Type 2 Diabetes Mellitus- and Complication-Related Risk of Nontuberculous Mycobacterial Disease in a South Korean Cohort

• Published in: Microbiology spectrum 2023-03, Vol.11 (2), p.e0451122-e0451122
• Main Authors: Jeon, Da Som, Kim, Seonok, Kim, Mi Ae, Chong, Yong Pil, Shim, Tae Sun, Jung, Chang Hee, Kim, Ye-Jee, Jo, Kyung-Wook
• Format: Article
• Language: English
• Subjects: Epidemiology; Research Article
• ISSN: 2165-0497; 2165-0497
• DOI: 10.1128/spectrum.04511-22

We aimed to investigate whether type 2 diabetes mellitus (T2DM) and diabetes-related complications constitute significant risk factors for nontuberculous mycobacterial (NTM) disease. Data from the National Health Insurance Service-National Sample Cohort (which represents 2.2% of the total South Korean population) recorded between 2007 and 2019 were extracted to establish the NTM-naive T2DM cohort (  = 191,218) and the 1:1 age- and sex-matched NTM-naive matched cohort (  = 191,218). Intergroup comparisons were performed to determine differences in the NTM disease risk of the two cohorts during the follow-up period. During median follow-up of 9.46 and 9.25 years, the incidence of NTM disease was 43.58/100,000 and 32.98/100,000 person-years in the NTM-naive T2DM and NTM-naive matched cohorts, respectively. Multivariable analysis showed that T2DM alone did not confer a significant risk for incident NTM disease, although T2DM with ≥2 diabetes-related complications significantly increased NTM disease risk (adjusted hazard ratio [95% confidence interval], 1.12 [0.99 to 1.27] and 1.33 [1.03 to 1.17], respectively). In conclusion, the presence of T2DM with ≥2 diabetes-related complications significantly increases the risk for NTM disease. We assessed whether patients with T2DM are at higher risk for incident NTM disease through analysis of NTM-naive matched cohorts from the data of a national population-based cohort which represents 2.2% of the total South Korean population. Although T2DM alone is not a statistically significant risk factor for NTM disease, T2DM significantly increases the risk of NTM disease in those with ≥2 diabetes-related complications. This finding suggested that patients with T2DM with a larger number of complications should be considered a high-risk group for NTM disease.