Tuberculin test versus interferon gamma release assay in pregnant women with household contacts of tuberculosis patients.

Background: Pregnant women who live in tuberculosis (TB)-affected households are more likely to develop latent TB infection (LTBI), which often escapes treatment. This study aims to determine if Interferon-gamma release (IGRA) is reliable in screening for LTBI in pregnant women, compare to the tuberculin skin test (TST). Methods: It was a cross-sectional study that involved 60 pregnant women with TB contact history as a proxy for LTBI and 30 pregnant women without contact history. Latent TB was detected using the TST 5 tuberculin units and IGRA using the QuantiFERON Gold Plus TB Test kit (QFT-Plus). The sensitivity and specificity of the two diagnostic methods and the agreement between them were estimated using SPSS version 20.0. Results: The sensitivity 95% (95% confidence interval [CI]: 86.08%-98.96%) and specificity 26.7% (95% CI: 12.28%-45.89%) of TST were compared to that of the IGRA with 60% (95% CI: 46.54%-72.44%) and 73.3% (95% CI: 54.11%-87.72%) sensitivity and specificity, respectively in detecting LTBI in pregnancy. Although there was a significant difference (P < 0.05) between TST and IGRA, the agreement was fair (kappa 0.39; 95% CI: 0.24-0.45). Conclusion: TST assay is more sensitive than IGRA; however, the specificity of IGRA was superior to the TST method. In this study, a fair agreement of TST and IGRA was observed for detecting latent TB infection in pregnant women with household contact with TB patients.

The correlation between insulin-like growth factor binding protein 1 (IGFBP-1) and homeostasis model assessment of insulin resistance (HOMA-IR) in polycystic ovarian syndrome with insulin resistance.

BACKGROUND: The underlying etiology of polycystic ovarian syndrome (PCOS) is unknown and assumed to have a strong correlation with insulin resistance. Homeostasis Model Assessment of insulin resistance (HOMA-IR) is a good tool to assess insulin resistance. Low levels of serum Insulin-like Growth Factor-Binding Protein-1 (IGFBP-1) in PCOS women led to the hypothesis that hyperinsulinemia in PCOS inhibits the production of IGFBP-1, which in turn stimulates excessive androgen production. OBJECTIVE: The study is aimed to analyze the correlation between the levels of IGFBP-1 and HOMA-IR on insulin resistance in PCOS. MATERIALS AND METHODS: A cross-sectional study among 105 PCOS women, including 60 women with insulin resistance were recruited. The mean of IGFBP-1 and HOMA-IR were 6.507±4.7821 µg/l and 3.633±1.666 respectively. RESULTS: Low levels of IGFBP-1 were detected in all insulin resistance women. There was a correlation between HOMA-IR and overweight (p=0.045), while IGFBP-1 showed no correlation with overweight (p=0.106). In addition, no correlation between IGFBP-1 with HOMA-IR as a marker of insulin resistance was detected. CONCLUSION: Despite the decrease in IGFBP-1, it seems that there is no correlation between IGFBP-1 with HOMA-IR as a marker of insulin resistance.