International Journal of Research in Medical Sciences | February 2021 | Vol 9 | Issue 2 Page 338
International Journal of Research in Medical Sciences
Akinshipe BO et al. Int J Res Med Sci. 2021 Feb;9(2):338-346
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Elevated high-sensitivity C-reactive protein among apparently healthy
adults with concomitant prediabetes and latent tuberculosis infection
in Nigeria
Benson O. Akinshipe
1
*, Edirin O. Yusuf
2
, Alfred F. Ehiaghe
3
,
Tunde O. Egunjobi
1
, Opeoluwa A. Yusuf
4
INTRODUCTION
The global burden of disease from concomitant type 2
diabetes mellitus (DM) and pulmonary tuberculosis (TB)
is immense. The increasing prevalence and convergence
of DM and TB is an emerging public health problem,
especially among adults in the lower- and middle-income
countries (LMICs) where both disorders are common.
1,2
1
Departments of Medical Microbiology, School of Clinical Medicine, College of Health Sciences, Igbinedion
University and Igbinedion University Teaching Hospital, Okada, Nigeria
2
Department of Medical Microbiology, School of Clinical Medicine, University of Benin/ Teaching Hospital, Benin
City, Nigeria
3
Department of Medical Laboratory Science, Nnamdi Azikiwe University, Awka, Nigeria
4
Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria
Received: 18 December 2020
Accepted: 15 January 2021
*Correspondence:
Dr. Benson O. Akinshipe,
E-mail: bensonakinshipedr01@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: The increasing prevalence and convergence of type 2 diabetes mellitus (DM) and active tuberculosis
(TB) comorbidity, especially in adults in the lower-and middle-income countries, demand new approaches to control
the ‘syndemic’. Consequently, we set out to investigate the possibility of early detection of prediabetes mellitus
and/or latent tuberculosis infection using novel method.
Methods: This was a case-control study of 105 adults classified into 4 groups: Healthy Community Controls (HCC,
n=30); Prediabetes mellitus (PDM, n=25); Latent Tuberculosis Infection (LTBI, n=23); Individuals with Prediabetes
mellitus+Latent Tuberculosis Infection (PDM+LTBI, n=27). Sera collected were assayed for high-sensitivity C-
reactive protein (hs-CRP) using the ultra-sensitive Human high sensitivity C-reactive protein ELISA Kit (Melsin
Medical Co., Ltd, China). Other ancillary tests and measurements done include Erythrocyte Sedimentation Rate,
serum Glycated-hemoglobin (HbA1c), Interferon-gamma (INF-ϒ) and Waist circumference.
Results: A total of 88 (83.8%) of the enrolled participants had full complement of results and were included in the
analysis of four study groups: HCC (n=25), PDM (n=21), LTBI (n=19) and PDM+ LTBI (n=23). With respect to the
serum biomarkers, isolated PDM and LTBI cases recorded significantly higher HbA1c (%) and INF-ϒ positivity
respectively. Predictors of PDM+LTBI show statistically significant higher tertile (T3), representing elevated hs-CRP
levels, (OR=6.50, 95% CI=4.83-22.39, p=0.0037).
Conclusions: This study revealed that persons harboring the two associated asymptomatic conditions, PDM + LTBI
have higher inflammatory state detectable by assaying the biomarker, hs-CRP, which could be used for ‘one-time bi-
directional targeted screening’ for PDM in LTBI and vice versa.
Keywords: Adults, Biomarker, Highly-Sensitive C-reactive protein, Latent tuberculosis infection, Prediabetes
DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20210407