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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

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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.

No MeSH data available.


Related in: MedlinePlus

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.
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Figure 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.

Mentions: This study was based on data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2008 and 2012. The KNHANES is a cross-sectional, national surveillance system designed to examine the health and nutritional status of the non-institutionalized Korean population and is conducted by the Korea Centers for Disease Control and Prevention (KCDC). The KNHANES followed a multi-stage cluster probability sampling design to ensure independent and homogenous sampling for each year as well as nationally representative sampling (11). Among 23,612 subjects aged 40 years or older, a total of 13,522 participants who underwent CXR and spirometry with reliable spirometer data were eligible for the study. Subjects who had active TB (n = 26), and non-responders to the question regarding TB history were excluded from the study (n = 54) (Fig. 1).


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
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.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383611&req=5

Figure 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.
Mentions: This study was based on data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2008 and 2012. The KNHANES is a cross-sectional, national surveillance system designed to examine the health and nutritional status of the non-institutionalized Korean population and is conducted by the Korea Centers for Disease Control and Prevention (KCDC). The KNHANES followed a multi-stage cluster probability sampling design to ensure independent and homogenous sampling for each year as well as nationally representative sampling (11). Among 23,612 subjects aged 40 years or older, a total of 13,522 participants who underwent CXR and spirometry with reliable spirometer data were eligible for the study. Subjects who had active TB (n = 26), and non-responders to the question regarding TB history were excluded from the study (n = 54) (Fig. 1).

View Article: PubMed Central - PubMed

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.

No MeSH data available.


Related in: MedlinePlus