International Journal of Tuberculosis and Lung Disease
Volume 20, Issue 1, 2016, Pages 71-78

Increased risk of latent tuberculous infection among persons with pre-diabetes and diabetes mellitus (Article)

Hensel R.L. , Kempker R.R. , Tapia J. , Oladele A. , Blumberg H.M. , Magee M.J.*
  • a School of Medicine, Emory University, Atlanta, United States
  • b School of Medicine, Emory University, Atlanta, United States, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, United States
  • c Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, United States
  • d DeKalb County Board of Health, Decatur, United States
  • e School of Medicine, Emory University, Atlanta, United States, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, United States, Departments of Epidemiology and Global Health, Emory Rollins School of Public Health, Georgia State University, One Park Place NE, Atlanta, GA 30303, United States
  • f Departments of Epidemiology and Global Health, Emory Rollins School of Public Health, Georgia State University, One Park Place NE, Atlanta, GA 30303, United States, Division of Epidemiology and Biostatistics, Georgia State University, School of Public Health, Atlanta, GA, United States

Abstract

Setting: Although diabetes mellitus (DM) is an established risk factor for active tuberculosis (TB) disease, little is known about the association between pre-DM, DM, and latent tuberculous infection (LTBI). OBJECTIVE: To estimate the association between DM and LTBI. DESIGN: We conducted a cross-sectional study among recently arrived refugees seen at a health clinic in Atlanta, GA, USA, between 2013 and 2014. Patients were screened for DM using glycosylated-hemoglobin (HbA1c), and for LTBI using the QuantiFERONw-TB (QFT) test. HbA1c and QFT results, demographic information, and medical history were abstracted from patient charts. RESULT S: Among 702 included patients, 681 (97.0%) had HbA1c and QFT results. Overall, 54 (7.8%) patients had DM and 235 (33.8%) had pre-DM. LTBI was prevalent in 31.3% of the refugees. LTBI prevalence was significantly higher (P < 0.01) among patients with DM (43.4%) and pre-DM (39.1%) than in those without DM (25.9%). Refugees with DM (adjusted OR [aOR] 2.3, 95%CI 1.2-4.5) and pre-DM (aOR 1.7, 95%CI 1.1-2.4) were more likely to have LTBI than those without DM. CONCLUS ION: Refugees with DM or pre-DM from high TB burden countries were more likely to have LTBI than those without DM. Dysglycemia may impair the immune defenses involved in preventing Mycobacterium tuberculosis infection. © 2016 The Union.

Author Keywords

Vitamin D Refugee QuantiFERON test Hemoglobin A1c

Index Keywords

Mycobacterium tuberculosis test kit refugee metabolism non insulin dependent diabetes mellitus vitamin blood level Diabetes Mellitus, Type 2 human risk assessment Refugees middle aged statistics and numerical data diabetes mellitus Vitamin D priority journal clinical trial (topic) Aged Georgia hemoglobin A1c Cross-Sectional Studies United States cross-sectional study Humans glycosylated hemoglobin Hemoglobin A, Glycosylated male latent tuberculosis female Socioeconomic Factors risk factor Risk Factors socioeconomics population research prevalence Article glucose blood level major clinical study tuberculin test adult infection risk Prediabetic State medical history glucose body mass disease association impaired glucose tolerance
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84952036403&doi=10.5588%2fijtld.15.0457&partnerID=40&md5=b336dcd9a1493d52e742ffee5794d603
DOI: 10.5588/ijtld.15.0457
ISSN: 10273719
Cited by: 17
Original Language: English