Original Article

International Journal of Obesity advance online publication 28 March 2017; doi: 10.1038/ijo.2017.64

Obesity/overweight reduces the risk of active tuberculosis: a nationwide population-based cohort study in Taiwan

Y-F Yen1,2,3, H-Y Hu4,5, Y-L Lee6,7, P-W Ku8, I-F Lin5, D Chu2,9,10,13 and Y-J Lai2,11,12,13

  1. 1Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan
  2. 2School of Medicine, National Yang-Ming University, Taipei, Taiwan
  3. 3Department of Health and Welfare, College of City Management, University of Taipei, Taipei, Taiwan
  4. 4Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
  5. 5Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
  6. 6Department of Dentistry, Taipei City Hospital, Taipei, Taiwan
  7. 7School of Dentistry, National Yang-Ming University, Taipei, Taiwan
  8. 8Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan
  9. 9Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan
  10. 10Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
  11. 11Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan
  12. 12Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan

Correspondence: Dr D Chu, Department of Neurosurgery, Taipei City Hospital, TaiwanE-mail: DAD57@tpech.gov.tw; Dr Y-J Lai, Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, No. 1, Rongguang Road, Puli Township, Nantou County 545, Taiwan. E-mail: lailai841081@yahoo.com.tw

13These authors contributed equally to this work.

Received 3 October 2016; Revised 21 February 2017; Accepted 26 February 2017
Accepted article preview online 10 March 2017; Advance online publication 28 March 2017

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Abstract

Background:

 

Obesity affects immune function by increasing the number of T helper lymphocytes, which may reduce the risk of tuberculosis (TB) infection. However, the effect of obesity on TB development has not been extensively studied. This nationwide population-based cohort study investigated the effect of obesity on TB development in Taiwanese adults.

Methods:

 

We included 46028 adult participants (age greater than or equal to18 years) from three rounds (2001, 2005 and 2009) of the Taiwan National Health Interview Survey. Obesity and overweight were defined as a body mass index (BMI) greater than or equal to27 and 24–26.9 (kg/m2), respectively. Data on BMI and other covariates at baseline were collected by in-person interviews. Incident cases of active TB were identified from the National Health Insurance database. Multivariable logistic regression was used to estimate the associations of obesity and overweight with active TB, with adjustment for age, sex, smoking, alcohol consumption, socioeconomic status and other covariates.

Results:

 

In total, 241 new cases of active TB occurred during the study period. Obesity (adjusted odds ratio [AOR], 0.43; 95% confident interval [CI], 0.28–0.67) and overweight (AOR, 0.67; 95% CI, 0.49–0.91) were associated with lower risk of incident TB, after adjusting for demographic characteristics and comorbidities. There was a linear dose–response relation of BMI with active TB incidence (AOR per unit change in BMI, 0.92; 95% CI, 0.88-0.95; P <0.001).

Conclusion:

 

Obesity and overweight are associated with lower risk of active TB. Future studies should investigate the underlying mechanisms and clinical and epidemiological consequences of these findings.

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