Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
권호 표지
DOI QR코드

DOI QR Code

The Definition of Past Tuberculosis Affects the Magnitude of Association between Pulmonary Tuberculosis and Respiratory Dysfunction: Korea National Health and Nutrition Examination Survey, 2008-2012

  • Choi, Chang-Jin (Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Choi, Whan-Seok (Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Sook-Young (Division of Pulmonology Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Kyung-Soo (Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2016.11.24
  • Accepted : 2017.02.11
  • Published : 2017.05.10
⟨ Previous Next ⟩

Abstract

Tuberculosis (TB) is associated with an increased risk of chronic lung impairment. The aim of this study was to compare the clinical characteristics and lung functions according to definition of past TB. We used the population-based, Korea National Health and Nutrition Examination Survey (KNHANES) (2008-2012) to analyze 13,522 subjects age 40 years or older who underwent spirometry and chest X-ray (CXR). Subjects with TB lesions on CXR (with or without a history of TB) were older, more likely to be male, ever smokers, and of low socioeconomic status than subjects with only a history of TB or without evidence of TB. Airflow obstruction (AFO) was associated with only a history of TB (odds ratio [OR] 1.53, 95% confidence interval [CI] 0.95-2.46), only TB lesion on CXR (OR 2.37, 95% CI 1.80-3.12), and both a history and TB lesions on CXR (OR 4.47, 95% CI 3.07-6.51) after adjustment for gender, age, body mass index, education, income, and smoking amount (P for trend < 0.001). Spirometric restriction was associated with only a history of TB (OR 1.29, 95% CI 0.80-2.08), only TB lesions on CXR (OR 2.03, 95% CI 1.49-2.76), and both a history and TB lesions on CXR (OR 2.65, 95% CI 1.74-4.05) after adjustment for the above variables (P for trend < 0.001). How to define past TB in population study affects the magnitude of association between past TB and respiratory dysfunction. Without considering TB lesions on CXR, the association between TB and respiratory dysfunction could be underestimated.

Keywords

Acknowledgement

Supported by : Ministry of Health and Welfare

References

  1. World Health Organization. Global tuberculosis report 2015 [Internet]. Geneva, Switzerland: World Health Organization; 2015. Available at http: //www.who.int/tb/publications/global_report/en/ [accessed on 11 October 2016].
  2. Vecino M, Pasipanodya JG, Slocum P, Bae S, Munguia G, Miller T, Fernandez M, Drewyer G, Weis SE. Evidence for chronic lung impairment in patients treated for pulmonary tuberculosis. J Infect Public Health 2011; 4: 244-52. https://doi.org/10.1016/j.jiph.2011.08.005
  3. Dheda K, Booth H, Huggett JF, Johnson MA, Zumla A, Rook GA. Lung remodeling in pulmonary tuberculosis. J Infect Dis 2005; 192: 1201-9. https://doi.org/10.1086/444545
  4. Byrne AL, Marais BJ, Mitnick CD, Lecca L, Marks GB. Tuberculosis and chronic respiratory disease: a systematic review. Int J Infect Dis 2015; 32: 138-46. https://doi.org/10.1016/j.ijid.2014.12.016
  5. Allwood BW, Myer L, Bateman ED. A systematic review of the association between pulmonary tuberculosis and the development of chronic airflow obstruction in adults. Respiration 2013; 86: 76-85. https://doi.org/10.1159/000350917
  6. Amaral AF, Coton S, Kato B, Tan WC, Studnicka M, Janson C, Gislason T, Mannino D, Bateman ED, Buist S, et al. Tuberculosis associates with both airflow obstruction and low lung function: BOLD results. Eur Respir J 2015; 46: 1104-12. https://doi.org/10.1183/13993003.02325-2014
  7. Menezes AM, Hallal PC, Perez-Padilla R, Jardim JR, Muino A, Lopez MV, Valdivia G, Montes de Oca M, Talamo C, Pertuze J, et al. Tuberculosis and airflow obstruction: evidence from the PLATINO study in Latin America. Eur Respir J 2007; 30: 1180-5. https://doi.org/10.1183/09031936.00083507
  8. Caballero A, Torres-Duque CA, Jaramillo C, Bolivar F, Sanabria F, Osorio P, Orduz C, Guevara DP, Maldonado D. Prevalence of COPD in five Colombian cities situated at low, medium, and high altitude (PREPOCOL study). Chest 2008; 133: 343-9. https://doi.org/10.1378/chest.07-1361
  9. Lam KB, Jiang CQ, Jordan RE, Miller MR, Zhang WS, Cheng KK, Lam TH, Adab P. Prior TB, smoking, and airflow obstruction: a cross-sectional analysis of the Guangzhou Biobank Cohort Study. Chest 2010; 137: 593-600. https://doi.org/10.1378/chest.09-1435
  10. Lee SW, Kim YS, Kim DS, Oh YM, Lee SD. The risk of obstructive lung disease by previous pulmonary tuberculosis in a country with intermediate burden of tuberculosis. J Korean Med Sci 2011; 26: 268-73. https://doi.org/10.3346/jkms.2011.26.2.268
  11. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 2014; 43: 69-77. https://doi.org/10.1093/ije/dyt228
  12. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, et al. Standardisation of spirometry. Eur Respir J 2005; 26: 319-38. https://doi.org/10.1183/09031936.05.00034805
  13. Salvi SS, Barnes PJ. Chronic obstructive pulmonary disease in non-smokers. Lancet 2009; 374: 733-43. https://doi.org/10.1016/S0140-6736(09)61303-9
  14. Lee SJ, Kim SW, Kong KA, Ryu YJ, Lee JH, Chang JH. Risk factors for chronic obstructive pulmonary disease among never-smokers in Korea. Int J Chron Obstruct Pulmon Dis 2015; 10: 497-506.
  15. Mbatchou Ngahane BH, Nouyep J, Nganda Motto M, Mapoure Njankouo Y, Wandji A, Endale M, Afane Ze E. Post-tuberculous lung function impairment in a tuberculosis reference clinic in Cameroon. Respir Med 2016; 114: 67-71. https://doi.org/10.1016/j.rmed.2016.03.007
  16. Plit ML, Anderson R, Van Rensburg CE, Page-Shipp L, Blott JA, Fresen JL, Feldman C. Influence of antimicrobial chemotherapy on spirometric parameters and pro-inflammatory indices in severe pulmonary tuberculosis. Eur Respir J 1998; 12: 351-6. https://doi.org/10.1183/09031936.98.12020351
  17. Rhee CK, Yoo KH, Lee JH, Park MJ, Kim WJ, Park YB, Hwang YI, Kim YS, Jung JY, Moon JY, et al. Clinical characteristics of patients with tuberculosis-destroyed lung. Int J Tuberc Lung Dis 2013; 17: 67-75. https://doi.org/10.5588/ijtld.12.0351
  18. O'Toole RF, Shukla SD, Walters EH. TB meets COPD: An emerging global co-morbidity in human lung disease. Tuberculosis (Edinb) 2015; 95: 659-63. https://doi.org/10.1016/j.tube.2015.08.005
  19. Fletcher C, Peto R. The natural history of chronic airflow obstruction. BMJ 1977; 1: 1645-8. https://doi.org/10.1136/bmj.1.6077.1645
  20. Lokke A, Lange P, Scharling H, Fabricius P, Vestbo J. Developing COPD: a 25 year follow up study of the general population. Thorax 2006; 61: 935-9. https://doi.org/10.1136/thx.2006.062802
  21. Bates MN, Khalakdina A, Pai M, Chang L, Lessa F, Smith KR. Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis. Arch Intern Med 2007; 167: 335-42. https://doi.org/10.1001/archinte.167.4.335
  22. Slama K, Chiang CY, Enarson DA, Hassmiller K, Fanning A, Gupta P, Ray C. Tobacco and tuberculosis: a qualitative systematic review and meta-analysis. Int J Tuberc Lung Dis 2007; 11: 1049-61.
  23. Inghammar M, Ekbom A, Engstrom G, Ljungberg B, Romanus V, Lofdahl CG, Egesten A. COPD and the risk of tuberculosis--a population-based cohort study. PLoS One 2010; 5: e10138. https://doi.org/10.1371/journal.pone.0010138
  24. Lee CH, Kim K, Hyun MK, Jang EJ, Lee NR, Yim JJ. Use of inhaled corticosteroids and the risk of tuberculosis. Thorax 2013; 68: 1105-13. https://doi.org/10.1136/thoraxjnl-2012-203175
  25. Horsburgh CR Jr. Priorities for the treatment of latent tuberculosis infection in the United States. N Engl J Med 2004; 350: 2060-7. https://doi.org/10.1056/NEJMsa031667
  26. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CP, Gustafsson P, Hankinson J, et al. Interpretative strategies for lung function tests. Eur Respir J 2005; 26: 948-68. https://doi.org/10.1183/09031936.05.00035205
  27. Wesolowski S, Boros P. Restrictive pattern in spirometry: does FEV(1)/FVC need to be increased? Pneumonol Alergol Pol 2011; 79: 382-7.

Cited by

  1. Risk of Sarcopenia and Osteoporosis in Male Tuberculosis Survivors: Korea National Health and Nutrition Examination Survey vol.7, pp.None, 2017, https://doi.org/10.1038/s41598-017-12419-y
  2. Association of Lung Function with Serum 25-Hydroxyvitamin D Level according to the Presence of Past Pulmonary Tuberculosis in Korean Adults vol.40, pp.2, 2017, https://doi.org/10.4082/kjfm.17.0083
  3. Prognostic factors for unfavourable outcomes of patients with spinal tuberculosis in a country with an intermediate tuberculosis burden : a multicentre cohort study vol.b101, pp.12, 2017, https://doi.org/10.1302/0301-620x.101b12.bjj-2019-0558.r1
  4. Association of protein consumption and energy intake on sarcopenia in tuberculosis survivors vol.12, pp.None, 2017, https://doi.org/10.1177/20406223211056712