Lee Mei-Yueh, Lin Kun-Der, Hsu Wei-Hao, Chang Hsiu-Ling, Yang Yi-Hsin, Hsiao Pi-Jung, Shin Shyi-Jang
Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 812, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
Int J Mol Sci. 2015 May 18;16(5):11369-84. doi: 10.3390/ijms160511369.
It is well known that diabetes mellitus impairs immunity and therefore is an independent risk factor for tuberculosis. However, the influence of associated metabolic factors, such as hypertension, dyslipidemia and gout has yet to be confirmed. This study aimed to investigate whether the strong association between tuberculosis and diabetes mellitus is independent from the influence of hypertension and dyslipidemia, and its treatment in elderly Taiwanese patients.
A total of 27,958 patients aged more than 65 years were identified from the National Health Insurance Research Database (NIHRD) in 1997 and were followed from 1998 to 2009. The demographic characteristics between the patients with and without diabetes were analyzed using the χ2 test. A total of 13,981 patients with type 2 diabetes were included in this study. Cox proportional hazard regression models were used to determine the independent effects of diabetes on the risk of tuberculosis.
After adjusting for age, sex, other co-morbidities and medications, calcium channel blocker, beta blocker and statin users had a lower independent association, with risk ratios of 0.76 (95% CI, 0.58-0.98), 0.72 (95% CI, 0.58-0.91) and 0.76 (95% CI, 0.60-0.97), respectively.
Calcium channel blocker, beta blocker and statin therapy may decrease the incidence of tuberculosis infection in elderly Taiwanese patients with type 2 diabetes.
众所周知，糖尿病会损害免疫力，因此是结核病的独立危险因素。然而，高血压、血脂异常和痛风等相关代谢因素的影响尚未得到证实。本研究旨在调查结核病与糖尿病之间的强关联是否独立于高血压和血脂异常的影响，以及其在台湾老年患者中的治疗情况。
1997年从国民健康保险研究数据库（NIHRD）中识别出总共27958名年龄超过65岁的患者，并从1998年至2009年进行随访。使用χ2检验分析有糖尿病和无糖尿病患者之间的人口统计学特征。本研究共纳入13981名2型糖尿病患者。采用Cox比例风险回归模型确定糖尿病对结核病风险的独立影响。
在调整年龄、性别、其他合并症和药物后，使用钙通道阻滞剂、β受体阻滞剂和他汀类药物的患者有较低的独立关联，风险比分别为0.76（95%CI，0.58 - 0.98）、0.72（95%CI，0.58 - 0.91）和0.76（95%CI，0.60 - 0.97）。
钙通道阻滞剂、β受体阻滞剂和他汀类药物治疗可能会降低台湾老年2型糖尿病患者的结核病感染发生率。
