T-C Shen1, C-L Lin2, C-C Wei3, C-H Chen4, C-Y Tu5, T-C Hsia5, C-M Shih5, W-H Hsu5, C-J Chung6, F-C Sung7, C-H Kao8. 1. Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University Hospital, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Intensive Care Unit, Chu Shang Show Chwan Hospital, Nantou, Taiwan. 2. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 3. Division of Nephrology, Department of Paediatrics, China Medical University Hospital, Taichung, Taiwan. 4. Graduate Institute of Clinical Medicine Science, College of Medicine, College of Medicine, China Medical University Hospital, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. 5. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. 6. Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan. 7. Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University Hospital, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 8. Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
Abstract
BACKGROUND: Previous studies have suggested that mycobacterial infections could trigger autoimmune diseases, including rheumatoid arthritis (RA). OBJECTIVE: To explore the association between previous tuberculosis (TB) and RA. METHODS: We conducted a case-control study using data obtained from the National Health Insurance (NHI) system of Taiwan. We identified 26 535 adults with RA from 2002 to 2011, with the date of diagnosis as the index date. This number was randomly selected and frequency-matched four times by age, sex and the year of index date from among non-RA individuals. Odds ratios (ORs) of RA were calculated for associations with TB. RESULTS: Compared with controls, RA patients had a crude OR of 1.77 for TB (95%CI 1.61-1.94). The strength of the association between RA and TB remained at the same level after controlling for other potential risk factors (adjusted OR 1.73, 95%CI 1.57-1.90), although RA patients tended to have a higher prevalence of hypertension, coronary artery disease and kidney disease. CONCLUSION: TB was much more prevalent in RA patients than in control subjects. Prospective cohort studies are required to establish a causal relationship between previous TB and RA.
BACKGROUND: Previous studies have suggested that mycobacterial infections could trigger autoimmune diseases, including rheumatoid arthritis (RA). OBJECTIVE: To explore the association between previous tuberculosis (TB) and RA. METHODS: We conducted a case-control study using data obtained from the National Health Insurance (NHI) system of Taiwan. We identified 26 535 adults with RA from 2002 to 2011, with the date of diagnosis as the index date. This number was randomly selected and frequency-matched four times by age, sex and the year of index date from among non-RA individuals. Odds ratios (ORs) of RA were calculated for associations with TB. RESULTS: Compared with controls, RApatients had a crude OR of 1.77 for TB (95%CI 1.61-1.94). The strength of the association between RA and TB remained at the same level after controlling for other potential risk factors (adjusted OR 1.73, 95%CI 1.57-1.90), although RApatients tended to have a higher prevalence of hypertension, coronary artery disease and kidney disease. CONCLUSION: TB was much more prevalent in RApatients than in control subjects. Prospective cohort studies are required to establish a causal relationship between previous TB and RA.