口服葡萄糖负荷对结核分枝杆菌感染人群 IFN-γ 释放的影响。
The impact of an oral glucose load on IFN-γ-release in persons infected with Mycobacterium tuberculosis.
机构信息
Unit of Infectious Diseases, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Center for Clinical Metabolic Research, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
出版信息
BMC Infect Dis. 2024 Sep 30;24(1):1079. doi: 10.1186/s12879-024-09920-x.
BACKGROUND AND OBJECTIVE
To diagnose tuberculosis infection (TBI), whole blood is incubated with M.tuberculosis (Mtb)-specific peptides and the release of interferon-γ (IFN-γ) is measured in IFN-γ-release assays (IGRAs). Hyperglycaemia and fluctuations in blood glucose may modulate IFN-γ-release. Here, we investigated if glucose intake affects IFN-γ-release or IGRA results in IGRAs taken during an oral glucose tolerance test (OGTT).
METHODS
Persons with TB disease (TB) or TBI underwent a standard 75-g OGTT at the start and end of treatment for TB or TBI. Blood for the IGRA QuantiFERON-TB Gold Plus (QFT) containing Mtb-specific tubes (TB1 and TB2), a non-specific mitogen tube (MIT) and an empty control tube (NIL) was drawn at sample-timepoints -15 (baseline), 60, 90, 120 and 240 min during the OGTT. Blood glucose was measured in parallel at all timepoints. IFN-γ-release (after subtraction of NIL) at each timepoint was compared with baseline using linear-mixed-model analysis.
RESULTS
Twenty-four OGTTs from 14 participants were included in the final analysis. Compared to baseline, IFN-γ-release was increased at sample-timepoint 240 min for TB1; geometric mean (95% confidence interval) 3.0 (1.5-6.2) vs 2.5 (1.4-4.4) IU/mL (p = 0.047), and MIT; 182.6 (103.3-322.9) vs 146.0 (84.0-254.1) IU/mL (p = 0.002). Plasma glucose levels were not associated with IFN-γ-release and the QFT test results were unaffected by the OGTT.
CONCLUSION
Ingestion of glucose after a 10-h fast was associated with increased IFN-γ-release after 240 min in the MIT tube. However, there was no association between plasma glucose levels at the QFT sampling timepoint and IFN-γ-release. Furthermore, the QFT test results were not affected by glucose intake. The overall effect of an OGTT and prevailing plasma glucose levels on IFN-γ-release in IGRAs seem limited.
TRIAL REGISTRATION
Trial registration ID: NCT04830462 ( https://clinicaltrials.gov/study/NCT04830462 ). Registration date: 05-Apr-2021.
背景和目的
为了诊断结核病感染（TBI），将全血与结核分枝杆菌（Mtb）特异性肽孵育，并在干扰素-γ（IFN-γ）释放测定（IGRAs）中测量 IFN-γ 的释放。高血糖和血糖波动可能会调节 IFN-γ 的释放。在这里，我们研究了在口服葡萄糖耐量试验（OGTT）期间摄入葡萄糖是否会影响 IFN-γ 的释放或 IGRA 结果。
方法
患有结核病（TB）或 TBI 的患者在开始和结束 TB 或 TBI 治疗时进行了标准的 75 g OGTT。在 OGTT 过程中，在样本时间点-15（基线）、60、90、120 和 240 分钟时，从含有 Mtb 特异性管（TB1 和 TB2）、非特异性有丝分裂原管（MIT）和空对照管（NIL）的 QuantiFERON-TB Gold Plus（QFT）中采集用于 IGRA 的血液。在所有时间点均同时测量血糖。使用线性混合模型分析将每个时间点的 IFN-γ 释放（减去 NIL 后）与基线进行比较。
结果
最终分析纳入了 14 名参与者的 24 次 OGTT。与基线相比，TB1 在样本时间点 240 分钟时 IFN-γ 释放增加；几何均数（95%置信区间）分别为 3.0（1.5-6.2）与 2.5（1.4-4.4）IU/mL（p=0.047），以及 MIT；分别为 182.6（103.3-322.9）与 146.0（84.0-254.1）IU/mL（p=0.002）。血浆葡萄糖水平与 IFN-γ 释放无关，QFT 试验结果不受 OGTT 影响。
结论
空腹 10 小时后摄入葡萄糖与 MIT 管中 240 分钟后 IFN-γ 释放增加有关。然而，QFT 采样时间点的血浆葡萄糖水平与 IFN-γ 释放之间没有关联。此外，葡萄糖摄入并不影响 QFT 检测结果。OGTT 和普遍的血浆葡萄糖水平对 IGRAs 中 IFN-γ 释放的总体影响似乎有限。
试验注册
试验注册号：NCT04830462（https://clinicaltrials.gov/study/NCT04830462）。注册日期：2021 年 4 月 5 日。
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