Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population.

Autor: Castle AC; Africa Health Research Institute, KwaZulu-Natal, South Africa.; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America.; Harvard Medical School, Boston, Massachusetts, United States of America., Hoeppner SS; Harvard Medical School, Boston, Massachusetts, United States of America., Magodoro IM; Emory Global Diabetes Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America., Singh U; Africa Health Research Institute, KwaZulu-Natal, South Africa.; University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa., Moosa Y; Africa Health Research Institute, KwaZulu-Natal, South Africa.; University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa., Bassett IV; Africa Health Research Institute, KwaZulu-Natal, South Africa.; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America.; Harvard Medical School, Boston, Massachusetts, United States of America., Wong EB; Africa Health Research Institute, KwaZulu-Natal, South Africa.; University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.; Division of Infectious Diseases, University of Alabama Birmingham, Birmingham, Alabama, United States of America., Siedner MJ; Africa Health Research Institute, KwaZulu-Natal, South Africa.; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America.; Harvard Medical School, Boston, Massachusetts, United States of America.; University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Mar 16; Vol. 18 (3), pp. e0282371. Date of Electronic Publication: 2023 Mar 16 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0282371
Abstrakt: Objective: Tuberculosis (TB) may predispose individuals to the development of diabetes. Such a relationship could have an outsized impact in high-prevalence TB settings. However, few studies have explored this relationship in populations heavily burdened by diabetes and TB.
Methods: We analyzed data from a community-based population cohort that enrolled adults in rural South Africa. Individuals were considered to have prior TB if they self-reported a history of TB treatment. We fitted sex-specific logistic regression models, adjusted for potential clinical and demographic confounders, to estimate relationships between dysglycemia (HBA1c ≥6.5%) and prior TB. Propensity score-matched cohorts accounted for the differential age distributions between comparator groups. We examined the interactions between sex, prior TB, and HIV status.
Results: In the analytic cohort (n = 17,593), the prevalence of prior TB was 13.8% among men and 10.7% among women. Dysglycemia was found in 9.1% of the population, and HIV prevalence was 34.0%. We found no difference in dysglycemia prevalence by prior TB (men OR 0.96, 95% CI 0.60-1.56: women OR 1.05, 95% CI 0.79-1.39). However, there was a qualitative interaction by HIV serostatus, such that among men without HIV, those with a history of TB had a greater prevalence of dysglycemia than those without prior TB (10.1% vs. 4.6%, p = 0.0077). An inverse relationship was observed among men living with HIV (prior TB 3.3% vs. no TB 7.3%, p = 0.0073).
Conclusions: Treated TB disease was not associated with dysglycemia in an HIV-endemic, rural South African population. However, we found a significant interaction between prior TB and HIV status among men, suggesting distinct pathophysiological mechanisms between the two infections that may impact glucose metabolism. Longitudinal studies are needed to better establish a causal effect and underlying mechanisms related to resolved TB, HIV, and diabetes.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Castle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje