A combination of iron metabolism indexes and tuberculosis-specific antigen/phytohemagglutinin ratio for distinguishing active tuberculosis from latent tuberculosis infection.
Adult
Antigens, Bacterial
/ analysis
Biomarkers
/ blood
Cohort Studies
Diagnostic Techniques and Procedures
Discriminant Analysis
Female
Humans
Iron
/ blood
Latent Tuberculosis
/ blood
Male
Middle Aged
Mycobacterium tuberculosis
Phytohemagglutinins
/ blood
Sensitivity and Specificity
Tuberculosis
/ blood
Active tuberculosis
Diagnostic model
Iron metabolism
Latent tuberculosis infection
TBAg/PHA ratio
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
06
04
2020
revised:
18
05
2020
accepted:
23
05
2020
pubmed:
5
6
2020
medline:
6
10
2020
entrez:
5
6
2020
Statut:
ppublish
Résumé
Discriminating active tuberculosis (ATB) from latent tuberculosis infection (LTBI) remains challenging. This study aimed to investigate a diagnostic model based on a combination of iron metabolism and the TB-specific antigen/phytohemagglutinin ratio (TBAg/PHA ratio) in T-SPOT.TB assay for differentiation between ATB and LTBI. A total of 345 participants with ATB (n=191) and LTBI (n=154) were recruited based on positive T-SPOT.TB results at Tongji hospital between January 2017 and January 2020. Iron metabolism analysis was performed simultaneously. A diagnostic model for distinguishing ATB from LTBI was established according to multivariate logistic regression. The TBAg/PHA ratio showed 64.00% sensitivity and 90.10% specificity in distinguishing ATB from LTBI when a threshold of 0.22 was used. All iron metabolism biomarkers in the ATB group were significantly different from those in the LTBI group. Specifically, serum ferritin and soluble transferrin receptor in ATB were significantly higher than LTBI. On the contrary, serum iron, transferrin, total iron binding capacity, and unsaturated iron binding capacity in ATB were significantly lower than LTBI. The combination of iron metabolism indicators accurately predicted 60.00% of ATB cases and 91.09% of LTBI subjects, respectively. Moreover, the combination of iron metabolism indexes and TBAg/PHA ratio resulted in a sensitivity of 88.80% and specificity of 90.10%. Furthermore, the performance of models established in the Qiaokou cohort was confirmed in the Caidian cohort. The data suggest that the combination of iron metabolism indexes and TBAg/PHA ratio could serve as a biomarker to distinguish ATB from LTBI in T-SPOT-positive individuals.
Sections du résumé
BACKGROUND
BACKGROUND
Discriminating active tuberculosis (ATB) from latent tuberculosis infection (LTBI) remains challenging. This study aimed to investigate a diagnostic model based on a combination of iron metabolism and the TB-specific antigen/phytohemagglutinin ratio (TBAg/PHA ratio) in T-SPOT.TB assay for differentiation between ATB and LTBI.
METHODS
METHODS
A total of 345 participants with ATB (n=191) and LTBI (n=154) were recruited based on positive T-SPOT.TB results at Tongji hospital between January 2017 and January 2020. Iron metabolism analysis was performed simultaneously. A diagnostic model for distinguishing ATB from LTBI was established according to multivariate logistic regression.
RESULTS
RESULTS
The TBAg/PHA ratio showed 64.00% sensitivity and 90.10% specificity in distinguishing ATB from LTBI when a threshold of 0.22 was used. All iron metabolism biomarkers in the ATB group were significantly different from those in the LTBI group. Specifically, serum ferritin and soluble transferrin receptor in ATB were significantly higher than LTBI. On the contrary, serum iron, transferrin, total iron binding capacity, and unsaturated iron binding capacity in ATB were significantly lower than LTBI. The combination of iron metabolism indicators accurately predicted 60.00% of ATB cases and 91.09% of LTBI subjects, respectively. Moreover, the combination of iron metabolism indexes and TBAg/PHA ratio resulted in a sensitivity of 88.80% and specificity of 90.10%. Furthermore, the performance of models established in the Qiaokou cohort was confirmed in the Caidian cohort.
CONCLUSIONS
CONCLUSIONS
The data suggest that the combination of iron metabolism indexes and TBAg/PHA ratio could serve as a biomarker to distinguish ATB from LTBI in T-SPOT-positive individuals.
Identifiants
pubmed: 32497795
pii: S1201-9712(20)30416-1
doi: 10.1016/j.ijid.2020.05.109
pii:
doi:
Substances chimiques
Antigens, Bacterial
0
Biomarkers
0
Phytohemagglutinins
0
Iron
E1UOL152H7
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
190-196Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.