Cardiometabolic Biomarkers and Systemic Inflammation in US Adolescents and Young Adults With Latent Tuberculosis Infection: A Population-Based Cohort Study - Report - MDSpire
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Cardiometabolic Biomarkers and Systemic Inflammation in US Adolescents and Young Adults With Latent Tuberculosis Infection: A Population-Based Cohort Study
Cardiometabolic Health and Inflammation in US Youth with Latent Tuberculosis Infection
Overview
This cohort analysis of US adolescents and young adults found that latent tuberculosis infection (LTBI) is associated with increased inflammatory markers but not with adverse cardiometabolic profiles. Older adolescents and young adults with LTBI exhibited higher C-reactive protein and ferritin levels compared to uninfected peers, while glucose metabolism and cardiac biomarkers were similar.
Background
Mycobacterium tuberculosis infection in adults is linked to increased risks of type 2 diabetes and cardiovascular disease, likely due to chronic inflammation. However, it is unclear if these cardiometabolic detriments occur in younger populations with latent tuberculosis infection (LTBI). Adolescents and young adults represent a significant proportion of those with LTBI globally, and understanding the interplay between Mtb infection, inflammation, and cardiometabolic health in this group is critical for early prevention of chronic disease. The inflammatory response to Mtb varies by age, with peripubescent individuals showing a unique immune profile that may influence cardiometabolic outcomes.
Data Highlights
Parameter
LTBI (Older Adolescents/Young Adults)
Uninfected Controls
P Value
C-reactive protein (mg/dL, median [IQR])
0.22 [0.05–0.34]
0.11 [0.04–0.35]
0.027
Ferritin (ng/mL, median [IQR])
55.0 [25.1–90.3]
41.1 [29.5–136.2]
0.047
Fasting plasma glucose (mmol/L, adjusted mean difference [95% CI])
−0.05 [−0.22 to 0.12]
0.57
Hemoglobin A1c (% difference [95% CI])
0.0 [−0.17 to 0.17]
0.98
Diabetes/prediabetes prevalence (adjusted odds ratio [95% CI])
0.9 [0.29–2.29]
0.85
Key Findings
Older adolescents and young adults with LTBI had significantly higher inflammatory markers (C-reactive protein and ferritin) compared to uninfected peers.
No significant differences were observed in fasting plasma glucose or hemoglobin A1c between LTBI and uninfected groups.
The prevalence of diabetes or prediabetes did not differ significantly by LTBI status.
Markers of insulin secretion and resistance, as well as cardiac biomarkers (N-terminal prohormone of brain natriuretic peptide and high-sensitivity cardiac troponin T), were similar regardless of LTBI status.
Peripubescent adolescents (12–15 years) with LTBI did not show increased inflammation compared to uninfected peers.
Clinical Implications
Clinicians should recognize that while LTBI in older adolescents and young adults is associated with increased systemic inflammation, it does not appear to confer immediate cardiometabolic risk as measured by glucose metabolism or cardiac biomarkers. Monitoring inflammatory status in this population may be important, but routine cardiometabolic screening beyond standard care may not be warranted solely based on LTBI status. Long-term follow-up is needed to determine if chronic inflammation from LTBI contributes to future cardiometabolic disease.
Conclusion
Latent tuberculosis infection in US adolescents and young adults is linked to elevated inflammatory markers without concurrent cardiometabolic derangement. These findings suggest age-dependent effects of Mtb infection on cardiometabolic health, highlighting the need for further longitudinal studies to assess long-term outcomes.
References
Critchley et al 2020 -- Increased cardiovascular disease risk in adults with tuberculosis
NHANES -- National Health and Nutrition Examination Survey Protocols
