 |
|
Lower Risk of Tuberculosis in Obesity
Chi C. Leung, MBBS;
Tai H. Lam, MD;
Wai M. Chan, MBBS;
Wing W. Yew, MBBS;
Kin S. Ho, MBBS;
Gabriel Leung, MD;
Wing S. Law, MBChB;
Cheuk M. Tam, MBBS;
Chi K. Chan, MBBS;
Kwok C. Chang, MBBS
Arch Intern Med. 2007;167(12):1297-1304.
Background Obesity is increasingly prevalent in both developed and developing areas. Although undernutrition is well associated with tuberculosis, few studies have systematically examined the association with obesity.
Method A cohort of 42 116 individuals 65 years or older enrolled at 18 health centers for elderly patients in Hong Kong, China (which has a tuberculosis incidence of approximately 90 per 100 000 population), in 2000 were followed up prospectively through the territory-wide tuberculosis registry for the development of active tuberculosis from 3 months after enrollment until December 31, 2005, using the identity card number as the unique identifier. The association with body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters), as categorized by the Asian standards, was assessed with the control of other baseline characteristics.
Results Obese (BMI  30) and overweight (BMI, 25 to <30) individuals were at significantly lower risks of developing active tuberculosis than normal-weight individuals (BMI, 18.5 to <25), with hazard ratios (95% confidence intervals) of 0.36 (0.20-0.66) and 0.55 (0.44-0.70), respectively, after adjustment for baseline demographic, social, and clinical variables. An inverse linear association was observed predominantly for pulmonary but not extrapulmonary tuberculosis. This association persisted after controlling for potential confounders or excluding individuals with known tuberculosis risk factors.
Conclusions Obesity is associated with a lower risk of active pulmonary tuberculosis in the older population of Hong Kong. The presence of such a strong but selective association across the whole spectrum of BMI could have major biological, clinical, and/or epidemiological implications. Further studies are indicated to explore the underlying mechanisms, potential clinical utilities, and possible epidemiological consequences.
Author Affiliations: Tuberculosis and Chest Service (Drs C. C. Leung, Law, Tam, C. K. Chan, and Chang), Elderly Health Service, Department of Health (Drs W. M. Chan and Ho), and Department of Community Medicine (Drs Lam and G. Leung), The University of Hong Kong, and Tuberculosis and Chest Unit, Grantham Hospital (Dr Yew), Hong Kong, China.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Tuberculosis and the Inflammatory Processes of Obesity in Human Evolution--Reply
Roth
JAMA 2009;302:1754-1755.
FULL TEXT
Evolutionary Speculation About Tuberculosis and the Metabolic and Inflammatory Processes of Obesity
Roth
JAMA 2009;301:2586-2588.
FULL TEXT
To the Editors
Leung and Yew
Eur Respir J 2008;32:1663-1664.
FULL TEXT
Treatment Outcomes and Long-term Survival in Patients with Extensively Drug-resistant Tuberculosis
Kim et al.
Am. J. Respir. Crit. Care Med. 2008;178:1075-1082.
ABSTRACT
| FULL TEXT
Nutritional deficit as a negative prognostic factor in patients with miliary tuberculosis
Kim et al.
Eur Respir J 2008;32:1031-1036.
ABSTRACT
| FULL TEXT
Diabetic Control and Risk of Tuberculosis: A Cohort Study
Leung et al.
Am J Epidemiol 2008;167:1486-1494.
ABSTRACT
| FULL TEXT
Animal model of Mycobacterium abscessus lung infection
Ordway et al.
J. Leukoc. Biol. 2008;83:1502-1511.
ABSTRACT
| FULL TEXT
Update in Tuberculosis 2007
Yew and Leung
Am. J. Respir. Crit. Care Med. 2008;177:479-485.
FULL TEXT
|
