Han Minkyung, Ha Jang Woo, Jung Inkyung, Kim Chi Young, Ahn Sung Soo
Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea.
Rheumatology (Oxford). 2025 Mar 1;64(3):1400-1408. doi: 10.1093/rheumatology/keae185.
Tuberculosis (TB) is a highly prevalent disease associated with significant morbidity and mortality globally and is reported to be associated with the onset of autoimmunity. This study investigated the association between TB and the incidence of systemic vasculitides (SV).
Data were obtained from the South Korean National Claims database to identify patients with TB and controls (who had undergone appendectomy). The overall occurrence of SV and disease subtypes during the observation period was compared between the two groups. Adjusted Cox proportional hazards regression and Kaplan-Meier analysis were performed to identify the relationship between TB and SV and to compare SV incidence.
We identified 418 677 patients with TB and 160 289 controls. The overall SV incidence rate was 192/1 000 000 person-years during a mean follow-up of 7.5 years and was higher in patients with TB than controls. Cox regression revealed that the risk of SV was elevated in the TB group independently (adjusted hazard ratio [aHR]: 1.72, 95% confidence interval [CI]: 1.45-2.05). Furthermore, the risk of SV was significantly higher in extrapulmonary TB (aHR: 4.28, 95% CI: 3.52-5.21) when the TB group was categorized into pulmonary and extrapulmonary TB. The findings remained identical even after applying a stabilized inverse probability of treatment weighting analysis.
Patients with TB have an increased risk of SV, which is prominent in extrapulmonary TB. As well as confirming TB is associated with an increased incidence of immune-related vasculitis, our findings highlight the need for clinical vigilance for early diagnosis and initiation of treatment.
结核病（TB）是一种全球高发性疾病，与严重的发病率和死亡率相关，据报道还与自身免疫性疾病的发病有关。本研究调查了结核病与系统性血管炎（SV）发病率之间的关联。
从韩国国家索赔数据库中获取数据，以确定结核病患者和对照组（接受过阑尾切除术的患者）。比较两组在观察期内SV的总体发生率和疾病亚型。进行调整后的Cox比例风险回归分析和Kaplan-Meier分析，以确定结核病与SV之间的关系，并比较SV的发病率。
我们确定了418677例结核病患者和160289例对照组。在平均7.5年的随访期间，SV的总体发病率为每100万人年192例，结核病患者的发病率高于对照组。Cox回归显示，结核病组SV的风险独立升高（调整后的风险比[aHR]：1.72，95%置信区间[CI]：1.45-2.05）。此外，当将结核病组分为肺结核和肺外结核时，肺外结核患者发生SV的风险显著更高（aHR：4.28，95%CI：3.52-5.21）。即使应用稳定的治疗权重逆概率分析后，研究结果仍然相同。
结核病患者发生SV的风险增加，这在肺外结核中尤为突出。除了证实结核病与免疫相关血管炎的发病率增加有关外，我们的研究结果还强调了临床警惕早期诊断和治疗启动的必要性。
