Changes in the levels of adipokines in newly diagnosed pulmonary tuberculosis patients in case of treatment failure

Abstract

Improving the treatment efficacy for patients with newly diagnosed tuberculosis by reducing the number of treatment failure cases is very urgent issue nowadays. Purpose. To define the characteristics of adipokines levels changes in newly diagnosed pulmonary tuberculosis patients in case of treatment failure by examining the levels of leptin, adiponectin and leptin/adiponectin ratio. Materials and methods . A total of 58 patients with newly diagnosed pulmonary tuberculosis were the subject of this prospective study. The patients were divided into 2 groups: the first group was made up of 28 patients with the ineffectively treated newly diagnosed pulmonary tuberculosis; the second group (experimental group) consisted of 30 patients with successful treatment completion. The control group included 29 healthy voluntary donors. Changes in the levels of adipokines by measuring the blood serum leptin and adiponectin via enzyme linked immunosorbent assay using immunoassay analyzer Sirio S with “Mediagnost” kit (Germany) (ng/ml) were studied at the Scientific Medical Laboratory Center of Zaporizhzhia State Medical University. Leptin/adiponectin ratio was calculated mathematically (relative units). Blood samples were collected after an overnight fasting. Statistica for Windows 13.0 (Copyright 1984–2018 TIBCO Software Inc., all rights reserved, Licence No. JPZ8041382130ARCN10-J) software was used for the statistical analysis. Results. The following significant changes in the adipokines levels have been found in patients with newly diagnosed pulmonary tuberculosis with massive pulmonary lesions and destructions of over 3 сm in diameter and positive sputum smear. These patients will be diagnosed with ineffective treatment. At the beginning of the antimycobacterial therapy, there was a significant 12.7 times decrease in leptin and 1.4 times increase in adiponectin indicators and 21 times decrease in the leptin/adiponectin ratio. The levels of leptin, adiponectin and leptin/adiponectin ratio were significantly worse than similar levels in patients, who completed the treatment efficiently. The level of the leptin was slightly increased during the antimycobacterial therapy, albeit being significantly reduced, and the level of the adiponectin continued to increase significantly. The leptin/adiponectin ratio was significantly lower than that in patients who completed the treatment efficiently. Conclusions. Patients with newly diagnosed pulmonary tuberculosis with the risk of treatment failure are diagnosed with severe disorders of adipocyte functional activity, that antimycobacterial chemotherapy could not even restore the balance to the adipokine system and smooth down resulting concomitant variations in immune response. The findings showed the prognostic value of the changes in leptin, adiponectin and leptin/adiponectin ratio indicators at the beginning of the treatment in relation to treatment failure among patients with newly diagnosed pulmonary tuberculosis.