Effect of diabetes mellitus on risk of latent TB infection in a high TB incidence area: A community-based study in Taiwan
Journal
BMJ Open
Journal Volume
9
Journal Issue
10
Date Issued
2019-10-01
Author(s)
Lin, Ching Hsiung
Kuo, Shu Chen
Hsieh, Ming Chia
Ho, Shang Yun
Su, Ih Jen
Lin, Sheng Hao
Chi, Chia Yu
Su, Shih Li
Liao, Chiung Ying
Hsu, Shang Ren
Huang, Yuan Chun
Tseng, Fan Chen
Wang, Shu Yi
Dou, Horng Yunn
Lin, Shi Dou
Lin, Jen Shiou
Tu, Shih Te
Yeh, Yen Po
Abstract
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective To investigate the association between diabetes and latent tuberculosis infections (LTBI) in high TB incidence areas. Design Community-based comparison study. Setting Outpatient diabetes clinics at 4 hospitals and 13 health centres in urban and rural townships. A community-based screening programme was used to recruit non-diabetic participants. Participants A total of 2948 patients with diabetes aged older than 40 years were recruited, and 453 non-diabetic participants from the community were enrolled. Primary and secondary outcome measures The interferon-gamma release assay (IGRA) and the tuberculin skin test were used to detect LTBI. The IGRA result was used as a surrogate of LTBI in logistic regression analysis. Results Diabetes was significantly associated with LTBI (adjusted OR (aOR)=1.59; 95% CI 1.11 to 2.28) and age correlated positively with LTBI. Many subjects with diabetes also had additional risk factors (current smokers (aOR=1.28; 95% CI 0.95 to 1.71), comorbid chronic kidney disease (aOR=1.26; 95% CI 1.03 to 1.55) and history of TB (aOR=2.08; 95% CI 1.19 to 3.63)). The presence of BCG scar was protective (aOR=0.66; 95% CI 0.51 to 0.85). Duration of diabetes and poor glycaemic control were unrelated to the risk of LTBI. Conclusion There was a moderately increased risk of LTBI in patients with diabetes from this high TB incidence area. This finding suggests LTBI screening for the diabetics be combined with other risk factors and comorbidities of TB to better identify high-risk groups and improve the efficacy of targeted screening for LTBI.
Subjects
Bacillus Calmette-Guérin vaccination | diabetes mellitus | interferon-gamma release assay | latent infection | tuberculin skin test | tuberculosis
Bacillus Calmette-Gu?rin vaccination; diabetes mellitus; interferon-gamma release assay; latent infection; tuberculin skin test; tuberculosis
SDGs
Other Subjects
BCG vaccine; glucose; hemoglobin A1c; glycosylated hemoglobin; hemoglobin A1c protein, human; adult; aged; Article; BCG vaccination; chronic kidney failure; comorbidity; comparative study; controlled study; diabetes mellitus; disease duration; female; glycemic control; human; incidence; infection risk; interferon gamma release assay; latent tuberculosis; major clinical study; male; medical history; middle aged; obesity; scar; screening; smoking; Taiwan; tuberculin test; case control study; chronic kidney failure; diabetes mellitus; latent tuberculosis; metabolism; odds ratio; risk factor; tuberculosis; Adult; Aged; BCG Vaccine; Case-Control Studies; Diabetes Mellitus; Female; Glycated Hemoglobin A; Humans; Incidence; Interferon-gamma Release Tests; Latent Tuberculosis; Male; Middle Aged; Odds Ratio; Renal Insufficiency, Chronic; Risk Factors; Smoking; Taiwan; Tuberculin Test; Tuberculosis
Publisher
BMJ PUBLISHING GROUP
Type
journal article