Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls

Daniel Faurholt-Jepsen; Martine Grosos Aabye; Andreas Vestergaard Jensen; Nyagosya Range; George Praygod; Kidola Jeremiah; John Changalucha; Maria Faurholt-Jepsen; Lotte Jensen; Signe Marie Jensen; Henrik Krarup; Pernille Ravn; Henrik Friis; Åse Bengård Andersen

doi:10.3109/00365548.2014.885657

Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls

Daniel Faurholt-Jepsen, Martine Grosos Aabye, Andreas Vestergaard Jensen, Nyagosya Range, George Praygod, Kidola Jeremiah, John Changalucha, Maria Faurholt-Jepsen, Lotte Jensen, Signe Marie Jensen, Henrik Krarup, Pernille Ravn, Henrik Friis, Åse Bengård Andersen

32 Citations (Scopus)

Abstract

Background: Diabetes is increasingly common in TB endemic regions and plays a role as a possible risk factor for increased progression from latent TB infection (LTBI) to active TB disease. Although the pathophysiological mechanisms are not fully understood, the immune system is weakened in diabetes patients and therefore the validity of interferon gamma release assays (IGRA) may be compromised. The aim of the present study was to assess the association between diabetes and Mycobacterium tuberculosis (Mtb) antigen-specific interferon gamma (IFN-γ) release in a TB endemic area among culture-confirmed TB patients and non-TB controls. Methods: Culture-confirmed pulmonary TB patients (n = 187) and healthy non-TB neighbourhood controls (n = 190) from Mwanza, Tanzania were tested for the presence of circulating T cells recognizing Mtb antigens using an IGRA. The diabetes status of all participants was assessed using a standard oral glucose tolerance test. The impact of diabetes on the performance of the IGRA was estimated using robust linear and logistic regression. Results: Compared to normal glucose tolerance, diabetes was associated with reduced levels of Mtb-specific IFN-γ. Increasing levels of fasting blood glucose (B-0.3, 95% confidence interval-0.6 to-0.03, p = 0.033) was negatively associated with IFN-γ. Although TB patients had higher specific and lower unspecific mitogen IFN-γ responses compared to non-TB controls, the association between diabetes and IFN-γ did not depend on TB status. Conclusion: Diabetes is associated with lower levels of Mtb antigen-specific IFN-γ, and the validity of IFN-γ tests for LTBI may be questionable in individuals with diabetes.

Original language	English
Journal	Scandinavian Journal of Infectious Diseases
Volume	46
Issue number	5
Pages (from-to)	384-391
Number of pages	8
ISSN	0036-5548
DOIs	https://doi.org/10.3109/00365548.2014.885657
Publication status	Published - May 2014

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Faurholt-Jepsen, D., Aabye, M. G., Jensen, A. V., Range, N., Praygod, G., Jeremiah, K., Changalucha, J., Faurholt-Jepsen, M., Jensen, L., Jensen, S. M., Krarup, H., Ravn, P., Friis, H., & Andersen, Å. B. (2014). Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls. Scandinavian Journal of Infectious Diseases, 46(5), 384-391. https://doi.org/10.3109/00365548.2014.885657

Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls. / Faurholt-Jepsen, Daniel; Aabye, Martine Grosos; Jensen, Andreas Vestergaard et al.
In: Scandinavian Journal of Infectious Diseases, Vol. 46, No. 5, 05.2014, p. 384-391.

Research output: Contribution to journal › Journal article › Research › peer-review

Faurholt-Jepsen, D, Aabye, MG, Jensen, AV, Range, N, Praygod, G, Jeremiah, K, Changalucha, J, Faurholt-Jepsen, M, Jensen, L, Jensen, SM, Krarup, H, Ravn, P , Friis, H & Andersen, ÅB 2014, 'Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls', Scandinavian Journal of Infectious Diseases, vol. 46, no. 5, pp. 384-391. https://doi.org/10.3109/00365548.2014.885657

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title = "Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls",

abstract = "Background: Diabetes is increasingly common in TB endemic regions and plays a role as a possible risk factor for increased progression from latent TB infection (LTBI) to active TB disease. Although the pathophysiological mechanisms are not fully understood, the immune system is weakened in diabetes patients and therefore the validity of interferon gamma release assays (IGRA) may be compromised. The aim of the present study was to assess the association between diabetes and Mycobacterium tuberculosis (Mtb) antigen-specific interferon gamma (IFN-γ) release in a TB endemic area among culture-confirmed TB patients and non-TB controls. Methods: Culture-confirmed pulmonary TB patients (n = 187) and healthy non-TB neighbourhood controls (n = 190) from Mwanza, Tanzania were tested for the presence of circulating T cells recognizing Mtb antigens using an IGRA. The diabetes status of all participants was assessed using a standard oral glucose tolerance test. The impact of diabetes on the performance of the IGRA was estimated using robust linear and logistic regression. Results: Compared to normal glucose tolerance, diabetes was associated with reduced levels of Mtb-specific IFN-γ. Increasing levels of fasting blood glucose (B-0.3, 95% confidence interval-0.6 to-0.03, p = 0.033) was negatively associated with IFN-γ. Although TB patients had higher specific and lower unspecific mitogen IFN-γ responses compared to non-TB controls, the association between diabetes and IFN-γ did not depend on TB status. Conclusion: Diabetes is associated with lower levels of Mtb antigen-specific IFN-γ, and the validity of IFN-γ tests for LTBI may be questionable in individuals with diabetes.",

author = "Daniel Faurholt-Jepsen and Aabye, {Martine Grosos} and Jensen, {Andreas Vestergaard} and Nyagosya Range and George Praygod and Kidola Jeremiah and John Changalucha and Maria Faurholt-Jepsen and Lotte Jensen and Jensen, {Signe Marie} and Henrik Krarup and Pernille Ravn and Henrik Friis and Andersen, {{\AA}se Beng{\aa}rd}",

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T1 - Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls

AU - Faurholt-Jepsen, Daniel

AU - Aabye, Martine Grosos

AU - Jensen, Andreas Vestergaard

AU - Range, Nyagosya

AU - Praygod, George

AU - Jeremiah, Kidola

AU - Changalucha, John

AU - Faurholt-Jepsen, Maria

AU - Jensen, Lotte

AU - Jensen, Signe Marie

AU - Krarup, Henrik

AU - Ravn, Pernille

AU - Friis, Henrik

AU - Andersen, Åse Bengård

N1 - CURIS 2014 NEXS 115

PY - 2014/5

Y1 - 2014/5

N2 - Background: Diabetes is increasingly common in TB endemic regions and plays a role as a possible risk factor for increased progression from latent TB infection (LTBI) to active TB disease. Although the pathophysiological mechanisms are not fully understood, the immune system is weakened in diabetes patients and therefore the validity of interferon gamma release assays (IGRA) may be compromised. The aim of the present study was to assess the association between diabetes and Mycobacterium tuberculosis (Mtb) antigen-specific interferon gamma (IFN-γ) release in a TB endemic area among culture-confirmed TB patients and non-TB controls. Methods: Culture-confirmed pulmonary TB patients (n = 187) and healthy non-TB neighbourhood controls (n = 190) from Mwanza, Tanzania were tested for the presence of circulating T cells recognizing Mtb antigens using an IGRA. The diabetes status of all participants was assessed using a standard oral glucose tolerance test. The impact of diabetes on the performance of the IGRA was estimated using robust linear and logistic regression. Results: Compared to normal glucose tolerance, diabetes was associated with reduced levels of Mtb-specific IFN-γ. Increasing levels of fasting blood glucose (B-0.3, 95% confidence interval-0.6 to-0.03, p = 0.033) was negatively associated with IFN-γ. Although TB patients had higher specific and lower unspecific mitogen IFN-γ responses compared to non-TB controls, the association between diabetes and IFN-γ did not depend on TB status. Conclusion: Diabetes is associated with lower levels of Mtb antigen-specific IFN-γ, and the validity of IFN-γ tests for LTBI may be questionable in individuals with diabetes.

AB - Background: Diabetes is increasingly common in TB endemic regions and plays a role as a possible risk factor for increased progression from latent TB infection (LTBI) to active TB disease. Although the pathophysiological mechanisms are not fully understood, the immune system is weakened in diabetes patients and therefore the validity of interferon gamma release assays (IGRA) may be compromised. The aim of the present study was to assess the association between diabetes and Mycobacterium tuberculosis (Mtb) antigen-specific interferon gamma (IFN-γ) release in a TB endemic area among culture-confirmed TB patients and non-TB controls. Methods: Culture-confirmed pulmonary TB patients (n = 187) and healthy non-TB neighbourhood controls (n = 190) from Mwanza, Tanzania were tested for the presence of circulating T cells recognizing Mtb antigens using an IGRA. The diabetes status of all participants was assessed using a standard oral glucose tolerance test. The impact of diabetes on the performance of the IGRA was estimated using robust linear and logistic regression. Results: Compared to normal glucose tolerance, diabetes was associated with reduced levels of Mtb-specific IFN-γ. Increasing levels of fasting blood glucose (B-0.3, 95% confidence interval-0.6 to-0.03, p = 0.033) was negatively associated with IFN-γ. Although TB patients had higher specific and lower unspecific mitogen IFN-γ responses compared to non-TB controls, the association between diabetes and IFN-γ did not depend on TB status. Conclusion: Diabetes is associated with lower levels of Mtb antigen-specific IFN-γ, and the validity of IFN-γ tests for LTBI may be questionable in individuals with diabetes.

U2 - 10.3109/00365548.2014.885657

DO - 10.3109/00365548.2014.885657

M3 - Journal article

C2 - 24621055

SN - 0036-5548

VL - 46

SP - 384

EP - 391

JO - Scandinavian Journal of Infectious Diseases

JF - Scandinavian Journal of Infectious Diseases

IS - 5

ER -

Diabetes is associated with lower tuberculosis antigen-specific interferon gamma release in Tanzanian tuberculosis patients and non-tuberculosis controls

Abstract

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