Lin, Ching HsiungChing HsiungLinKuo, Shu ChenShu ChenKuoHsieh, Ming ChiaMing ChiaHsiehHo, Shang YunShang YunHoSu, Ih JenIh JenSuLin, Sheng HaoSheng HaoLinChi, Chia YuChia YuChiSu, Shih LiShih LiSuLiao, Chiung YingChiung YingLiaoYEE-CHUN CHENHsu, Shang RenShang RenHsuHuang, Yuan ChunYuan ChunHuangTseng, Fan ChenFan ChenTsengWang, Shu YiShu YiWangDou, Horng YunnHorng YunnDouLin, Shi DouShi DouLinLin, Jen ShiouJen ShiouLinTu, Shih TeShih TeTuYeh, Yen PoYen PoYeh2020-07-022020-07-022019-10-012044-6055https://scholars.lib.ntu.edu.tw/handle/123456789/507933© 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.journal articleBacillus Calmette-Guérin vaccination | diabetes mellitus | interferon-gamma release assay | latent infection | tuberculin skin test | tuberculosisBacillus Calmette-Gu?rin vaccination; diabetes mellitus; interferon-gamma release assay; latent infection; tuberculin skin test; tuberculosis[SDGs]SDG3BCG 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; Tuberculosisjournal article10.1136/bmjopen-2019-029948316623652-s2.0-85074275449WOS:000512882200114https://api.elsevier.com/content/abstract/scopus_id/85074275449