Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population.
<h4>Objective</h4>Tuberculosis (TB) may predispose individuals to the development of diabetes. Such a relationship could have an outsized impact in high-prevalence TB settings. However, few studies have explored this relationship in populations heavily burdened by diabetes and TB.<h4&...
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0282371&type=printable |
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| author | Alison C Castle Susanne S Hoeppner Itai M Magodoro Urisha Singh Yumna Moosa Ingrid V Bassett Emily B Wong Mark J Siedner Vukuzazi Study Team |
| author_facet | Alison C Castle Susanne S Hoeppner Itai M Magodoro Urisha Singh Yumna Moosa Ingrid V Bassett Emily B Wong Mark J Siedner Vukuzazi Study Team |
| author_sort | Alison C Castle |
| collection | DOAJ |
| description | <h4>Objective</h4>Tuberculosis (TB) may predispose individuals to the development of diabetes. Such a relationship could have an outsized impact in high-prevalence TB settings. However, few studies have explored this relationship in populations heavily burdened by diabetes and TB.<h4>Methods</h4>We analyzed data from a community-based population cohort that enrolled adults in rural South Africa. Individuals were considered to have prior TB if they self-reported a history of TB treatment. We fitted sex-specific logistic regression models, adjusted for potential clinical and demographic confounders, to estimate relationships between dysglycemia (HBA1c ≥6.5%) and prior TB. Propensity score-matched cohorts accounted for the differential age distributions between comparator groups. We examined the interactions between sex, prior TB, and HIV status.<h4>Results</h4>In the analytic cohort (n = 17,593), the prevalence of prior TB was 13.8% among men and 10.7% among women. Dysglycemia was found in 9.1% of the population, and HIV prevalence was 34.0%. We found no difference in dysglycemia prevalence by prior TB (men OR 0.96, 95% CI 0.60-1.56: women OR 1.05, 95% CI 0.79-1.39). However, there was a qualitative interaction by HIV serostatus, such that among men without HIV, those with a history of TB had a greater prevalence of dysglycemia than those without prior TB (10.1% vs. 4.6%, p = 0.0077). An inverse relationship was observed among men living with HIV (prior TB 3.3% vs. no TB 7.3%, p = 0.0073).<h4>Conclusions</h4>Treated TB disease was not associated with dysglycemia in an HIV-endemic, rural South African population. However, we found a significant interaction between prior TB and HIV status among men, suggesting distinct pathophysiological mechanisms between the two infections that may impact glucose metabolism. Longitudinal studies are needed to better establish a causal effect and underlying mechanisms related to resolved TB, HIV, and diabetes. |
| format | Article |
| id | doaj-art-d6eee1e3a74c42bbb58f68a6af75c36d |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-d6eee1e3a74c42bbb58f68a6af75c36d2025-01-24T05:31:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01183e028237110.1371/journal.pone.0282371Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population.Alison C CastleSusanne S HoeppnerItai M MagodoroUrisha SinghYumna MoosaIngrid V BassettEmily B WongMark J SiednerVukuzazi Study Team<h4>Objective</h4>Tuberculosis (TB) may predispose individuals to the development of diabetes. Such a relationship could have an outsized impact in high-prevalence TB settings. However, few studies have explored this relationship in populations heavily burdened by diabetes and TB.<h4>Methods</h4>We analyzed data from a community-based population cohort that enrolled adults in rural South Africa. Individuals were considered to have prior TB if they self-reported a history of TB treatment. We fitted sex-specific logistic regression models, adjusted for potential clinical and demographic confounders, to estimate relationships between dysglycemia (HBA1c ≥6.5%) and prior TB. Propensity score-matched cohorts accounted for the differential age distributions between comparator groups. We examined the interactions between sex, prior TB, and HIV status.<h4>Results</h4>In the analytic cohort (n = 17,593), the prevalence of prior TB was 13.8% among men and 10.7% among women. Dysglycemia was found in 9.1% of the population, and HIV prevalence was 34.0%. We found no difference in dysglycemia prevalence by prior TB (men OR 0.96, 95% CI 0.60-1.56: women OR 1.05, 95% CI 0.79-1.39). However, there was a qualitative interaction by HIV serostatus, such that among men without HIV, those with a history of TB had a greater prevalence of dysglycemia than those without prior TB (10.1% vs. 4.6%, p = 0.0077). An inverse relationship was observed among men living with HIV (prior TB 3.3% vs. no TB 7.3%, p = 0.0073).<h4>Conclusions</h4>Treated TB disease was not associated with dysglycemia in an HIV-endemic, rural South African population. However, we found a significant interaction between prior TB and HIV status among men, suggesting distinct pathophysiological mechanisms between the two infections that may impact glucose metabolism. Longitudinal studies are needed to better establish a causal effect and underlying mechanisms related to resolved TB, HIV, and diabetes.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0282371&type=printable |
| spellingShingle | Alison C Castle Susanne S Hoeppner Itai M Magodoro Urisha Singh Yumna Moosa Ingrid V Bassett Emily B Wong Mark J Siedner Vukuzazi Study Team Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population. PLoS ONE |
| title | Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population. |
| title_full | Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population. |
| title_fullStr | Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population. |
| title_full_unstemmed | Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population. |
| title_short | Association between prior tuberculosis disease and dysglycemia within an HIV-endemic, rural South African population. |
| title_sort | association between prior tuberculosis disease and dysglycemia within an hiv endemic rural south african population |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0282371&type=printable |
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