Differential Role of Type 2 Diabetes as a Risk Factor for Tuberculosis in the Elderly versus Younger Adults

Authors

Blanca I. Restrepo, The University of Texas Rio Grande Valley
Julia M. Scordo, Texas Biomedical Research Institute
Genesis P. Aguillón-Durán, Secretaria de Salud de Tamaulipas
Doris Ayala, University of Texas Health Science Center at Houston
Ana P. Quirino-Cerrillo, University of Texas Health Science Center at Houston
Raúl Loera-Salazar, Secretaria de Salud de Tamaulipas
America Cruz-González, Secretaria de Salud de Tamaulipas
Jose A. Caso, The University of Texas Rio Grande ValleyFollow
Mateo Joya-Ayala, The University of Texas Rio Grande Valley
Esperanza M. García-Oropesa, Universidad Autónoma de Tamaulipas
Alejandra B. Salinas, University of Texas Health Science Center at Houston

Document Type

Article

Publication Date

12-16-2022

Abstract

The elderly are understudied despite their high risk of tuberculosis (TB). We sought to identify factors underlying the lack of an association between TB and type 2 diabetes (T2D) in the elderly, but not adults. We conducted a case–control study in elderly (≥65 years old; ELD) vs. younger adults (young/middle-aged adults (18–44/45–64 years old; YA|MAA) stratified by TB and T2D, using a research study population (n = 1160) and TB surveillance data (n = 8783). In the research study population the adjusted odds ratio (AOR) of TB in T2D was highest in young adults (AOR 6.48) but waned with age becoming non-significant in the elderly. Findings were validated using TB surveillance data. T2D in the elderly (vs. T2D in younger individuals) was characterized by better glucose control (e.g., lower hyperglycemia or HbA1c), lower insulin resistance, more sulphonylureas use, and features of less inflammation (e.g., lower obesity, neutrophils, platelets, anti-inflammatory use). We posit that differences underlying glucose dysregulation and inflammation in elderly vs. younger adults with T2D, contribute to their differential association with TB. Studies in the elderly provide valuable insights into TB-T2D pathogenesis, e.g., here we identified insulin resistance as a novel candidate mechanism by which T2D may increase active TB risk.

Comments

© 2022 by the authors

Recommended Citation

Restrepo, B.I.; Scordo, J.M.; Aguillón-Durán, G.P.; Ayala, D.; Quirino-Cerrillo, A.P.; Loera-Salazar, R.; Cruz-González, A.; Caso, J.A.; Joya-Ayala, M.; García-Oropesa, E.M.; et al. Differential Role of Type 2 Diabetes as a Risk Factor for Tuberculosis in the Elderly versus Younger Adults. Pathogens 2022, 11, 1551. https://doi.org/10.3390/pathogens11121551

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

Pathogens

DOI

10.3390/pathogens11121551

Academic Level

faculty

Mentor/PI Department

Office of Human Genetics