Association between alcohol consumption and risk of developing tuberculosis in patients with diabetes

Diabetes mellitus (DM) and alcohol consumption are risk factors for tuberculosis (TB). A study investigated the association between alcohol consumption and TB development in individuals with type 2 DM (T2DM).
Individuals who underwent the national health examination during 2009-2012 were screened using the Korean National Health Information Database. In total, 2,437,443 eligible individuals with T2DM were followed up until December 2018. 21,275 individuals were identified with newly developed TB. Alcohol consumption was evaluated based on the health examination questionnaire, and individuals were categorised into none (0 g/day), mild-to-moderate (1-29.9 g/day), and heavy (≥ 30 g/day) drinkers. The adjusted hazard ratio (aHR) of risk factors for TB were estimated
Mild-to-moderate alcohol drinkers had a lower risk of developing TB (aHR 0.92, 95% confidence interval [CI] 0.89-0.96), and heavy alcohol drinkers had a higher risk of developing TB (aHR 1.21, 95% CI 1.16-1.27) than non alcohol drinkers. When categorised by an alcohol intake of 5 g/day, alcohol drinkers of < 5 g/day had the lowest risk (aHR 0.85, 95% CI 0.81-0.90). The risk increased with alcohol intake, resulting in ≥ 20 g/day as the threshold (20-25 g/day, aHR 1.09, 95% CI 1.02-1.16). Current smokers had an increased risk of developing TB even among mild-to-moderate drinkers.
Heavy alcohol consumption has been linked to an increased risk of developing TB in patients with T2DM. In contrast, mild-to-moderate alcohol consumption was associated with a reduced risk of TB, except in current smokers, where it led to a higher risk of TB. The risk of TB substantially increased with alcohol intake of 20 g/day or more, following a J-shaped curve.
Source: Chung, C., Lee, K.N., Han, K. et al. Association between alcohol consumption and risk of developing tuberculosis in patients with diabetes: a nationwide retrospective cohort study. Respir Res 25, 420 (2024).