Clinical Scorecard: Cardiometabolic Health Indicators and Inflammatory Responses in US Adolescents and Young Adults with Latent Tuberculosis Infection: A Cohort Analysis

At a Glance

Key Highlights

• Older adolescents and young adults (16–30 years) with LTBI exhibit higher inflammatory markers (C-reactive protein and ferritin) compared to uninfected peers.
• No significant differences in fasting plasma glucose, hemoglobin A1c, diabetes/prediabetes prevalence, insulin resistance, or cardiac biomarkers were observed by LTBI status.
• Peripubescent adolescents (12–15 years) with LTBI do not show elevated inflammation or cardiometabolic derangement compared to uninfected peers.

Guideline-Based Recommendations

Diagnosis

• Use tuberculin skin testing (induration ≥10 mm) to identify latent tuberculosis infection in adolescents and young adults.

Management

• Monitor LTBI patients for inflammatory markers, especially in older adolescents and young adults, to assess potential chronic inflammation.
• Consider the absence of current cardiometabolic derangement in young LTBI patients when planning management, but remain vigilant for long-term consequences.

Monitoring & Follow-up

• Regular assessment of inflammatory biomarkers such as C-reactive protein and ferritin in LTBI-positive young adults.
• Monitor cardiometabolic indicators including fasting plasma glucose, hemoglobin A1c, and insulin resistance markers over time.

Risks

• Chronic inflammation associated with LTBI in older adolescents and young adults may pose long-term cardiometabolic risks that require further study.
• Current evidence does not support increased diabetes or cardiovascular disease risk in young people with LTBI, unlike in adults.

Patient & Prescribing Data

US adolescents and young adults aged 12–30 years with latent tuberculosis infection

LTBI in young people is associated with increased inflammatory markers but not with altered cardiometabolic profiles; long-term monitoring is advised to understand potential future risks.

Clinical Best Practices

• Employ propensity score matching to control for sociodemographic confounders when assessing LTBI impact on cardiometabolic health.
• Recognize age-related variations in inflammatory response to LTBI, with peripubescent adolescents showing less inflammation than older youth.
• Integrate inflammatory biomarker assessment in LTBI evaluation protocols for adolescents and young adults to identify subclinical inflammation.

References

• Critchley et al, 2020 meta-analysis on TB and cardiovascular risk
• NHANES Study Protocols