Longitudinal trends in glycated hemoglobin during and after tuberculosis treatment.
Longitudinal trends in glycated hemoglobin during and after tuberculosis treatment.
复制标题
结核病治疗期间和治疗后糖化血红蛋白的纵向趋势。
DOI：
10.1016/j.diabres.2023.110242
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发表时间：
2023
影响因子：
5.1
通讯作者：
Viswanathan,Vijay
中科院分区：
文献类型：
--
作者：
Kornfeld,Hardy;Procter-Gray,Elizabeth;Kumpatla,Satyavani;Kane,Kevin;Li,Wenjun;Magee,MatthewJ;Babu,Subash;Viswanathan,Vijay
目的探讨肺结核治疗期间和治疗后对血糖状况的影响，以及血糖趋势与抗糖尿病治疗和结核病结局的关系。方法对印度金奈两项成人肺结核患者的前瞻性队列研究数据进行综合分析。参与者根据基线血红蛋白A1c（A1c）分为血糖正常（NG, n = 74）、糖尿病前期（DM前期，n = 110）和糖尿病（DM, n = 244）。在结核病治疗3个月和6个月，然后在结核病治疗结束后6个月和12个月进行重复A1C测量。结果所有组在开始结核病治疗后，基线时A1C中位数下降。研究结束时，没有基线NG或糖尿病前期受试者进展为糖尿病，而16.7%的基线DM受试者的A1C水平转移到糖尿病前期或糖尿病前期水平。在基线DM组中，强化结核治疗阶段后A1C升高与不良结核结局显著相关。结论：偶发性结核可促进短暂性血糖升高，但未明确显示可促进慢性血糖异常。在结核病治疗期间和之后，A1C升高可能预示在结核病诊断时A1C≥6.5%的患者的不良治疗反应。
AimsTo investigate the impact of pulmonary TB on glycemic status during and after TB treatment, and associations of glycemic trends with antidiabetic therapy and TB outcomes.MethodsData from two prospective cohort studies of adults in Chennai, India, with pulmonary TB were combined for this analysis. Participants were classified by baseline hemoglobin A1c(A1C) as having normoglycemia (NG; n = 74), prediabetes (pre-DM; n = 110), or diabetes (DM; n = 244). Repeat A1C measurements were performed at TB treatment months 3 and 6, and then 6 and 12 months after TB treatment completion.ResultsMedian A1C at baseline declined after TB treatment initiation in all groups. No baseline NG or pre-DM participants progressed to DM by end of study, while 16.7% of baseline DM participants shifted to pre-DM or NG levels of A1C. In the baseline DM group, rising A1C after the intensive phase of TB treatment was significantly associated with adverse TB outcomes.ConclusionsIncident TB promotes transient glucose elevation but was not conclusively shown to promote chronic dysglycemia. Rising A1C during and after TB treatment may predict unfavorable treatment response in persons presenting with A1C ≥ 6.5 % at the time of TB diagnosis.