Adults with Mycobacterium tuberculosis infection and pre-diabetes have increased levels of QuantiFERON interferon-gamma responses - 28/07/20
, Susanna L. Trost a, Argita D. Salindri b, Genet Amere b, Cheryl L. Day c, Neel R. Gandhi a, dAbstract |
Background |
Diabetes is associated with increased prevalence of TB infection in the US. We assessed associations between diabetes and interferon-gamma (IFN-γ) TB antigen response among adults with TB infection using US representative data.
Methods |
National Health and Nutrition Examination (NHANES) participants >19 years from 2011 to 2012 with positive QuantiFERON®-TB Gold-In-Tube (QFT) results were eligible. Diabetes was defined by combination of self-report and glycated hemoglobin (HbA1c). Quantitative IFN-γ TB antigen was classified as high (
10 IU/mL), intermediate (1.01–9.99 IU/mL), or low (0.35–1.00 IU/mL). Analyses accounted for NHANES weighted design.
Results |
Among NHANES participants >19 years, n = 513 had positive QFT (5.9%). Among those with positive QFT, diabetes prevalence was 22.2% and pre-diabetes was 25.9%. Overall, 16.7% of positive QFT participants had high IFN-γ TB antigen levels including 21.7% among those with diabetes, 20.8% among those with pre-diabetes, and 12.6% among euglycemic participants. In adjusted analyses, high IFN-γ TB antigen response was more common among those with pre-diabetes (aOR 1.9, 95%CI 1.0, 3.6) compared to euglycemic participants.
Conclusion |
Higher antigen responses may reflect immunopathy consistent with an exaggerated inflammatory but ineffectual response to TB or a reflection of more Mtb replication in participants with pre-diabetes or diabetes.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Latent tuberculosis infection prevalence is higher in patients with pre-diabetes. |
• | Adults with LTBI and diabetes had higher quantitative QFT TB antigen responses. |
• | LTBI-diabetes link unlikely due to hyperglycemia inhibited IFN-γ TB antigen responses. |
Keywords : Tuberculosis infection, Diabetes mellitus, Interferon-gamma
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Vol 122
Article 101935- mai 2020 Retour au numéro
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