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

RL Hensel, RR Kempker, J Tapia… - … of Tuberculosis and …, 2016 - ingentaconnect.com
RL Hensel, RR Kempker, J Tapia, A Oladele, HM Blumberg, MJ Magee
The International Journal of Tuberculosis and Lung Disease, 2016ingentaconnect.com
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 QuantiFERON®-TB …
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 QuantiFERON®-TB (QFT) test. HbA1c and QFT results, demographic information, and medical history were abstracted from patient charts.RESULTS: 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 CONCLUSION: 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.
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