Published: 2021-01-29

Elevated high-sensitivity C-reactive protein among apparently healthy adults with concomitant prediabetes and latent tuberculosis infection in Nigeria

Benson O. Akinshipe, Edirin O. Yusuf, Alfred F. Ehiaghe, Tunde O. Egunjobi, Opeoluwa A. Yusuf


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.


Adults, Biomarker, Highly-Sensitive C-reactive protein, Latent tuberculosis infection, Prediabetes

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