title: 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.
  
  
  CONCLUSIONS
  Calcium channel blocker, beta blocker and statin therapy may decrease the incidence of tuberculosis infection in elderly Taiwanese patients with type 2 diabetes.
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 812, Taiwan. lovellelee@hotmail.com.|Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan. lovellelee@hotmail.com.
authors.forename: Mei-Yueh
authors.initials: MY
authors.lastname: Lee
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan. 890073@kmuh.org.tw.
authors.forename: Kun-Der
authors.initials: KD
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 812, Taiwan. my345677@yahoo.com.tw.|Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan. my345677@yahoo.com.tw.
authors.forename: Wei-Hao
authors.initials: WH
authors.lastname: Hsu
authors.affiliation: Department of Nursing, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 812, Taiwan. 0880170@kmhk.org.tw.
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Chang
authors.affiliation: Statistical Analysis Laboratory, Department of Clinical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan. yihsya@kmu.edu.tw.
authors.forename: Yi-Hsin
authors.initials: YH
authors.lastname: Yang
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan. pjhsiao@cc.kmu.edu.tw.
authors.forename: Pi-Jung
authors.initials: PJ
authors.lastname: Hsiao
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan. sjshin@kmu.edu.tw.|Center for Lipid and Glycomedicine Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan. sjshin@kmu.edu.tw.
authors.forename: Shyi-Jang
authors.initials: SJ
authors.lastname: Shin
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology* / Q000401:mortality
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: beta blocker; calcium channel blocker; diabetes; elderly; statin; tuberculosis