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conferenceseries
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Volume 8
Epidemiology: Open Access
ISSN: 2161-1165
Epidemiology 2018
September 17-19, 2018
September 17-19, 2018 | Rome, Italy
8
th
International Conference on
Epidemiology & Public Health
Prediabetes and the extensionof pulmonary tuberculosis inpatientswithdrug-susceptible tuberculosis
Bruno Martel
1
, Segundo R. León
1
, Karen Tintaya
1
, Judith Jimenez
1
, Epifanio Sánchez
2
, Dante Vargas
3
, Leonid Lecca
1
and
Carole D. Mitnick
4
1
Socios en Salud Sucursal Peru, Peru
2
Hospital Nacional Sergio E. Bernales, Peru
3
Hospital Nacional Hipolito Unanue, Peru
4
Harvard Medical School, USA
Background:
Prediabetes is frequent in patients with pulmonary tuberculosis (PTB). It may occur due to an inflammatory
response induced citoqunes as a consecuence of tuberculosis infection. Likewise, hyperglycemia may lead to a proinflammatory
response and a subsequently progress of disease. In contrast to diabetes mellitus (DM), there is a little evidence if prediabetes
may be associated with an extension and/or poor prognosis of tuberculosis. We determine the association between prediabetes
and the extension of PTB in drug-susceptible cases.
Methods:
We included 180 consenting adults with newly diagnosed, previously untreated, smear positive (≥2+) PTB from
East and North Lima, Peru, between 2013 to 2015. All participants were susceptible to isoniazid and rifampin by GenoType
MTBDRplus 2.0 and met other eligibility criteria for the parent study. Baseline glycosylated hemoglobin (HbA1c) was
measured to determine prediabetes (5.7-6.4%) and chest X-ray was interpreted by a pulmonologist to define limited, moderate
and extensive tuberculosis. We do a cross-sectional analysis. We dichotomized the outcome in limited vs moderate-extensive.
Confounders collected at baseline were included in the regression. We used Log-Poisson (robust) to determine prevalence
ratio (PR).
Results:
We excluded 4 patients from the analysis: one had DM and three had not HbA1b and X-ray data. A total of 30 (17.1%)
patients had prediabetes and 104(59.1) had moderate-extensive PTB. Compared to patients with limited disease, patients
with moderate-extensive PTB showed a higher PR of prediabetes (8.3% vs 23.1%; p=0.011). In multivariable analysis patients
with prediabetes were 42% more likely to have moderate-extensive PTB than those without prediabetes (PR 1.42; 1.12-1.80,
p=0.004).
Conclusion:
Prediabetes was common in this population. We found an association between prediabetes and the extension
of PTB in drug-susceptible cases. It is likely that prediabetes is exacerbating the progress of PTB disease. However, we can
not determine causality in this study. Longitudinal studies including patients with multidrug and extensively drug-resistant
tuberculosis would describe better this association.
Epidemiology (Sunnyvale) 2018, Volume 8
DOI: 10.4172/2161-1165-C1-021