Anti-diabetic medication reduces risk of pulmonary tuberculosis in diabetic patients: a population-based cohort study in Taiwan

Objective: The increased risk of pulmonary tuberculosis [PTB] in patients with diabetes mellitus [DM] remains to be clarified with cohort study. The present study further examined whether the anti-diabetic drug treatment associates with developing PTB. Design: Nation wide cohort study Setting: China Medical University Hospital

Subjects: From the Taiwan National Health Insurance database, we identified 22,256 adult patients newly diagnosed with DM in 2000-2006 as DM cohort and 89,024 persons without DM frequency matched with sex, age and DM diagnosed year as non-DM comparison cohort. Intervention: None Main outcome measures: Both cohorts were followed till the end of 2009 to document PTB incidence. Medications were analyzed for the DM cohort to examine the hazard of developing PTB

Results: The incidence of PTB was 1.64-fold higher in DM cohort than in comparison cohort [52.1 Vs 31.8 per 10,000 person-years] with an adjusted hazard ratio of 1.53 [95% CI = 1.40 - 1.67], measured using multivariable Cox proportional hazards regression analysis. Men were at higher risk than women to have PTB. The age-specific incidence rates showed that DM cohort to comparison cohort incidence rate ratio was higher in younger group. However, the Cox model measured HR increased with age. Alcoholism, chronic obstructive pulmonary disease, alcoholic liver damage and chronic kidney diseases were comorbidities independently associated with PTB. In the DM cohort, anti-DM medications significantly reduced the risk of PTB with a HR of 0.52 for those who had taken metformin, followed by alpha-glucosidase inhibitors, thiazolidinediones, insulins and sulfonylureas [HR = 0.76]. The effects of all anti-diabetic drugs were statistically significant

Conclusions: These findings show patients with DM are associated with an elevated risk of developing PTB, but treatment with anti-diabetic drugs may mediate the risk significantly

Kidney cancer and diabetes mellitus: a population-based case-control study in Taiwan

<p><b>INTRODUCTION</b>The purpose of this study was to explore whether diabetes mellitus (DM) correlates with the risk of kidney cancer in Taiwan.</p><p><b>MATERIALS AND METHODS</b>We designed a population-based case-control study from the Taiwan National Health Insurance Database, which consisted of 116 patients with newly diagnosed kidney cancer as cases and 464 subjects without kidney cancer as controls in 2000 to 2009. Both cases and controls were aged ≥20 years. Baseline comorbidities were compared between kidney cancer cases and controls.</p><p><b>RESULTS</b>Multivariable analysis showed no association was detected between DM and kidney cancer (OR 1.06, 95% CI, 0.58 to 1.94). Hypertension (OR 2.05, 95% CI, 1.23 to 3.42), chronic kidney diseases (OR 2.57, 95% CI, 1.23 to 5.37), cystic kidney diseases (OR 18.6, 95% CI, 1.84 to 187.6) and kidney stones (OR 4.02, 95% CI, 2.43 to 6.66) were significant comorbidities associated with increased risk of kidney cancer. Use of alpha-glucosidase inhibitor was associated with increased risk of kidney cancer (OR 4.31, 95% CI, 1.07 to 17.3).</p><p><b>CONCLUSION</b>DM does not correlate with the risk of kidney cancer. Hypertension, chronic kidney diseases, cystic kidney diseases, kidney stones and use of alpha-glucosidase inhibitors are associated with kidney cancer.</p>

Cardiovascular disease and colorectal cancer: a population-based observation in Taiwan

To explore the relationship between cardiovascular disease and colorectal cancer in Taiwan. Population-based cohort study. Using database of the Taiwan National Health Insurance program from 2000 to 2006, 89,034 patients [35 years or older] with newly diagnosed cardiovascular disease [CVD] which included coronary artery disease, heart failure, cerebrovascular disease, peripheral atherosclerosis, or hypertension, and 89,034 control subjects without CVD were studied. The incidence of colorectal cancer at the end of 2009 and the association with CVD and other co-morbidities were determined. The incidence of colorectal cancer was 1.19-fold higher in the CVD group compared with the non-CVD group [10.87 Vs 9.11 per 10,000 person-years, 95%CI = 1.05-1.36]. After adjustment for covariates, no association was found between CVD and colorectal cancer [95%CI = 0.87-1.13]. Men [HR = 1.53, 95%CI = 1.34-1.75], increasing age [HR = 1.07, 95%CI = 1.06-1.07], and colorectal adenoma [HR = 1.80, 95%CI = 1.06-3.05] were associated with colorectal cancer. No association between cardiovascular disease and colorectal cancer is found. Men, increasing age, and colorectal adenoma correlate with the increased risk of colorectal cancer