# The Role of Tuberculosis Disease on Non-Communicable Disease Risk: Comparative Analysis of Large Healthcare Databases

> **NIH NIH R21** · EMORY UNIVERSITY · 2022 · $132,253

## Abstract

PROJECT SUMMARY
The intersection of tuberculosis (TB) disease with non-communicable diseases (NCDs), including diabetes mellitus,
pulmonary disease, and cardiovascular disease, has emerged as a critical public health concern. Rapidly
expanding NCD epidemics threaten TB control in low- and middle-income countries, where preventing and treating
TB disease remains a great burden. However, to date, the notion that TB disease may increase the risk of chronic
NCDs has not been well explored. Using two large healthcare databases, we will determine the extent that TB
increases the risk of post-TB diabetes, pulmonary disease, and cardiovascular disease. This secondary data
analysis research study will advance understanding of dual burdens of TB and NCD multimorbidity and build a
knowledge base for integrated care and prevention of NCDs.
The overall objective of this study is to improve understanding of the relationship between TB disease and
subsequent risks of diabetes, pulmonary disease, and cardiovascular disease, and to identify targets for preventing
these NCDs among TB patients. The specific aims of this proposal are to: (1) determine the extent to which TB
disease increases the risk of future development of diabetes mellitus, pulmonary disease (asthma and COPD) and
cardiovascular disease (ischemic stroke, coronary artery disease, peripheral vascular disease, and transient
ischemic attack TIA), (2) determine the extent to biologic sex, BMI, HIV, race/ethnicity, and age at time of TB
disease modify and mediate the relationships between TB and incidence of diabetes, pulmonary disease, and
CVD, and (3) explore TB clinical characteristics that predict early NCD incidence (a first diagnosis of diabetes,
pulmonary diseases, or CVD within 5 years after TB cure) among patients with previous TB disease. To meet the
study’s objectives and aims, we will leverage two well-characterized and comprehensive health care databases.
First, we will use electronic health records from the US Veterans Affairs Medical Care Centers to assemble
comparable data on diagnostic codes, prescription medication use, hospitalization, and vital status. Second, we
will use the Clinical Practice Research Datalink, a database of primary care patients in the United Kingdom that is
nationally representative and linked to hospital admissions and mortality data. The proposed approach will allow
us to assemble a cohort of >16,000 TB survivors and follow them for an average of 6.5 years. We will then compare
NCD incidence among TB survivors to >64,000 age, sex, and race/ethnicity matched controls without previous TB.
The proposed study will importantly characterize the extent to which TB contributes to post-TB NCD multimorbidity.
The comparison of post-TB outcomes across two large health care will greatly strengthen the validity of our results
and increase the ability to suggest causal inferences based on our findings. A long-term goal of the proposed work
is to prepare for prospective interv...

## Key facts

- **NIH application ID:** 10308522
- **Project number:** 5R21AI156161-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Julia Alison Critchley
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $132,253
- **Award type:** 5
- **Project period:** 2020-12-01 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10308522

## Citation

> US National Institutes of Health, RePORTER application 10308522, The Role of Tuberculosis Disease on Non-Communicable Disease Risk: Comparative Analysis of Large Healthcare Databases (5R21AI156161-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10308522. Licensed CC0.

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