Body Mass Index, Diabetes, and Risk of Tuberculosis: A Retrospective Cohort Study
Hayoung Choi1, Jung Eun Yoo2, Kyungdo Han3
1Division of Allergy, Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
Frontiers in Nutrition
|December 20, 2021
Summary
Underweight and diabetes mellitus (DM) independently increase tuberculosis (TB) risk. Combined, underweight and DM showed a synergistic effect on TB incidence, especially in younger, smoking, or drinking individuals.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Research
Background:
- Diabetes mellitus (DM) and underweight are independently linked to higher tuberculosis (TB) risk.
- Limited data exist on the combined impact of body mass index (BMI) and DM on TB incidence.
Purpose of the Study:
- To evaluate the simultaneous effects of BMI and DM on the risk of incident TB.
- To identify specific populations where the combined risk is amplified.
Main Methods:
- Retrospective cohort study of 10,087,903 participants from the Korean National Health Screening Program (2009-2018).
- Analysis of TB incidence rates and risk ratios across different BMI categories (underweight, normal weight, severely obese) and DM status.
- Investigation of potential synergistic effects between BMI and DM.
Main Results:
- Underweight individuals with DM had the highest TB incidence (5.35 per 1,000 person-years).
- Compared to normal weight without DM, underweight without DM had a 2.21-fold increased TB risk, while underweight with DM had a 3.24-fold increased risk.
- Severely obese individuals, with or without DM, showed a decreased risk of TB.
- A synergistic effect of underweight and DM on TB risk was observed in participants <65 years, current smokers, and heavy drinkers.
Conclusions:
- Both underweight and DM are significant independent risk factors for incident TB.
- Focused TB screening in patients with DM is recommended.
- The interaction between underweight and DM poses a particularly high TB risk in specific demographic and lifestyle groups.
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