Ann Pediatr Endocrinol Metab.  2023 Dec;28(4):251-257. 10.6065/apem.2244254.127.

Association between the incidence of type 1 diabetes mellitus and tuberculosis or bacillus Calmette-Guérin immunization in children and adolescents

• Park JY
• Choe YJ
• Lim Y
• Kim H
• Kim J

• KMID: 2549317
• DOI: http://doi.org/10.6065/apem.2244254.127

Abstract

Purpose
The correlation between the incidence of type 1 diabetes mellitus (T1DM) and tuberculosis or bacillus Calmette-Guérin (BCG) vaccination rate in individuals aged <15 years was investigated using worldwide data.
Methods
The incidence of T1DM, rate of BCG vaccination, and incidence of tuberculosis were obtained from the Diabetes Atlas 9th edition of the International Diabetes Federation and the Global Health Observatory data repository of the World Health Organization. Gross domestic product (GDP) per capita and population data by country were obtained from the World Bank and United Nations, respectively.
Results
GDP per capita negatively correlated with the incidence of tuberculosis and positively correlated with the incidence of T1DM (coefficient=-0.630 and 0.596, respectively; all P<0.001). The incidence of T1DM and tuberculosis was significantly associated with the Organisation for Economic Cooperation and Development (OECD) status (P<0.001). After adjusting for GDP per capita, regional grouping, and OECD status, the incidence of T1DM negatively correlated with that of tuberculosis (R² =0.729, P=0.009). However, there was no association between the BCG vaccination rate and incidence of T1DM (P=0.890).
Conclusion
There was a negative correlation between the incidence of tuberculosis and T1DM in children and adolescents aged <15 years at the country level.

Keyword

Association; Type 1 diabetes mellitus; Tuberculosis

Figure

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  Fig. 1. World map showing the enrolled countries in 2019 based on the bacillus Calmette-Guérin immunization rate among 1-year-old children, the incidence of tuberculosis and type 1 diabetes mellitus in children and adolescents aged <15 years (black), countries based on the incidence of tuberculosis and type 1 diabetes mellitus in children and adolescents aged <15 years (gray), and countries without information (white). BCG, bacillus Calmette-Guerin; TB, tuberculosis; T1DM, type 1 diabetes mellitus.

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  Fig. 2. Scatter plot of the associations between the incidence of tuberculosis and gross domestic product per capita (A) and between the incidence of type 1 diabetes mellitus (T1DM) and gross domestic product (GDP) per capita (B). Sqrt, square root transformation.

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  Fig. 3. Scatter plot of the association between the incidence of tuberculosis and type 1 diabetes mellitus (T1DM) in children and adolescents aged <15 years. Sqrt, square root transformation.

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  Fig. 4. Scatter plot of the association between bacillus Calmette-Guérin (BCG) immunization rate among 1-year-old children and the incidence of type 1 diabetes mellitus (T1DM) .

Reference

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