Elderly Patients with Tuberculosis Combined with Diabetes Mellitus: A Comprehensive Analysis of Lymphocyte Subpopulation Dynamics, Clinical Features, Drug Resistance and Disease Regression.

IF 2.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2025-03-05 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S502996

Xin Wang, Yu Song, Na Li, JingYi Huo, BingBing Wang, Xue Jiang, YuLiang Zhang

{"title":"Elderly Patients with Tuberculosis Combined with Diabetes Mellitus: A Comprehensive Analysis of Lymphocyte Subpopulation Dynamics, Clinical Features, Drug Resistance and Disease Regression.","authors":"Xin Wang, Yu Song, Na Li, JingYi Huo, BingBing Wang, Xue Jiang, YuLiang Zhang","doi":"10.2147/IJGM.S502996","DOIUrl":null,"url":null,"abstract":"Objective: The aim of this study was to evaluate lymphocyte subsets and clinical outcomes in patients with pulmonary tuberculosis (PTB) combined with type 2 diabetes mellitus (T2DM).Methods: Between January 2022 and March 2024, 320 patients aged > 60 years were included, 95 of whom had comorbid DM. Lymphocyte subsets (T-lymphocytes, B-lymphocytes, and natural killer cells, NK) were assessed in both groups of patients using fluorescence-associated cell sorting. Clinical characteristics, drug resistance, regression and lymphocyte subsets were compared in PTB patients with DM versus PTB patients alone. The correlation between lymphocyte subsets-related indices and the above characteristics in PTB patients with DM was analyzed.Results: Compared with PTB patients alone, PTB patients with comorbid DM had a higher positive rate (81.05% vs 62.67%, P = 0.001), prolonged course of antituberculosis treatment (298 [244, 339] days vs 223 [179, 254], P < 0.001) and a lower cured rate (64.21% vs 75.56%, P = 0.039). Compared with PTB patients only, PTB patients with comorbid DM had higher T-lymphocytes and CD4+ T-lymphocytes (P < 0.001, P = 0.006) and lower NK cells (P < 0.001). In PTB patients with comorbid DM, both treatment-prolonged patients and drug-resistant patients showed reduced NK cells. NK cells were slightly elevated in cured patients, although there was no significant difference (P = 0.082).Conclusion: Lymphocyte homeostasis is altered in PTB patients with comorbid DM, making them more susceptible to severe clinical manifestations and therapeutic outcomes. Notably, NK cells have been identified as key regulatory cells with a significant impact on prolonged treatment course and drug resistance. This study provides new ideas and methods for individualized treatment of PTB combined with DM in the elderly, which can help to optimize the treatment plan and improve the outcome and quality of life of patients.","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1271-1282"},"PeriodicalIF":2.1000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892736/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of General Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJGM.S502996","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: The aim of this study was to evaluate lymphocyte subsets and clinical outcomes in patients with pulmonary tuberculosis (PTB) combined with type 2 diabetes mellitus (T2DM).

Methods: Between January 2022 and March 2024, 320 patients aged > 60 years were included, 95 of whom had comorbid DM. Lymphocyte subsets (T-lymphocytes, B-lymphocytes, and natural killer cells, NK) were assessed in both groups of patients using fluorescence-associated cell sorting. Clinical characteristics, drug resistance, regression and lymphocyte subsets were compared in PTB patients with DM versus PTB patients alone. The correlation between lymphocyte subsets-related indices and the above characteristics in PTB patients with DM was analyzed.

Results: Compared with PTB patients alone, PTB patients with comorbid DM had a higher positive rate (81.05% vs 62.67%, P = 0.001), prolonged course of antituberculosis treatment (298 [244, 339] days vs 223 [179, 254], P < 0.001) and a lower cured rate (64.21% vs 75.56%, P = 0.039). Compared with PTB patients only, PTB patients with comorbid DM had higher T-lymphocytes and CD4⁺ T-lymphocytes (P < 0.001, P = 0.006) and lower NK cells (P < 0.001). In PTB patients with comorbid DM, both treatment-prolonged patients and drug-resistant patients showed reduced NK cells. NK cells were slightly elevated in cured patients, although there was no significant difference (P = 0.082).

Conclusion: Lymphocyte homeostasis is altered in PTB patients with comorbid DM, making them more susceptible to severe clinical manifestations and therapeutic outcomes. Notably, NK cells have been identified as key regulatory cells with a significant impact on prolonged treatment course and drug resistance. This study provides new ideas and methods for individualized treatment of PTB combined with DM in the elderly, which can help to optimize the treatment plan and improve the outcome and quality of life of patients.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.