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Author Notes:

Correspondence to: Matthew Magee, Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, One Park Place NE, Atlanta, GA 30303, USA. Tel: (þ1) 404 413 1797. Fax: (þ1) 404 413 2344. e-mail: mjmagee@gsu.edu

Conflicts of interest: none declared.


Research Funding:

This work was supported in part by the National Institute of Health (NIH), National Institute of Allergy and Infectious Diseases, Bethesda, MD (K23AI1030344), and the Atlanta Clinical and Translational Science Institute, Atlanta, GA, USA (NIH/NCATS UL1TR000454).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Infectious Diseases
  • Respiratory System
  • hemoglobin A1c
  • QuantiFERON test
  • refugee
  • vitamin D

Increased risk of latent tuberculous infection among persons with pre-diabetes and diabetes mellitus


Journal Title:

International Journal of Tuberculosis and Lung Disease


Volume 20, Number 1


, Pages 71-U123

Type of Work:

Article | Post-print: After Peer Review


SETTING: Although diabetes mellitus (DM) is an established risk factor for active tuberculosis (TB) disease, little is known about the association between pre-DM, DM, and latent tuberculous infection (LTBI). OBJECTIVE: To estimate the association between DM and LTBI. DESIGN: We conducted a cross-sectional study among recently arrived refugees seen at a health clinic in Atlanta, GA, USA, between 2013 and 2014. Patients were screened for DM using glycosylated-hemoglobin (HbA1c), and for LTBI using the QuantiFERONw-TB (QFT) test. HbA1c and QFT results, demographic information, and medical history were abstracted from patient charts. RESULTS: Among 702 included patients, 681 (97.0%) had HbA1c and QFT results. Overall, 54 (7.8%) patients had DM and 235 (33.8%) had pre-DM. LTBI was prevalent in 31.3% of the refugees. LTBI prevalence was significantly higher (P < 0.01) among patients with DM (43.4%) and pre-DM (39.1%) than in those without DM (25.9%). Refugees with DM (adjusted OR [aOR] 2.3, 95%CI 1.2-4.5) and pre-DM (aOR 1.7, 95%CI 1.1-2.4) were more likely to have LTBI than those without DM. CONCLUSION: Refugees with DM or pre-DM from high TB burden countries were more likely to have LTBI than those without DM. Dysglycemia may impair the immune defenses involved in preventing Mycobacterium tuberculosis infection.

Copyright information:

© 2016 The Union.

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