BACKGROUND Diabetes is associated with increased prevalence of TB infection in the US. We assessed associations between diabetes and interferon-gamma (IFN-γ) TB antigen response among adults with TB infection using US representative data. METHODS National Health and Nutrition Examination (NHANES) participants >19 years from 2011 to 2012 with positive QuantiFERON®-TB Gold-In-Tube (QFT) results were eligible. Diabetes was defined by combination of self-report and glycated hemoglobin (HbA1c). Quantitative IFN-γ TB antigen was classified as high (≥10 IU/mL), intermediate (1.01-9.99 IU/mL), or low (0.35-1.00 IU/mL). Analyses accounted for NHANES weighted design. RESULTS Among NHANES participants >19 years, n = 513 had positive QFT (5.9%). Among those with positive QFT, diabetes prevalence was 22.2% and pre-diabetes was 25.9%. Overall, 16.7% of positive QFT participants had high IFN-γ TB antigen levels including 21.7% among those with diabetes, 20.8% among those with pre-diabetes, and 12.6% among euglycemic participants. In adjusted analyses, high IFN-γ TB antigen response was more common among those with pre-diabetes (aOR 1.9, 95%CI 1.0, 3.6) compared to euglycemic participants. CONCLUSION Higher antigen responses may reflect immunopathy consistent with an exaggerated inflammatory but ineffectual response to TB or a reflection of more Mtb replication in participants with pre-diabetes or diabetes.

中文翻译：

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患有结核分枝杆菌感染和糖尿病前期的成年人的 QuantiFERON 干扰素-γ 反应水平升高

背景糖尿病与美国结核病感染率的增加有关。我们使用美国代表性数据评估了患有 TB 感染的成人中糖尿病与干扰素-γ (IFN-γ) TB 抗原反应之间的关联。方法 2011 年至 2012 年间超过 19 岁且 QuantiFERON®-TB Gold-In-Tube (QFT) 结果阳性的国家健康和营养检查 (NHANES) 参与者符合资格。糖尿病由自我报告和糖化血红蛋白 (HbA1c) 的组合定义。定量 IFN-γ TB 抗原分为高 (≥10 IU/mL)、中 (1.01-9.99 IU/mL) 或低 (0.35-1.00 IU/mL)。分析考虑了 NHANES 加权设计。结果 在大于 19 岁的 NHANES 参与者中，n = 513 的 QFT 呈阳性 (5.9%)。在 QFT 阳性的患者中，糖尿病患病率为 22.2%，糖尿病前期为 25.9%。总的来说，16。7% 的 QFT 阳性参与者具有高 IFN-γ TB 抗原水平，其中 21.7% 的糖尿病患者、20.8% 的糖尿病前期参与者和 12.6% 的血糖正常参与者。在调整后的分析中，与血糖正常的参与者相比，高 IFN-γ TB 抗原反应在糖尿病前期 (aOR 1.9, 95% CI 1.0, 3.6) 中更为常见。结论 较高的抗原反应可能反映了免疫病，与对 TB 的夸大炎症反应但无效反应一致，或者反映了糖尿病前期或糖尿病参与者中更多的 Mtb 复制。95% CI 1.0, 3.6) 与血糖正常的参与者相比。结论 较高的抗原反应可能反映了免疫病，与对 TB 的夸大炎症反应但无效反应一致，或者反映了糖尿病前期或糖尿病参与者中更多的 Mtb 复制。95% CI 1.0, 3.6) 与血糖正常的参与者相比。结论 较高的抗原反应可能反映了免疫病，与对 TB 的夸大炎症反应但无效反应一致，或者反映了糖尿病前期或糖尿病参与者中更多的 Mtb 复制。