderate alcohol consumption was associated with an increased TB risk among current smokers, highlighting the complex interaction between alcohol intake and smoking status.

Specifically, mild-to-moderate alcohol consumption was associated with a lower overall risk of TB development, with an adjusted hazard ratio (aHR) of 0.92 (95% confidence interval [CI] 0.89–0.96). In contrast, heavy alcohol consumption was linked to a higher risk of TB, with an aHR of 1.21 (95% CI 1.16–1.27). Among all alcohol drinkers, those consuming less than 5 grams of alcohol per day exhibited the lowest risk of TB development (aHR 0.85, 95% CI 0.81–0.90), suggesting a potential protective effect at very low levels of consumption.

When stratifying by age, the protective association of mild-to-moderate alcohol consumption was observed only in individuals aged 65 years and older (aHR 0.85, 95% CI 0.81–0.89). No significant protective effect was found among individuals younger than 65 years. In analyses stratified by smoking status, mild-to-moderate alcohol consumption reduced the risk of TB among noncurrent smokers (aHR 0.85, 95% CI 0.81–0.89). However, among current smokers, even mild-to-moderate drinking increased the risk of TB (aHR 1.08, 95% CI 1.01–1.14). Heavy drinkers who were also current smokers faced an even greater risk of TB development (aHR 1.36, 95% CI 1.27–1.46).

Overall, these findings suggest that heavy alcohol consumption significantly increases the risk of TB in individuals with T2DM. Mild-to-moderate drinking may have a protective effect, particularly among older adults and nonsmokers. However, even low levels of alcohol intake could elevate TB risk among current smokers. Importantly, a daily alcohol consumption threshold of 20 grams was identified as critical for a notable increase in TB risk.

Source: Chung, C., Lee, K.N., Han, K., Park, J., Shin, D.W. and Lee, S.W., 2024. Association between alcohol consumption and risk of developing tuberculosis in patients with diabetes: a nationwide retrospective cohort study. Respiratory Research, 25(1), p.420.