The Graduate Program in Medicine and Health, School of Medicine of Bahia, Federal University of Bahia, Salvador, Bahia, Brazil.
Clinical Biochemistry Laboratory, Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Bahia, Salvador, Bahia, Brazil.
J Med Microbiol. 2023 Jun;72(6). doi: 10.1099/jmm.0.001726.
In recent years, cholesterol has received interest in the study of infection due to evidence of a relationship between low plasma cholesterol levels and tuberculosis (TB). Plasma lipid profiles of serum amyloid A (SAA), apolipoprotein A-I and high-density lipoprotein cholesterol (HDL-C) are biomarkers associated with symptomatic TB patients. We aimed to evaluate plasma lipid profiles of apolipoprotein A-I, SAA and the size of HDL as biomarkers to diagnose symptomatic TB patients. Patients with TB symptoms attending the Instituto Brasileiro para a Investigação da Tuberculose/Fundação José Silveira (IBIT/FJS) between September 2015 and August 2016 for diagnosis of TB were studied. From 129 patients, 97 were classified as pulmonary TB and 32 as negative-bacilloscopy (non-TB group). Medical history, fasting serum and plasma were obtained. Total cholesterol (TC), HDL-C, apolipoprotein A-I and SAA were measured by enzymatic or immunochemical reaction assays. HDL size was measured by laser light-scattering. In TB patients, TC (147.0±37 vs. 168±44 mg dL), HDL-C (37±14 vs. 55±18 mg dL) and apolipoprotein A-I (102±41 vs. 156±47 mg dL) concentrations were lower (<0.0001), while HDL particle size (10.16±1.02 vs. 9.62±0.67 nm) and SAA levels (280±36 vs. 19±8 mg L) were higher (<0.0001). Using receiver-operating characteristic curve analysis for predicting TB, the cutoff values were <83.85 mg L for SAA (sensitivity=96.88 %, specificity=78.43 %, <0.0001), >44.50 mg dL for HDL-C (sensitivity=75 %, specificity=72.16 %, <0.001) and >118.5 mg dL for apolipoprotein A-I (sensitivity=83.83 %, specificity=72.22 %, <0.001). SAA, HDL-C and apolipoprotein A-I are associated with TB infection and could be used as laboratory biomarkers, especially in patients who are negative for alcohol-acid-resistant bacilli.
近年来，由于低血浆胆固醇水平与结核病（TB）之间存在关联的证据，胆固醇在感染研究中受到关注。血清淀粉样蛋白 A（SAA）、载脂蛋白 A-I 和高密度脂蛋白胆固醇（HDL-C）的血浆脂质谱是与有症状的 TB 患者相关的生物标志物。我们旨在评估载脂蛋白 A-I、SAA 和 HDL 大小的血浆脂质谱作为诊断有症状 TB 患者的生物标志物。2015 年 9 月至 2016 年 8 月期间，因诊断结核病而在巴西结核病研究所/何塞西尔维拉基金会（IBIT/FJS）就诊的具有 TB 症状的患者参与了此项研究。从 129 名患者中，97 名被分类为肺结核，32 名被归类为非抗酸杆菌镜检阴性（非 TB 组）。采集病史、空腹血清和血浆。采用酶或免疫化学反应测定总胆固醇（TC）、HDL-C、载脂蛋白 A-I 和 SAA。采用激光光散射法测量 HDL 大小。在 TB 患者中，TC（147.0±37 与 168±44 mg/dL）、HDL-C（37±14 与 55±18 mg/dL）和载脂蛋白 A-I（102±41 与 156±47 mg/dL）浓度较低（<0.0001），而 HDL 颗粒大小（10.16±1.02 与 9.62±0.67 nm）和 SAA 水平（280±36 与 19±8 mg/L）较高（<0.0001）。使用受试者工作特征曲线分析预测 TB 的截断值为 SAA<83.85 mg/L（灵敏度=96.88%，特异性=78.43%，<0.0001）、HDL-C>44.50 mg/dL（灵敏度=75%，特异性=72.16%，<0.001）和载脂蛋白 A-I>118.5 mg/dL（灵敏度=83.83%，特异性=72.22%，<0.001）。SAA、HDL-C 和载脂蛋白 A-I 与 TB 感染相关，可作为实验室生物标志物，尤其是在抗酸杆菌阴性的患者中。
