Impact of hyperglycemia on tuberculosis treatment outcomes: a cohort study.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
12 06 2024
12 06 2024
Historique:
received:
07
10
2023
accepted:
10
06
2024
medline:
13
6
2024
pubmed:
13
6
2024
entrez:
12
6
2024
Statut:
epublish
Résumé
Hyperglycemia is prevalent and closely associated with pulmonary tuberculosis (PTB). This study aimed to investigate the effects of hyperglycemia on the outcomes of PTB treatment. This study comprised 791 patients with PTB in total. Patients with fasting plasma glucose levels of ≥ 6.1 mmol/L were diagnosed with hyperglycemia. Anthropometric and baseline demographic data were also collected. The treatment response was assessed based on clinical symptoms (sputum production, cough, chest pain, fever, hemoptysis, night sweats, loss of appetite, and fatigue), sputum smear, chest computed tomography (CT), and adverse gastrointestinal responses (vomiting, nausea, abdominal distension, diarrhea, and constipation). A generalized estimating equation (GEE) was used to evaluate these relationships. Hyperglycemia affected 266 (33.6%) of the 791 patients with PTB. In GEE analyses, patients with hyperglycemia exhibited a greater incidence of elevated tuberculosis (TB) scores (odds ratio (OR) 1.569; 95% CI 1.040-2.369), cough (OR 1.332; 95% CI 1.050-1.690), and night sweats (OR 1.694; 95% CI 1.288-2.335). Hyperglycemia was linked with a higher risk of positive sputum smears (OR 1.941; 95% CI 1.382-2.727). During therapy, hyperglycemia was also associated with an increased incidence of vomiting (OR 2.738; 95% CI 1.041-7.198), abdominal distension (OR 2.230; 95% CI 1.193-4.171), and constipation (OR 2.372; 95% CI 1.442-3.902). However, the CT results indicated that hyperglycemia did not affect pulmonary lesions in patients with TB. Patients with TB and hyperglycemia are at a higher risk of severe clinical manifestations, positive sputum smears, and adverse gastrointestinal effects and, therefore, the special situation of hyperglycemic patients should be considered in the prevention and treatment of TB.
Identifiants
pubmed: 38866898
doi: 10.1038/s41598-024-64525-3
pii: 10.1038/s41598-024-64525-3
doi:
Substances chimiques
Antitubercular Agents
0
Blood Glucose
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
13586Informations de copyright
© 2024. The Author(s).
Références
Natarajan, A., Beena, P. M., Devnikar, A. V. & Mali, S. A systemic review on tuberculosis. Indian J. Tuberc. 67(3), 295–311 (2020).
pubmed: 32825856
doi: 10.1016/j.ijtb.2020.02.005
Shariq, M. et al. COVID-19 and tuberculosis: The double whammy of respiratory pathogens. Eur. Respir. Rev. 31(164), 210264 (2022).
pubmed: 35418488
pmcid: 9488123
doi: 10.1183/16000617.0264-2021
Organization, W. H. Global Tuberculosis Report 2023 (World Health Organization, 2023).
Jarde, A. et al. Prevalence and risks of tuberculosis multimorbidity in low-income and middle-income countries: A meta-review. BMJ Open 12(9), e060906 (2022).
pubmed: 36175100
pmcid: 9528681
doi: 10.1136/bmjopen-2022-060906
Ayelign, B., Negash, M., Genetu, M., Wondmagegn, T. & Shibabaw, T. Immunological impacts of diabetes on the susceptibility of Mycobacterium tuberculosis. J. Immunol. Res. 2019, 6196532 (2019).
pubmed: 31583258
pmcid: 6754884
doi: 10.1155/2019/6196532
Barreda, N. N. et al. Severe pulmonary radiological manifestations are associated with a distinct biochemical profile in blood of tuberculosis patients with dysglycemia. BMC Infect. Dis. 20(1), 139 (2020).
pubmed: 32059707
pmcid: 7023734
doi: 10.1186/s12879-020-4843-0
Jeon, C. Y. & Murray, M. B. Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med. 5(7), e152 (2008).
pubmed: 18630984
pmcid: 2459204
doi: 10.1371/journal.pmed.0050152
Chen, L., Magliano, D. J. & Zimmet, P. Z. The worldwide epidemiology of type 2 diabetes mellitus–present and future perspectives. Nat. Rev. Endocrinol. 8(4), 228–236 (2011).
pubmed: 22064493
doi: 10.1038/nrendo.2011.183
Calderon, R. I. et al. High prevalence and heterogeneity of Dysglycemia in patients with tuberculosis from Peru: A prospective cohort study. BMC Infect. Dis. 19(1), 799 (2019).
pubmed: 31510930
pmcid: 6737721
doi: 10.1186/s12879-019-4416-2
Kornfeld, H. et al. High prevalence and heterogeneity of diabetes in patients with TB in South India: A report from the effects of diabetes on tuberculosis severity (EDOTS) study. Chest 149(6), 1501–1508 (2016).
pubmed: 26973015
pmcid: 4944775
doi: 10.1016/j.chest.2016.02.675
Wang, Q. et al. Hyperglycemia is associated with increased risk of patient delay in pulmonary tuberculosis in rural areas. J. Diabetes 9(7), 648–655 (2017).
pubmed: 27508345
doi: 10.1111/1753-0407.12459
Nandy, D., Janardhanan, R., Mukhopadhyay, D. & Basu, A. Effect of hyperglycemia on human monocyte activation. J. Investig. Med. 59(4), 661–667 (2011).
pubmed: 21307779
pmcid: 3143266
doi: 10.2310/JIM.0b013e31820ee432
Kumar Nathella, P. & Babu, S. Influence of diabetes mellitus on immunity to human tuberculosis. Immunology 152(1), 13–24 (2017).
pubmed: 28543817
pmcid: 5543489
doi: 10.1111/imm.12762
Kumar, N. P. et al. Persistent inflammation during anti-tuberculosis treatment with diabetes comorbidity. eLife 8, 46477 (2019).
doi: 10.7554/eLife.46477
Kumar, A. K. et al. Anti-tuberculosis drug concentrations in tuberculosis patients with and without diabetes mellitus. Eur. J. Clin. Pharmacol. 73(1), 65–70 (2017).
pubmed: 27651240
doi: 10.1007/s00228-016-2132-z
Restrepo, B. I. & Schlesinger, L. S. Host-pathogen interactions in tuberculosis patients with type 2 diabetes mellitus. Tuberculosis 93, S10-14 (2013).
pubmed: 24388642
doi: 10.1016/S1472-9792(13)70004-0
Skowroński, M., Zozulińska-Ziółkiewicz, D. & Barinow-Wojewódzki, A. Tuberculosis and diabetes mellitus: An underappreciated association. Arch. Med. Sci. 10(5), 1019–1027 (2014).
pubmed: 25395955
pmcid: 4223145
doi: 10.5114/aoms.2014.46220
Almeida-Junior, J. L. et al. Glucose metabolism disorder is associated with pulmonary tuberculosis in individuals with respiratory symptoms from Brazil. PLoS ONE 11(4), e0153590 (2016).
pubmed: 27078026
pmcid: 4831681
doi: 10.1371/journal.pone.0153590
GBT Tuberculosis Collaborators. Global, regional, and national burden of tuberculosis, 1990–2016: Results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. Lancet Infect. Dis. 18(12), 1329–1349 (2018).
doi: 10.1016/S1473-3099(18)30625-X
BoDCaP, MoHo. C. China MHo: The Chinese National Tuberculosis Prevention and Control Guideline (Peking Union Medical College Press, 2008).
World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications: Report of a WHO Consultation. Part 1, Diagnosis and Classification of Diabetes Mellitus (WHO, 1999).
Nahid, P. et al. Grzemska MJCid: Official American thoracic society/centers for disease control and prevention/infectious diseases society of America clinical practice guidelines: Treatment of drug-susceptible tuberculosis. Clin. Infect. Dis. 63(7), e147–e195 (2016).
pubmed: 27516382
pmcid: 6590850
doi: 10.1093/cid/ciw376
Xiong, K. et al. Association of dietary micronutrient intake with pulmonary tuberculosis treatment failure rate: A cohort study. Nutrients 12(9), 2491 (2020).
pubmed: 32824912
pmcid: 7551724
doi: 10.3390/nu12092491
Wejse, C. et al. TBscore: Signs and symptoms from tuberculosis patients in a low-resource setting have predictive value and may be used to assess clinical course. Scand. J. Infect. Dis. 40(2), 111–120 (2008).
pubmed: 17852907
doi: 10.1080/00365540701558698
Drossman, D. A. & Dumitrascu, D. L. Rome III: New standard for functional gastrointestinal disorders. J. Gastrointest. Liver Dis. 15(3), 237–241 (2006).
Glass, E. J. et al. Impairment of monocyte “lectin-like” receptor activity in type 1 (insulin-dependent) diabetic patients. Diabetologia 30(4), 228–231 (1987).
pubmed: 3596079
doi: 10.1007/BF00270420
Liu, Q. et al. Diabetes mellitus and the risk of multidrug resistant tuberculosis: A meta-analysis. Sci. Rep. 7(1), 1090 (2017).
pubmed: 28439071
pmcid: 5430797
doi: 10.1038/s41598-017-01213-5
Ferlita, S. et al. Type 2 diabetes mellitus and altered immune system leading to susceptibility to pathogens, especially mycobacterium tuberculosis. J. Clin. Med. 8(12), 2219 (2019).
pubmed: 31888124
pmcid: 6947370
doi: 10.3390/jcm8122219
Dooley, K. E. & Chaisson, R. E. Tuberculosis and diabetes mellitus: Convergence of two epidemics. Lancet Infect. Dis. 9(12), 737–746 (2009).
pubmed: 19926034
pmcid: 2945809
doi: 10.1016/S1473-3099(09)70282-8
Repine, J. E., Clawson, C. C. & Goetz, F. C. Bactericidal function of neutrophils from patients with acute bacterial infections and from diabetics. J. Infect. Dis. 142(6), 869–875 (1980).
pubmed: 7007524
doi: 10.1093/infdis/142.6.869
Restrepo, B. I. Diabetes and tuberculosis. Microbiol. Spectr. https://doi.org/10.1128/microbiolspec.tnmi7-0023-2016 (2016).
doi: 10.1128/microbiolspec.tnmi7-0023-2016
pubmed: 28084206
Alisjahbana, B. et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin. Infect. Dis. 45(4), 428–435 (2007).
pubmed: 17638189
doi: 10.1086/519841
Chiang, C. Y. et al. The influence of diabetes, glycemic control, and diabetes-related comorbidities on pulmonary tuberculosis. PLoS ONE 10(3), e0121698 (2015).
pubmed: 25822974
pmcid: 4378948
doi: 10.1371/journal.pone.0121698
Webber, T., Ronacher, K., Conradie-Smit, M. & Kleynhans, L. Interplay between the immune and endocrine systems in the lung: Implications for TB susceptibility. Front. Immunol. 13, 829355 (2022).
pubmed: 35273609
pmcid: 8901994
doi: 10.3389/fimmu.2022.829355
Kumar, N. P. et al. Type 2 diabetes mellitus coincident with pulmonary tuberculosis is associated with heightened systemic type 1, type 17, and other proinflammatory cytokines. Ann. Am. Thorac. Soc. 10(5), 441–449 (2013).
pubmed: 23987505
pmcid: 3960913
doi: 10.1513/AnnalsATS.201305-112OC
Restrepo, B. I. & Schlesinger, L. S. Impact of diabetes on the natural history of tuberculosis. Diabetes Res. Clin. Pract. 106(2), 191–199 (2014).
pubmed: 25082309
pmcid: 4260985
doi: 10.1016/j.diabres.2014.06.011
Zhan, S. et al. Extensive radiological manifestation in patients with diabetes and pulmonary tuberculosis: A cross-sectional study. Ther. Clin. Risk Manag. 18, 595–602 (2022).
pubmed: 35645562
pmcid: 9137957
doi: 10.2147/TCRM.S363328
Ruslami, R., Aarnoutse, R. E., Alisjahbana, B., van der Ven, A. J. & van Crevel, R. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop. Med. Int. Health 15(11), 1289–1299 (2010).
pubmed: 20955495
doi: 10.1111/j.1365-3156.2010.02625.x
Leung, C. C. et al. Effects of diabetes mellitus on the clinical presentation and treatment response in tuberculosis. Respirology 22(6), 1225–1232 (2017).
pubmed: 28244689
doi: 10.1111/resp.13017
Duangrithi, D. et al. Impact of diabetes mellitus on clinical parameters and treatment outcomes of newly diagnosed pulmonary tuberculosis patients in Thailand. Int. J. Clin. Pract. 67(11), 1199–1209 (2013).
pubmed: 23750554
doi: 10.1111/ijcp.12215
Ma, Q. et al. Research progress in the relationship between type 2 diabetes mellitus and intestinal flora. Biomed. Pharmacother. 117, 109138 (2019).
pubmed: 31247468
doi: 10.1016/j.biopha.2019.109138
Cheng, L. et al. Correlations among the plasma concentrations of first-line anti-tuberculosis drugs and the physiological parameters influencing concentrations. Front. Pharmacol. 14, 1248331 (2023).
pubmed: 37869746
pmcid: 10587680
doi: 10.3389/fphar.2023.1248331
Alffenaar, J. W. C. et al. Clinical standards for the dosing and management of TB drugs. Int. J. Tuberc. Lung Dis. 26(6), 483–499 (2022).
pubmed: 35650702
pmcid: 9165737
doi: 10.5588/ijtld.22.0188