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

• DOI: 10.5588/ijtld.15.0457
• Publication Date: 2015-12-14T22:32:48Z
• Authors: R. L. Hensel; R. R. Kempker; J. Tapia; A. Oladele; H. M. Blumberg; M. J. Magee
• Keywords: Adult; Glycated Hemoglobin; Male; Refugees; Georgia; Tuberculin Test; Middle Aged; 3. Good health; Prediabetic State; 03 medical and health sciences; Cross-Sectional Studies; 0302 clinical medicine; Diabetes Mellitus, Type 2; Socioeconomic Factors; Latent Tuberculosis; Risk Factors; Humans; Female; Aged

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).To estimate the association between DM and LTBI.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.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.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.