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Diabetes mellitus and latent tuberculosis infection: baseline analysis of a large UK cohort
  1. Charlotte Jackson1,
  2. Jo Southern2,
  3. Ajit Lalvani3,
  4. Francis Drobniewski3,4,
  5. Chris J Griffiths5,
  6. Marc Lipman6,7,
  7. Graham H Bothamley8,
  8. Jonathan J Deeks9,10,
  9. Ambreen Imran2,
  10. Onn Min Kon11,12,
  11. Sithembinkosi Mpofu2,
  12. Vladyslav Nikolayevskyy3,4,13,
  13. Melanie Rees-Roberts3,
  14. Alice Sitch9,
  15. Saranya Sridhar3,
  16. Chuen-Yan Tsou4,
  17. Hilary Whitworth3,14,
  18. Ibrahim Abubakar1
  1. 1Institute for Global Health, University College London, London, UK
  2. 2TB Section, Public Health England, London, UK
  3. 3Department of Medicine, Imperial College London, London, UK
  4. 4National Mycobacterium Reference Laboratory, Public Health England, London, UK
  5. 5Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
  6. 6Respiratory & HIV Medicine, Royal Free London NHS Foundation Trust, London, UK
  7. 7UCL Respiratory, Division of Medicine, University College London, London, UK
  8. 8Respiratory Medicine, Homerton University Hospital NHS Foundation Trust, London, UK
  9. 9Test Evaluation Group, Institute for Applied Health Research, University of Birmingham, Birmingham, UK
  10. 10National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK
  11. 11Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
  12. 12National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
  13. 13Blizard Institute, Queen Mary University of London, London, UK
  14. 14Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Dr Charlotte Jackson, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK; cjackson{at}sgul.ac.uk

Abstract

We conducted a cross-sectional analysis of baseline data from a UK cohort study which enrolled participants at risk of latent tuberculosis infection (LTBI, defined as a positive result for either of the two interferon gamma release assays). Binomial regression with a log link was used to estimate crude and adjusted prevalence ratios (PRs) and 95% CIs for the relationship between diabetes mellitus (DM) and LTBI. Adjusted for age, sex, ethnicity, body mass index and the presence of other immunocompromising conditions, DM was associated with a 15% higher prevalence of LTBI (adjusted PR=1.15, 95% CI 1.02 to 1.30, p=0.025).

Trial registration number PREDICT is registered on clinicaltrials.gov (NCT01162265)

  • tuberculosis
  • clinical epidemiology

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Footnotes

  • Contributors IA conceived and oversaw the design and conduct of this analysis. JS coordinated the study and contributed to study design. CJG, ML, GHB and OMK contributed to study design and recruitment. AL, FD and JJD contributed to study design. CJ conducted statistical analysis with support from AS and JJD and drafted the manuscript. AI and SM recruited participants. VN, MR-R, SS, C-YT and HW performed laboratory work supervised by AL and FD. All authors critically reviewed and contributed to the manuscript. IA is the chief investigator of the PREDICT study; FD and AL are co-PIs.

  • Funding This work was supported by the National Institute for Health Research [grant numbers NIHR HTA 08/68/01, NIHR SRF-2011-04-001, NIHR NF-SI-0616-10037 to IA]. FD was supported by the Imperial Biomedical Research Centre.

  • Competing interests CJ has undertaken paid consultancy work for Otsuka Pharmaceutical unrelated to the content of this paper. AL has several issued patents underpinning immunodiagnostics for tuberculosis. The ESAT-6/CFP-10 interferon-gamma ELISpot was commercialised by an Oxford University spin-out company (Oxford Immunotec, Abingdon, UK) from which Oxford University and AL have royalty entitlements.

  • Patient consent Not required.

  • Ethics approval PREDICT study was approved by the Brent Research Ethics Committee (reference 10/H0717/14).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at Interim results of this study were presented at the British Thoracic Society Winter Meeting, London, December 2013 (abstract number S57).

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