Modulation of Iron Status Biomarkers in Tuberculosis-diabetes Co-morbidity

Overview

Journal Tuberculosis (Edinb)

Specialties Infectious Diseases
Pulmonary Medicine

Date 2018 Mar 11

PMID 29523313

Citations 5

Authors

Nathella Pavan Kumar

Vaithilingam V Banurekha

Dina Nair

Chandrakumar Dolla

Paul Kumaran

Subash Babu

Affiliations

Soon will be listed here.

Abstract

Tuberculosis (TB) and diabetes mellitus (DM) remain vital disease burdens in developing countries and the dual burden of DM and TB clearly signifies a growing global public health concern. While modulation of iron status biomarkers in TB is well described, very little is known about the association of these markers with TB-DM. To examine the association of circulating iron status biomarkers in TB disease, we examined the systemic levels of ferritin, hepcidin, soluble transferrin receptor (sTfR), transferrin, apotransferrin and hemopexin in pulmonary TB (PTB) individuals with DM (PTB-DM), without DM (PTB) and those with diabetes only (DM). Circulating levels of ferritin and hepcidin were significantly enhanced in PTB-DM and PTB compared to the DM group. On the other hand, the circulating levels of transferrin and apotransferrin were significantly diminished in PTB-DM and PTB compared to the DM group. The levels of ferritin and hepcidin exhibited a significant positive relationship with HbA1c, whereas apotransferrin exhibited negative relationship with HbA1c in PTB-DM and PTB. ROC analysis revealed that ferritin, hepcidin and transferrin are markers that can distinguish PTB-DM from DM individuals. Our results suggest that some of these circulating iron status markers could prove useful as biomarkers to monitor disease severity.

Citing Articles

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References

. Standards of medical care in diabetes--2013. Diabetes Care. 2012; 36 Suppl 1:S11-66. PMC: 3537269. DOI: 10.2337/dc13-S011. View

Lonnroth K, Roglic G, Harries A . Improving tuberculosis prevention and care through addressing the global diabetes epidemic: from evidence to policy and practice. Lancet Diabetes Endocrinol. 2014; 2(9):730-9. DOI: 10.1016/S2213-8587(14)70109-3. View

Camaschella C, Poggiali E . Towards explaining "unexplained hyperferritinemia". Haematologica. 2009; 94(3):307-9. PMC: 2649347. DOI: 10.3324/haematol.2008.005405. View

Kerkhoff A, Meintjes G, Burton R, Vogt M, Wood R, Lawn S . Relationship Between Blood Concentrations of Hepcidin and Anemia Severity, Mycobacterial Burden, and Mortality Among Patients With HIV-Associated Tuberculosis. J Infect Dis. 2015; 213(1):61-70. PMC: 4676545. DOI: 10.1093/infdis/jiv364. View

Harrison P, Arosio P . The ferritins: molecular properties, iron storage function and cellular regulation. Biochim Biophys Acta. 1996; 1275(3):161-203. DOI: 10.1016/0005-2728(96)00022-9. View

Boelaert J, Vandecasteele S, Appelberg R, Gordeuk V . The effect of the host's iron status on tuberculosis. J Infect Dis. 2007; 195(12):1745-53. DOI: 10.1086/518040. View

Pan S, Ku C, Kao D, Ezzati M, Fang C, Lin H . Effect of diabetes on tuberculosis control in 13 countries with high tuberculosis: a modelling study. Lancet Diabetes Endocrinol. 2015; 3(5):323-30. DOI: 10.1016/S2213-8587(15)00042-X. View

Jeon C, Murray M . Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med. 2008; 5(7):e152. PMC: 2459204. DOI: 10.1371/journal.pmed.0050152. View

Hodgson K, Morris J, Bridson T, Govan B, Rush C, Ketheesan N . Immunological mechanisms contributing to the double burden of diabetes and intracellular bacterial infections. Immunology. 2014; 144(2):171-85. PMC: 4298412. DOI: 10.1111/imm.12394. View

10.

Shin D, Jo E . Antimicrobial Peptides in Innate Immunity against Mycobacteria. Immune Netw. 2011; 11(5):245-52. PMC: 3242998. DOI: 10.4110/in.2011.11.5.245. View

11.

Armitage A, Eddowes L, Gileadi U, Cole S, Spottiswoode N, Selvakumar T . Hepcidin regulation by innate immune and infectious stimuli. Blood. 2011; 118(15):4129-39. DOI: 10.1182/blood-2011-04-351957. View

12.

Minchella P, Armitage A, Darboe B, Jallow M, Drakesmith H, Jaye A . Elevated hepcidin at HIV diagnosis is associated with incident tuberculosis in a retrospective cohort study. Int J Tuberc Lung Dis. 2014; 18(11):1337-9. DOI: 10.5588/ijtld.14.0143. View

13.

Crichton R . Iron transport and storage. Eur J Biochem. 1987; 164(3):485-506. DOI: 10.1111/j.1432-1033.1987.tb11155.x. View

14.

Peleg A, Weerarathna T, McCarthy J, Davis T . Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev. 2006; 23(1):3-13. DOI: 10.1002/dmrr.682. View

15.

Prentice A, Doherty C, Abrams S, Cox S, Atkinson S, Verhoef H . Hepcidin is the major predictor of erythrocyte iron incorporation in anemic African children. Blood. 2012; 119(8):1922-8. PMC: 3351093. DOI: 10.1182/blood-2011-11-391219. View

16.

Skikne B, Punnonen K, Caldron P, Bennett M, Rehu M, Gasior G . Improved differential diagnosis of anemia of chronic disease and iron deficiency anemia: a prospective multicenter evaluation of soluble transferrin receptor and the sTfR/log ferritin index. Am J Hematol. 2011; 86(11):923-7. DOI: 10.1002/ajh.22108. View

17.

Karyadi E, Schultink W, Nelwan R, Gross R, Amin Z, Dolmans W . Poor micronutrient status of active pulmonary tuberculosis patients in Indonesia. J Nutr. 2000; 130(12):2953-8. DOI: 10.1093/jn/130.12.2953. View

18.

Gomez D, Twahirwa M, Schlesinger L, Restrepo B . Reduced Mycobacterium tuberculosis association with monocytes from diabetes patients that have poor glucose control. Tuberculosis (Edinb). 2012; 93(2):192-7. PMC: 3580120. DOI: 10.1016/j.tube.2012.10.003. View

19.

Shah B, Hux J . Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care. 2003; 26(2):510-3. DOI: 10.2337/diacare.26.2.510. View

20.

Restrepo B, Fisher-Hoch S, Pino P, Salinas A, Rahbar M, Mora F . Tuberculosis in poorly controlled type 2 diabetes: altered cytokine expression in peripheral white blood cells. Clin Infect Dis. 2008; 47(5):634-41. PMC: 2900313. DOI: 10.1086/590565. View