Impact of concurrent diabetes on the intensity of systematic inflammatory response syndrome and nutritive status of pulmonary tuberculosis patients

Abstract

52 pulmonary tuberculosis patients with concurrent diabetes and 76 pulmonary tuberculosis patients without concurrent diabetes (control group) have been examined. Systemic inflammation response syndrome (SIRS) has been evaluated by the concentration in the blood serum (plasma) of C-reactive protein, A serum amyloid protein, α1 -antitrypsin, haptoglobin and fibrinogen; nutritive status has been assessed by body mass index and concentrations in the blood serum of general protein, albumin and transthyretin. It has been found out that SIRS in those with concurrent conditions was less expressed compared to the control group. In particular in 56.9% of them the rates of C-reactive protein were within normal limits (in control group in 19.7%, p < 0.01). When evaluating the nutritive status in pulmonary tuberculosis patients with concurrent diabetes as per transthyretin and general protein, the protein deprivation (nitrogenous) has been found out along with paradox tendency in albumin and body mass index increase. The control group demonstrated less expressed signs of protein deprivation, but they were followed by the adequate reduction of albumin and body mass index. The detected changes allow presuming that the negative effect of diabetes on the course of pulmonary tuberculosis is determined by defective formation of SIRS, destroying its initial protective character and nitrogenous deprivation, restraining the reparation.