Elevated high-sensitivity C-reactive protein among apparently healthy adults with concomitant prediabetes and latent tuberculosis infection in Nigeria

Abstract

Background: The increasing prevalence and convergence of type 2 diabetes mellitus (DM) and active tuberculosis (TB) comorbidity, especially in adults in the lower-and middle-income countries, demand new approaches to control the ‘syndemic’. Consequently, we set out to investigate the possibility of early detection of prediabetes mellitus and/or latent tuberculosis infection using novel method.Methods: This was a case-control study of 105 adults classified into 4 groups: Healthy Community Controls (HCC, n=30); Prediabetes mellitus (PDM, n=25); Latent Tuberculosis Infection (LTBI, n=23); Individuals with Prediabetes mellitus+Latent Tuberculosis Infection (PDM+LTBI, n=27). Sera collected were assayed for high-sensitivity C-reactive protein (hs-CRP) using the ultra-sensitive Human high sensitivity C-reactive protein ELISA Kit (Melsin Medical Co., Ltd, China). Other ancillary tests and measurements done include Erythrocyte Sedimentation Rate, serum Glycated-hemoglobin (HbA1c), Interferon-gamma (INF-ϒ) and Waist circumference.Results: A total of 88 (83.8%) of the enrolled participants had full complement of results and were included in the analysis of four study groups: HCC (n=25), PDM (n=21), LTBI (n=19) and PDM+ LTBI (n=23). With respect to the serum biomarkers, isolated PDM and LTBI cases recorded significantly higher HbA1c (%) and INF-ϒ positivity respectively. Predictors of PDM+LTBI show statistically significant higher tertile (T3), representing elevated hs-CRP levels, (OR=6.50, 95% CI=4.83-22.39, p=0.0037).Conclusions: This study revealed that persons harboring the two associated asymptomatic conditions, PDM + LTBI have higher inflammatory state detectable by assaying the biomarker, hs-CRP, which could be used for ‘one-time bi-directional targeted screening’ for PDM in LTBI and vice versa.

Latent tuberculosis infection in psoriasis patients

“…In research conducted in Nigeria, while the values of WBC in the LTBI group approximated the normal range, ESR and CRP levels were found to be higher in these patients than in the healthy group. 17 In our results, not the CRP levels, but white blood count, and ESR were found to be higher in the psoriasis patients with positive Quantiferon test than in the negative ones. In a Japanese study comparing blood markers in LTBI and active TB patients, WBC and lymphocyte counts were higher in LTBI patients whereas neutrophil, platelet counts, and CRP levels were higher in patients with sputum-positive active tuberculosis.…”

Real time endobronchial ultrasound transbronchial needle aspiration for the diagnosis of tuberculous intrathoracic lymphadenopathy

“…Some of these factors have been previously documented to be associated with PPD positivity. 27 In this study, no major complications, whether procedure-related or anesthetic care-related, were recorded. This further emphasizes the safety profile of EBUS-TBNA.…”

Evaluation of Interleukin 4, High Sensitivity C-Reactive Protein and Activity of Alanine Transaminase Among Cooks in Nnewi

“…High-sensitivity CRP assays (hs-CRP) have been developed recently for sensitive CRP quantification. These assays are particularly valuable because they may indicate the presence of low-grade inflammatory lesions as they can detect little fluctuations in serum CRP levels within the range of normal limits 28 . Hs-CRP is employed as a predictive marker of the likelihood of developing heart disease and stroke 29 .…”