J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 17, Number 11, November 2025, pages 642-652

The Risk of Tuberculosis in Chronic Obstructive Pulmonary Disease Across Different Comorbidities

↓ Figure 2. Cumulative incidence rate of tuberculosis in patients with and without COPD. COPD: chronic obstructive pulmonary disease.

↓ **Table 1.** Demographic Characteristics and Comorbidities of Patients With and Without COPD
Variables	COPD (n = 117,989)	Without-COPD (n = 117,989)	Standardized mean difference
COPD: chronic obstructive pulmonary disease; SD: standard deviation.
Age (%)
40 - 49	15,371 (13.03)	15,351 (13.01)
50 - 59	26,456 (22.42)	26,419 (22.39)
60 - 69	33,389 (28.3)	33,063 (28.02)
≥ 70	42,773 (36)	43,156 (36.58)
Mean (± SD)	64.583 (± 12.18)	64.625 (± 12.19)	0.003
Gender (%)
Male	65,038 (55.12)	64,409 (54.59)	0.011
Female	52,951 (44.88)	53,580 (45.41)
Comorbidities (%)
Diabetes mellitus	40,030 (33.93)	39,159 (33.19)	0.016
Hypertension	75,707 (64.16)	75,814 (64.26)	0.002
Hyperlipidemia	40,751 (34.54)	40,609 (34.42)	0.003
Coronary artery disease	36,005 (30.52)	36,400 (30.85)	0.007
End-stage renal disease	19,213 (16.28)	18,953 (16.06)	0.006
Hepatitis B or C	7,369 (6.25)	7,288 (6.18)	0.003
Pneumoconiosis	457 (0.39)	316 (0.27)	0.021
Lung cancer	7,899 (6.69)	7,558 (6.41)	0.012
Rheumatoid arthritis	3,144 (2.66)	3,098 (2.63)	0.002
Head and neck cancer	4,974 (4.22)	4,693 (3.98)
Outcomes (%)
Tuberculosis	221 (0.19)	176 (0.15)	0.009

↓ Table 1. Demographic Characteristics and Comorbidities of Patients With and Without COPD

Variables

COPD (n = 117,989)

Without-COPD (n = 117,989)

Standardized mean difference

COPD: chronic obstructive pulmonary disease; SD: standard deviation.

Age (%)

40 - 49

15,371 (13.03)

15,351 (13.01)

50 - 59

26,456 (22.42)

26,419 (22.39)

60 - 69

33,389 (28.3)

33,063 (28.02)

≥ 70

42,773 (36)

43,156 (36.58)

Mean (± SD)

64.583 (± 12.18)

64.625 (± 12.19)

0.003

Gender (%)

Male

65,038 (55.12)

64,409 (54.59)

0.011

Female

52,951 (44.88)

53,580 (45.41)

Comorbidities (%)

Diabetes mellitus

40,030 (33.93)

39,159 (33.19)

0.016

Hypertension

75,707 (64.16)

75,814 (64.26)

0.002

Hyperlipidemia

40,751 (34.54)

40,609 (34.42)

0.003

Coronary artery disease

36,005 (30.52)

36,400 (30.85)

0.007

End-stage renal disease

19,213 (16.28)

18,953 (16.06)

0.006

Hepatitis B or C

7,369 (6.25)

7,288 (6.18)

0.003

Pneumoconiosis

457 (0.39)

316 (0.27)

0.021

Lung cancer

7,899 (6.69)

7,558 (6.41)

0.012

Rheumatoid arthritis

3,144 (2.66)

3,098 (2.63)

0.002

Head and neck cancer

4,974 (4.22)

4,693 (3.98)

Outcomes (%)

Tuberculosis

221 (0.19)

176 (0.15)

0.009

↓ **Table 2.** Incidence of Tuberculosis in Patients With and Without COPD
Characteristics	COPD (n = 117,989)	Non-COPD (n = 117,989)	aHR (95%CI)	P-value
aHR: adjusted hazard ratio; CI: confidence interval; COPD: chronic obstructive pulmonary disease; IR: incident rate per 10,000 person-years; PY: per 10,000 person-years; TFP: total follow-up period.
Tuberculosis	221	690,506.3	3.20	176	1,213,800	1.45	1.74 (1.423 - 2.135)	< 0.001
Age
40 - 49	12	82,838.7	1.45	4	144,864.6	0.28	3.64 (1.16 - 11.46)	0.027
50 - 59	36	152,159.3	2.37	21	269,416.5	0.78	2.16 (1.244 - 3.74)	< 0.001
60 - 69	53	189,244.0	2.80	47	339,772.1	1.38	1.66 (1.11 - 2.48)	0.014
≥ 70	120	266,264.3	4.51	104	459,746.5	2.26	1.59 (1.22 - 2.08)	< 0.001
Gender
Male	153	386,644.6	3.96	115	653,822.8	1.76	1.80 (1.41 - 2.3)	< 0.001
Female	68	303,861.7	2.24	61	559,976.8	1.09	1.59 (1.11 - 2.26)	0.011
Diabetes mellitus
Presence	77	248,046.2	3.10	77	418,748.7	1.84	1.31 (0.95 - 1.81)	0.097
Absence	144	442,460	3.25	99	795,051	1.25	2.09 (1.61 - 2.72)	< 0.001
Hypertension
Presence	146	468,761.9	3.11	128	807,871.7	1.58	1.61 (1.27 - 2.06)	< 0.001
Absence	75	221,744.4	3.38	48	405,928	1.18	2.03 (1.40 - 2.94)	< 0.001
Hyperlipidemia
Presence	73	248,683.1	2.94	57	439,668.1	1.30	1.83 (1.28 - 2.61)	< 0.001
Absence	148	441,823.2	3.35	119	774,131.6	1.54	1.71 (1.34 - 2.19)	< 0.001
Coronary artery disease
Presence	79	230,300.4	3.43	73	391,213.1	1.87	1.55 (1.12 - 2.15)	0.008
Absence	142	460,205.9	3.09	103	822,586.6	1.25	1.85 (1.427 - 2.399)	< 0.001
End-stage renal disease
Presence	48	122,849.1	3.91	58	204,352.9	2.84	1.17 (0.79 - 1.72)	0.441
Absence	173	567,657.1	3.05	118	1,009,447	1.17	2.00 (1.57 - 2.54)	< 0.001
Hepatitis B or C
Presence	19	45,944.76	4.14	19	78,950.59	2.41	1.20 (0.63 - 2.29)	0.584
Absence	202	644,561.5	3.13	157	1,134,849	1.38	1.82 (1.47 - 2.25)	< 0.001
Pneumoconiosis
Presence	5	3,295.30	15.17	3	3,309.62	9.06	1.21 (0.29 - 5.06)	0.796
Absence	216	687,211	3.14	173	1,210,490	1.43	1.75 (1.42 - 2.14)	< 0.001
Lung cancer
Presence	23	47,726.22	4.82	28	78,702.87	3.56	1.11 (0.63 - 1.95)	0.714
Absence	198	642,780.1	3.08	148	1,135,097	1.30	1.86 (1.50 - 2.31)	< 0.001
Rheumatoid arthritis
Presence	10	18,919.67	5.29	0	33,426.95	-	-	-
Absence	211	671,586.6	3.14	176	1,180,373	1.49	1.67 (1.36 - 2.05)	< 0.001
Head and neck cancer
Presence	11	28,943.24	3.80	11	48,490.89	2.27	1.41 (0.60 - 3.31)	0.434
Absence	210	661,563	3.17	165	1,165,309	1.42	1.76 (1.43 - 2.17)	< 0.001

↓ Table 2. Incidence of Tuberculosis in Patients With and Without COPD

Characteristics

COPD (n = 117,989)

Non-COPD (n = 117,989)

aHR (95%CI)

P-value

Event

TFP (PY)

Event

TFP (PY)

aHR: adjusted hazard ratio; CI: confidence interval; COPD: chronic obstructive pulmonary disease; IR: incident rate per 10,000 person-years; PY: per 10,000 person-years; TFP: total follow-up period.

Tuberculosis

221

690,506.3

3.20

176

1,213,800

1.45

1.74 (1.423 - 2.135)

< 0.001

Age

40 - 49

82,838.7

1.45

144,864.6

0.28

3.64 (1.16 - 11.46)

0.027

50 - 59

152,159.3

2.37

269,416.5

0.78

2.16 (1.244 - 3.74)

< 0.001

60 - 69

189,244.0

2.80

339,772.1

1.38

1.66 (1.11 - 2.48)

0.014

≥ 70

120

266,264.3

4.51

104

459,746.5

2.26

1.59 (1.22 - 2.08)

< 0.001

Gender

Male

153

386,644.6

3.96

115

653,822.8

1.76

1.80 (1.41 - 2.3)

< 0.001

Female

303,861.7

2.24

559,976.8

1.09

1.59 (1.11 - 2.26)

0.011

Diabetes mellitus

Presence

248,046.2

3.10

418,748.7

1.84

1.31 (0.95 - 1.81)

0.097

Absence

144

442,460

3.25

795,051

1.25

2.09 (1.61 - 2.72)

< 0.001

Hypertension

Presence

146

468,761.9

3.11

128

807,871.7

1.58

1.61 (1.27 - 2.06)

< 0.001

Absence

221,744.4

3.38

405,928

1.18

2.03 (1.40 - 2.94)

< 0.001

Hyperlipidemia

Presence

248,683.1

2.94

439,668.1

1.30

1.83 (1.28 - 2.61)

< 0.001

Absence

148

441,823.2

3.35

119

774,131.6

1.54

1.71 (1.34 - 2.19)

< 0.001

Coronary artery disease

Presence

230,300.4

3.43

391,213.1

1.87

1.55 (1.12 - 2.15)

0.008

Absence

142

460,205.9

3.09

103

822,586.6

1.25

1.85 (1.427 - 2.399)

< 0.001

End-stage renal disease

Presence

122,849.1

3.91

204,352.9

2.84

1.17 (0.79 - 1.72)

0.441

Absence

173

567,657.1

3.05

118

1,009,447

1.17

2.00 (1.57 - 2.54)

< 0.001

Hepatitis B or C

Presence

45,944.76

4.14

78,950.59

2.41

1.20 (0.63 - 2.29)

0.584

Absence

202

644,561.5

3.13

157

1,134,849

1.38

1.82 (1.47 - 2.25)

< 0.001

Pneumoconiosis

Presence

3,295.30

15.17

3,309.62

9.06

1.21 (0.29 - 5.06)

0.796

Absence

216

687,211

3.14

173

1,210,490

1.43

1.75 (1.42 - 2.14)

< 0.001

Lung cancer

Presence

47,726.22

4.82

78,702.87

3.56

1.11 (0.63 - 1.95)

0.714

Absence

198

642,780.1

3.08

148

1,135,097

1.30

1.86 (1.50 - 2.31)

< 0.001

Rheumatoid arthritis

Presence

18,919.67

5.29

33,426.95

Absence

211

671,586.6

3.14

176

1,180,373

1.49

1.67 (1.36 - 2.05)

< 0.001

Head and neck cancer

Presence

28,943.24

3.80

48,490.89

2.27

1.41 (0.60 - 3.31)

0.434

Absence

210

661,563

3.17

165

1,165,309

1.42

1.76 (1.43 - 2.17)

< 0.001

↓ **Table 3.** Impact of Comorbidities on Tuberculosis Among COPD Patients (n = 117,989)
Comorbidity	Number	Event	aHR (95% CI)	P-value
^aNumber/n (%); ^bEvent/Number (%). *P < 0.05. aHR: adjusted hazard ratio; CI: confidence interval; COPD: chronic obstructive pulmonary disease.
No comorbidity	23,832 (20.20)^a	36 (0.15)^b	-	-
Diabetes mellitus	40,030 (33.93)	77 (0.19)	1.19 (0.80 - 1.76)	0.400
Hypertension	75,707 (64.16)	146 (0.19)	1.16 (0.80 - 1.67)	0.436
Hyperlipidemia	40,751 (34.54)	73 (0.18)	1.10 (0.74 - 1.65)	0.631
Coronary artery disease	36,005 (30.52)	79 (0.22)	1.27 (0.86 - 1.89)	0.236
End-stage renal disease	19,213 (16.28)	48 (0.25)	1.51 (0.98 - 2.32)	0.065
Hepatitis B or C	7,369 (6.25)	19 (0.26)	1.63 (0.94 - 2.85)	0.085
Pneumoconiosis	457 (0.39)	5 (1.09)	6.94 (2.72 - 17.71)	0.001*
Lung cancer	7,899 (6.69)	23 (0.29)	1.81 (1.07 - 3.05)	0.027*
Rheumatoid arthritis	3,144 (2.66)	10 (0.32)	2.05 (1.01 - 4.12)	0.046*
Head and neck cancer	4,974 (4.22)	11 (0.22)	1.42 (0.72 - 2.79)	0.312

↓ Table 3. Impact of Comorbidities on Tuberculosis Among COPD Patients (n = 117,989)

Comorbidity

Number

Event

aHR (95% CI)

P-value

^aNumber/n (%); ^bEvent/Number (%). *P < 0.05. aHR: adjusted hazard ratio; CI: confidence interval; COPD: chronic obstructive pulmonary disease.

No comorbidity

23,832 (20.20)^a

36 (0.15)^b

Diabetes mellitus

40,030 (33.93)

77 (0.19)

1.19 (0.80 - 1.76)

0.400

Hypertension

75,707 (64.16)

146 (0.19)

1.16 (0.80 - 1.67)

0.436

Hyperlipidemia

40,751 (34.54)

73 (0.18)

1.10 (0.74 - 1.65)

0.631

Coronary artery disease

36,005 (30.52)

79 (0.22)

1.27 (0.86 - 1.89)

0.236

End-stage renal disease

19,213 (16.28)

48 (0.25)

1.51 (0.98 - 2.32)

0.065

Hepatitis B or C

7,369 (6.25)

19 (0.26)

1.63 (0.94 - 2.85)

0.085

Pneumoconiosis

457 (0.39)

5 (1.09)

6.94 (2.72 - 17.71)

0.001*

Lung cancer

7,899 (6.69)

23 (0.29)

1.81 (1.07 - 3.05)

0.027*

Rheumatoid arthritis

3,144 (2.66)

10 (0.32)

2.05 (1.01 - 4.12)

0.046*

Head and neck cancer

4,974 (4.22)

11 (0.22)

1.42 (0.72 - 2.79)

0.312