Impact of diabetes mellitus on indeterminate results of the QuantiFERON TB Gold In-Tube test: A propensity score matching analysis

PLoS One. 2017 Jul 21;12(7):e0181887. doi: 10.1371/journal.pone.0181887. eCollection 2017.

Abstract

Background: The sensitivity of interferon-gamma release assays (IGRAs) in the detection of Mycobacterium tuberculosis infection could be affected by conditions of immune dysregulation. For this reason, diabetes mellitus (DM) may increase the frequency of indeterminate results of IGRAs. However, there have been inconsistent reports of role of DM on indeterminate IGRA results.

Methods: We retrospectively reviewed all patients who underwent QuantiFERON-TB Gold In-Tube testing (QFT-GIT) at Chonnam National University Hospital. We collected the clinical and laboratory data of these patients.

Results: Of all 3,391 subjects, 1,265 (37.3%) had a positive QFT-GIT result, 266 (7.8%) had an indeterminate result, and 1,860 (54.9%) had a negative result. The mean age was 54.8 ± 18.1 years and 55.0% of the patients were male. There were 512 (15.1%) patients with DM. Multivariable analysis revealed that systemic corticosteroid use, tuberculosis, lymphocytopenia, low serum albumin, and high serum C-reactive protein (CRP) levels were significantly associated with indeterminate QFT-GIT results. However, DM was not associated with indeterminate QFT-GIT results (adjusted odds ratio, 0.98; 95% confidence interval, 0.69-1.41; P = 0.939). After propensity score matching, DM was not associated with indeterminate results of QFT-GIT.

Conclusion: In this large cohort study, DM does not affect the incidence of indeterminate results of QFT-GIT.

MeSH terms

  • C-Reactive Protein / metabolism
  • Diabetes Mellitus / metabolism*
  • Diabetes Mellitus / pathology
  • Female
  • Hospitals, University
  • Humans
  • Interferon-gamma / metabolism*
  • Interferon-gamma Release Tests / methods
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / pathogenicity
  • Propensity Score
  • Retrospective Studies
  • Tuberculin Test / methods
  • Tuberculosis / diagnosis*
  • Tuberculosis / metabolism*

Substances

  • Interferon-gamma
  • C-Reactive Protein

Grants and funding

This study was supported by the National Research Foundation of Korea funded by the Korean Government (Grant 2016R1D1A1B03931132). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.