Determining the Best Screening Strategy for Patients with Mycobacterium Tuberculosis Infection and Glucose Intolerance and Associated Dyslipidemia in a Tertiary Care Hospital in North India.

ABSTRACT

To determine prevalence of glucose intolerance and dyslipidemia in patients with mycobacterium tuberculosis infection. MATERIAL: A prospective study done on 164 patients infected with MTB were enrolled in the study. Patients with tuberculosis (TB) were selected from Medicine and Pulmonary Medicine departments in MLN Medical College Prayagraj. Patients were screened for glucose intolerance using A1C, FPG and 2h-PP at baseline, 3 months, and 6 months, and then further, divided into two categories on the basis of glucose tolerance; abnormal glucose tolerance (AGT) and normal glucose tolerance (NGT). OBSERVATION A total of 164 patients with TB were taken in the study, AGT group had 76 patients, which include patients with 50 impaired glucose tolerance (IGT), and who were newly diagnosed to have 26 diabetes mellitus, and 88 patients in NGT group. The mean age of the patients in AGT group was 44.65 years. Any of the 3 criteria (FPG and/or, PPG and/or, A1C) revealing dysglycemia the true sensitivity was 77.63%, 100% and 98.68% at baseline, 3months and 6months interval. Using FPG alone as the criteria, the sensitivity was 43.42%, 81.58% and 68.42%, where as A1C alone as the criteria, the sensitivity was 77.63%, 100% and 98.68% baseline, 3 months and 6 months intervals respectively whereas specificity was 100%. Among AGT and NGT, dyslipidemia was found to be statistically significant among AGT group (p=0.01). Mean Serum triglycerides (165.11, p <0.001) and LDL cholesterol (99.65, p<0.001) in AGT group. CONCLUSION: There is increased prevalence of prediabetes and newly diagnosed DM in patients with TB and they are more to develop dyslipidemia.