The impact of nutrition and glucose intolerance on the development of tuberculosis in Japan.

BACKGROUND: Although Japan is categorised as an intermediate tuberculosis (TB) burden country, the incidence of TB is nevertheless decreasing. OBJECTIVE: To identify metabolic and nutritional risk factors for the development of TB. DESIGN: We compared 522 TB in-patients (350 males, 172 females) with age- and sex-matched 522 controls randomly selected from among individuals undergoing comprehensive medical examinations. Patients with relapsed or multidrug-resistant TB were excluded. RESULT: The proportion of males with glucose intolerance was significantly higher in TB patients than in controls (34.2% vs. 14.4%). Among females, the proportion with glucose intolerance was higher in TB patients than in controls (18.3% vs. 10.0%). In male and female controls and female TB patients, individuals with glucose intolerance had significantly higher body mass index (BMI) than those without glucose intolerance. Low BMI was prevalent in male TB patients; there was no significant difference between the BMIs of TB patients with glucose intolerance and those without. Significant associations were found between BMI, peripheral white blood cell count, serum albumin concentration and glucose intolerance and the development of TB in males. Albumin was a parameter significantly associated with TB development in females. CONCLUSION: In Japan, the development of TB is still associated with glucose intolerance and malnutrition.