J Korean Med Sci.  2017 May;32(5):789-795. 10.3346/jkms.2017.32.5.789.

The Definition of Past Tuberculosis Affects the Magnitude of Association between Pulmonary Tuberculosis and Respiratory Dysfunction: Korea National Health and Nutrition Examination Survey, 2008–2012

• Choi CJ
• Choi WS
• Lee SY
• Kim KS

• KMID: 2375079
• DOI: http://doi.org/10.3346/jkms.2017.32.5.789

Abstract

Tuberculosis (TB) is associated with an increased risk of chronic lung impairment. The aim of this study was to compare the clinical characteristics and lung functions according to definition of past TB. We used the population-based, Korea National Health and Nutrition Examination Survey (KNHANES) (2008-2012) to analyze 13,522 subjects age 40 years or older who underwent spirometry and chest X-ray (CXR). Subjects with TB lesions on CXR (with or without a history of TB) were older, more likely to be male, ever smokers, and of low socioeconomic status than subjects with only a history of TB or without evidence of TB. Airflow obstruction (AFO) was associated with only a history of TB (odds ratio [OR] 1.53, 95% confidence interval [CI] 0.95-2.46), only TB lesion on CXR (OR 2.37, 95% CI 1.80-3.12), and both a history and TB lesions on CXR (OR 4.47, 95% CI 3.07-6.51) after adjustment for gender, age, body mass index, education, income, and smoking amount (P for trend < 0.001). Spirometric restriction was associated with only a history of TB (OR 1.29, 95% CI 0.80-2.08), only TB lesions on CXR (OR 2.03, 95% CI 1.49-2.76), and both a history and TB lesions on CXR (OR 2.65, 95% CI 1.74-4.05) after adjustment for the above variables (P for trend < 0.001). How to define past TB in population study affects the magnitude of association between past TB and respiratory dysfunction. Without considering TB lesions on CXR, the association between TB and respiratory dysfunction could be underestimated.

Keyword

Mass Chest X-Ray; Spirometry; Lung Diseases; Epidemiology, Korea

MeSH Terms

Body Mass Index
Education
Humans
Korea*
Lung
Lung Diseases
Male
Mass Chest X-Ray
Nutrition Surveys*
Smoke
Smoking
Social Class
Spirometry
Thorax
Tuberculosis*
Tuberculosis, Pulmonary*
Smoke

Figure

• 

  Fig. 1 Flowchart of the study population. KNHANES = Korean National Health and Nutrition Examination Survey, CXR = chest X-ray, TB = tuberculosis, Hx = history of physician diagnosis, TB Hx (+)/CXR (−) = subjects with a history of TB without TB lesions on CRX, TB Hx (−)/CXR (+) = subjects with TB lesions on CRX without a history of TB, TB Hx (+)/CXR (+) = subjects with both having a history of TB and TB lesions on CXR.

• 

  Fig. 2 Proportion of those with respiratory dysfunction among subjects with different evidence of TB by smoking status. TB = tuberculosis, Hx = history of physician diagnosis, CXR = chest X-ray, TB Hx (+)/CXR (−) = subjects with a history of TB without TB lesions on CRX, TB Hx (−)/CXR (+) = subjects with TB lesions on CRX without a history of TB, TB Hx (+)/CXR (+) = subjects with both having a history of TB and TB lesions on CXR.

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