High prevalence and heterogeneity of Dysglycemia in patients with tuberculosis from Peru: A prospective cohort study

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Alvarez R.
Arroyo J.
López D.
Rodriguez S.
Torres F.G.
Troncoso O.
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BioMed Central Ltd.
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Background: The accuracy of different laboratory tests for diagnosis of diabetes mellitus (DM) and prediabetes (preDM) in populations exposed to tuberculosis (TB) remains poorly understood. Here, we examined the prevalence of DM and preDM in TB affected people in Lima, Peru. Methods: A prospective cohort study of patients affected TB and their household contacts (HHC), was conducted between February and November 2017 in Lima, Peru. Fasting plasma glucose (FPG), HbA1c and oral glucose tolerance test (OGTT) were used to detect DM and preDM in a prospective cohort of TB patients (n = 136) and household contacts (n = 138). Diagnostic performance of the laboratory tests was analyzed. Potential effects of sociodemographic and clinical factors on detection of dysglycemia were analyzed. Results: In TB patients, prevalence of DM and preDM was 13.97 and 30.88% respectively. Lower prevalence of both DM (6.52%) and preDM (28.99%) were observed in contacts. FPG, HbA1c and OGTT had poor agreement in detection of preDM in either TB cases or contacts. TB-DM patients had substantially lower hemoglobin levels, which resulted in low accuracy of HbA1c-based diagnosis. Classic sociodemographic and clinical characteristics were not different between TB patients with or without dysglycemia. Conclusion: High prevalence of DM and preDM was found in both TB patients and contacts in Lima. Anemia was strongly associated with TB-DM, which directly affected the diagnostic performance of HbA1c in such population. © 2019 The Author(s).
This work was mainly supported by the Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica (CONCYTEC-Peru) / Fondo Nacional de Desarrollo Científico, Tecnológico y de Innovación Tecnológica (FONDECYT, Convenio 175–2015). The work from BBA was supported by intramural research program from FIOCRUZ, by the National Institutes of Health (U01AI115940 and U01AI069923) and by the Departamento de Ciência e Tecnologia (DECIT) - Secretaria de Ciência e Tecnologia (SCTIE) – Ministério da Saúde (MS), Brazil (25029.000507/2013–07). MBA receives a fellowship from the Fundaçăo de Amparo à Pesquisa da Bahia (FAPESB). BBA is a senior scientist from the Conselho Nacional de Desenvolvimento Científico e Tecnológico. The funders had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
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