Statin, Calcium Channel Blocker and Beta Blocker Therapy May Decrease the Incidence of Tuberculosis Infection in Elderly Taiwanese Patients with Type 2 Diabetes

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: Calcium channel blocker, beta blocker and statin therapy may decrease the incidence of tuberculosis infection in elderly Taiwanese patients with type 2 diabetes.

Association between statins and infections among patients with diabetes: a cohort and prescription sequence symmetry analysis

“…24 Some observational studies with conventional cohort and case-control designs suggest that statins may reduce the risk of infection among patients with drugtreated type 2 diabetes, but unmeasured confounding could not be ruled out. [25][26][27][28][29] Hence, we aimed to evaluate whether statins reduce the risk of receiving first antibiotic prescriptions (as a proxy for infections) among patients with drug-treated type 2 diabetes using two observational studies that are designed to address confounding in different ways: a prescription sequence symmetry analysis (PSSA) and a matched cohort study. In secondary analysis, we evaluated whether the effect among patients without drug-treated diabetes would be less pronounced.…”

Statin Use May Be Associated With Reduced Active Tuberculosis Infection: A Meta-Analysis of Observational Studies

“…Of these, 12 were further excluded because two of them did not treat statin use as the exposure, six did not report tuberculosis infection as the outcome, one study did not provide available outcome data, and the other three were abstracts of already included studies. Finally, nine observational studies were included (10)(11)(12)(13)(14)(15)(16)(17)(18).…”

“…These studies were published between 2014 and 2019, and all of them included Asian people. Regarding the study design, five studies were retrospective cohort studies (10,(15)(16)(17)(18), one was a prospective cohort study (11), two were nested case-control studies (12,14), and another one was a retrospective case-control study (13).…”

“…As for the characteristics of the included patients, four of them included diabetic patients (10,11,15,18), while three studies provided data stratified by the diabetic status (12,14,17). The mean ages of the patients varied between 51 and 65 years, with the proportions of male ranging from 44 to 70%.…”

“…Moreover, statins may also synergistically increase the treatment efficacy of antituberculosis, such as rifampin (9). However, an early cohort study did not show a significant association between statin use and tuberculosis infection (10), while subsequent studies indicated that use of statins may be associated with reduced tuberculosis infection (11)(12)(13)(14)(15)(16)(17)(18). The potential reasons for the inconsistencies of the above findings remain unknown.…”