Retrospective cohort study on bidirectional relationship between diabetes mellitus and tuberculosis in Taiwan

• Main Authors: Jia-Wen Kang, 康嘉文
• Other Authors: 江舟峰
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/ur4q2m

碩士 === 中國醫藥大學 === 公共衛生學系碩士班 === 102 === Background: Approximately 1/3 of world population have been infected by tuberculosis bacteria and 360 million of people are diabetics. Tuberculosis remains a prevalent disease with a rate of 97/100,000 in Taiwan and the diabetes incidence is increasing. Previous studies have shown that patients with diabetes mellitus (DM) are at a higher risk of tuberculosis (TB). This study determined whether there is a bidirectional association between these 2 diseases. Method: Using Taiwan’s National Health Insurance claims data, we identified a DM cohort of 17903 patients newly diagnosed from 2000-2003 and 71612 comparison subjects without DM, frequency matched by sex, age and diagnosis date. Incidence rates and risks of TB were identified for both cohorts by the end of 2010. Using the same claims data set, a TB cohort of 3130 patients with newly diagnosed TB and 12516 comparison subjects without TB were also identified from 2000-2010 , frequency matched by sex, age and diagnosis date. Incidence rates and risks of DM were identified for both cohorts by the end of 2010. Result: The incidence of TB was 1.28-fold higher in the DM cohort than in the non-DM cohort (40.3 v.s. 31.6 per 10,000 person-years), with an adjusted HR of 1.25 (95% CI: 1.14-1.38) measured in multivariate Cox proportional hazards regression model. Patients with comorbidities of DM, COPD, asthma and stroke had an adjusted HR of 5.97 (95% CI: 2.24-15.9). On the other hand, incidence of DM in the TB cohort was slightly lower than that in the non-TB cohort (89.5 v.s. 98.5 per 10,000 person-years), with an adjusted HR of 1.00 (95% CI: 0.83-1.21) also estimated in multivariate Cox proportional hazards regression model. Conclusion: This study shows no evidence of bidirectional association between DM and TB. DM patients are at higher risk of having TB than general population. TB patients are not likely at higher risk of developing DM.