title: The sensitivity of interferon-gamma release assays is not compromised in tuberculosis patients with diabetes.
abstract: OBJECTIVE
  the sensitivity of the interferon-gamma release assays (IGRAs) in the detection of Mycobacterium tuberculosis infection or disease may be affected by immune dysregulation in diabetes. As millions of type 2 diabetes patients are at risk for tuberculosis (TB) worldwide, it is important to determine if the sensitivity of IGRAs is compromised in this vulnerable population.
  
  
  METHODS
  the sensitivity of the IGRAs QuantiFERON®-TB Gold (QFT-G) and T-SPOT®.TB was evaluated among specimens from newly diagnosed adults with microbiologically confirmed TB with and without diabetes. We also evaluated the association between QFT-G results and diabetes-associated conditions (dyslipidemia, obesity).
  
  
  RESULTS
  QFT-G sensitivity was 70% among TB patients. Patients with diabetes, chronic hyperglycemia or overweight/obesity were more than twice as likely to have positive test results in multivariate models (P < 0.05). Low high-density lipoprotein cholesterol or high triglycerides were not associated with assay results. In a separate group of TB patients (n = 43), T-SPOT.TB was 93% sensitive, with similar performance in patients with and without diabetes.
  
  
  CONCLUSIONS
  IGRA sensitivity is not compromised by diabetes in TB patients. Accordingly, IGRAs may also be suitable for diagnosing TB infection in diabetes patients, which is required to assess TB risk.
authors.affiliation: Division of Epidemiology, School of Public Health in Brownsville, University of Texas Health Science Center at Houston, Brownsville, Texas, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Walsh
authors.forename: A J
authors.initials: AJ
authors.lastname: Camerlin
authors.forename: R
authors.initials: R
authors.lastname: Miles
authors.forename: P
authors.initials: P
authors.lastname: Pino
authors.forename: P
authors.initials: P
authors.lastname: Martinez
authors.forename: F
authors.initials: F
authors.lastname: Mora-Guzmán
authors.forename: J G
authors.initials: JG
authors.lastname: Crespo-Solis
authors.forename: S P
authors.initials: SP
authors.lastname: Fisher-Hoch
authors.forename: J B
authors.initials: JB
authors.lastname: McCormick
authors.forename: B I
authors.initials: BI
authors.lastname: Restrepo
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology*; D050171:Dyslipidemias / Q000276:immunology; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D016015:Logistic Models; D008214:Lymphocytes / Q000276:immunology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D009765:Obesity / Q000276:immunology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D055815:Young Adult
chemical_list: D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma