Temporal trends in mortality of TB attributable to HFPG in China [TB0091]

TB patients with diabetes or hyperglycemia face a higher likelihood of experiencing more severe disease and unfavorable treatment outcomes compared to those without co-morbidities. Long-term elevated blood glucose levels can impair immune cells crucial for combating TB bacteria, weakening the immune response and enabling TB bacteria to multiply and spread throughout the body, thereby increasing the risk of developing active TB. Additionally, diabetes and hyperglycemia can reduce the body's ability to effectively treat TB infections.

See also: https://tbreadingnotes.blogspot.com/2024/07/exposure-to-secondhand-smoke-and-risk.html

In China, the age-standardized mortality rates (ASMRs) for TB related to hyperglycemia were lower than the global average. Although men showed higher TB mortality rates, the reduction in mortality was smaller in men compared to women. Notably,  high fasting plasma glucose (HFPG)-related TB mortality initially increased and then decreased with age, with the most significant decrease in the average annual percentage change (AAPC) observed in the 60–64 age group. This suggests that this age range is a critical period for HFPG’s impact on TB mortality, indicating that interventions focused on managing diabetes and hyperglycemia during this life stage could significantly improve TB health outcomes.

See also: https://tbreadingnotes.blogspot.com/2024/07/the-relationship-between-malnutrition.html

In older adults, TB cases are often due to the reactivation of dormant TB lesions, which can be attributed to age-related changes in the immune system, such as a reduced ability to reactivate previously acquired immunity. Elevated TB mortality in men may also be linked to biological factors, including differences in sex hormone effects on macrophage activation. For example, oestradiol, a female sex hormone, enhances macrophage activation, whereas androgen does not have a similar effect.

See also: https://tbreadingnotes.blogspot.com/2024/07/ending-tb-in-southeast-asia.html

Mortality related to TB is associated with harmful health habits, which may be influenced by gender-specific norms and behaviors. Men often exhibit delayed healthcare-seeking behavior and poorer treatment adherence compared to women. A crucial obstacle in managing glucose levels among TB patients is adherence to medication; thus, strategies for controlling HFPG should particularly focus on men.

Source: 

Wang C, Yang X, Zhang H, Zhang Y, Tao J, Jiang X and Wu C (2023) Temporal trends in mortality of tuberculosis attributable to high fasting plasma glucose in China from 1990 to 2019: a joinpoint regression and age-period-cohort analysis. Front. Public Health 11:1225931.

 

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