Discovery of serum biomarkers for diagnosis of tuberculosis by NMR metabolomics including cross-validation with a second cohort.

BACKGROUND: Tuberculosis (TB) is a disease with worldwide presence and a major cause of death in several developing countries. Current diagnostic methodologies often lack specificity and sensitivity, whereas a long time is needed to obtain a conclusive result. METHODS: In an effort to develop better diagnostic methods, this study aimed at the discovery of a biomarker signature for TB diagnosis using a Nuclear Magnetic Resonance based metabolomics approach. In this study, we acquired 1H NMR spectra of blood serum samples of groups of healthy subjects, individuals with latent TB and of patients with pulmonary and extra-pulmonary TB. The resulting data were treated with uni- and multivariate statistical analysis. RESULTS: Six metabolites (inosine, hypoxanthine, mannose, asparagine, aspartate and glutamate) were validated by an independent cohort, all of them related with metabolic processes described as associated with TB infection. CONCLUSION: The findings of the study are according with the WHO Target Product Profile recommendations for a triage test to rule-out active TB.

Diabetic retinopathy in a population of 1,302 insulin dependent diabetics (IDDM) diagnosed before 30 years of age.

The authors analyse the data resulting from the first ophthalmological observation of 1,302 insulin dependent diabetics whose age at diagnosis is less than 30 years and who have been observed regularly by the Portuguese Diabetic Association. The prevalence of retinopathy is 41, 6%; 34.3% is non-proliferative and 7.3% is proliferative. Retinopathy is more frequent in males (P < 0.001). The prevalence of retinopathy increases with the duration of diabetes and it is equal to or greater than 80% in people who have had diabetes for 10 years or more. 'Poor' glucose control, the coexistence of other late complications and arterial hypertension increase the risk of retinopathy (P < 0.001).