在美国（NHANES），结核分枝杆菌致敏和2型糖尿病测量之间的不一致：一项基于人群的队列研究

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2025-04-30 DOI:10.1016/j.jinf.2025.106496

Itai M. Magodoro , Katalin A. Wilkinson , Brian L. Claggett , Ntobeko A.B. Ntusi , Mark J. Siedner M , Robert J. Wilkinson

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引用次数: 0

摘要

目的通过对结核分枝杆菌（Mtb）抗原的细胞介导免疫应答来评估潜伏性结核感染（LTBI）如何影响美国成年人的糖代谢。方法采用干扰素γ (IFN-γ)释放试验（IGRA+：试验反应性）和结核菌素皮肤试验（TST+：皮肤硬化≥10 mm）评价smtb致敏性，并将其分为：IGRA-/TST- （TB未感染对照）；IGRA - / TST +;IGRA + / TST -;或IGRA + / TST +。通过空腹血糖(FPG)≥7.0 mmol/L, HbA1c≥6.5%和/或降糖药确定糖尿病。调整后的广义加性模型检验了皮肤硬化和IFN-γ反应性对FPG和HbA1c的非线性影响；和LTBI对糖尿病患病率的影响。结果在1787例（IGRA-/TST-）、101例（IGRA-/TST+）、92例（IGRA+/TST-）和99例（IGRA+/TST+）成人中，皮肤硬结与FPG呈线性相关[有效自由度(EDF) =1.01；p<；0.001]与HbA1c呈非线性关系[EDF=1.76；p = 0.003)。IFN-γ反应性与FPG [p=0.58]和HbA1c [p=0.94]无关。与此相关，IGRA-/TST+组调整后的糖尿病患病率更高[24.9%；p=0.048]和IGRA+/TST+ [27.3%；p=0.004]而IGRA+/TST- [15.9%；P =0.69]个体比对照组[15.3%]。结论通过皮肤硬化评估sltbi与血糖测量和糖尿病相关，但与IFN-γ释放无关。通过体外IFN-γ释放试验确定，这表明与先天免疫激活有关，而不是获得性t细胞反应。

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Discordance between measures of Mycobacterium tuberculosis sensitization and type 2 diabetes mellitus in the United States (NHANES): A population-based cohort study

Objective

We examined how latent TB infection (LTBI), evaluated by cell-mediated immune responses to Mycobacterium tuberculosis (Mtb) antigens, impacts glucose metabolism in US adults.

Methods

Mtb sensitization was evaluated by interferon-γ (IFN-γ) release assay (IGRA+: assay reactivity) and tuberculin skin testing (TST+: skin induration ≥10 mm), and categorized as: IGRA-/TST- (TB uninfected controls); IGRA-/TST+; IGRA+/TST-; or IGRA+/TST+. Diabetes was ascertained by fasting plasma glucose (FPG) ≥7.0 mmol/L, HbA1c ≥6.5% and/or antidiabetic medication. Adjusted generalized additive models examined nonlinear effects of skin induration and IFN-γ reactivity on FPG and HbA1c; and LTBI on diabetes prevalence.

Results

Among 1787 (IGRA-/TST-), 101 (IGRA-/TST+), 92 (IGRA+/TST-), and 99 (IGRA+/TST+) adults, skin induration linearly associated with FPG [effective degrees of freedom (EDF) =1.01; p<0.001] and non-linearly with HbA1c [EDF=1.76; p=0.003]. IFN-γ reactivity correlated with neither FPG [p=0.58] nor HbA1c [p=0.94]. Relatedly, adjusted diabetes prevalence was greater in IGRA-/TST+ [24.9%; p=0.048] and IGRA+/TST+ [27.3%; p=0.004] but not IGRA+/TST- [15.9%; p=0.69] individuals than among controls [15.3%].

Conclusions

LTBI associated with glycemic measures and diabetes when assessed by skin induration, but not IFN-γ release. This suggests an association with innate immune activation rather than acquired T-cell response, as determined by ex vivo IFN-γ release assay.

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.