TB Risk Is Associated With Glycemic Control
Glycemic control may modify the relationship between diabetes and tuberculosis infection, according to a recent study.
The study included 4215 participants who underwent tuberculin skin testing to identify tuberculosis infection. Diabetes was diagnosed by physician evaluation and 1 of 3 laboratory tests: hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), or 2-hour plasma glucose (PG). Recommended targets were used to assess glycemic control linearly and categorically.
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Overall, the prevalence of tuberculosis was 4.1% among participants without diabetes, 5.5% among those with prediabetes, and 7.6% among those with diabetes.
Diabetes was associated with tuberculosis in multivariate analysis, with an adjusted odds ratio (AOR) of 1.5 (95% CI 1.0-2.2). Compared with participants without diabetes, those with undiagnosed diabetes (AOR 2.2), those with an FPG level above 130 mg/dL (AOR 2.6), and those not receiving insulin (AOR 1.7) had higher tuberculosis infection rates.
Additionally, linear dose-response analysis showed that increasing values of FPG, PG, and HbA1c had predicted tuberculosis infection.
“Our results suggest glycemic control may modify the relationship between tuberculosis infection and diabetes,” the researchers concluded.
—Melissa Weiss
Reference:
Martinez L, Zhu L, Castellanos ME, et al. Glycemic control and the prevalence of tuberculosis infection: a population-based observational study. Clin Infect Dis. 2017;65(12): 2060-2068. https://doi.org/10.1093/cid/cix632.