Pro-atherogenic lipid profile in pulmonary tuberculosis patients with concurrent insulin resistance

Abstract

Background. The problem of studying lipid metabolism in patients with tuberculosis is of interest to scientists around the world. The purpose of the study - to investigate lipid profile in pulmonary tuberculosis patients with concurrent insulin resistance. Materials and methods. Forty-one patients with pulmonary tuberculosis were examined. Insulin resistance index (HOMA-IR), total cholesterol level (TC), triglycerides (TG) level, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol and atherogenic index (AI) were measured. Results. Group 1 - 26 patients with tuberculosis and insulin resistance (HOMA-IR ˃ 2.7); Group 2 – 15 patients with tuberculosis without insulin resistance (HOMA-IR ˂ 2.7). Group 1 patients had severe course of TB with fever, severe fatigue and weakness, profuse sweating, weight loss, cough and shortness of breath. Median TC indices differed at significant level (p = 0.012): group 1 - 4.82 mmol/l, group 2 - 4.25 mmol/l. TG level was higher in group 1 patients - 1.32 mmol/l than in group 2 patients - 1.28 mmol/l. LDL cholesterol values were higher in group 1 patients - 3.2 mmol/l vs 2.5 mmol/l in group 2. The AI was higher in group1 (p = 0.005): 3.9 units against 2.8 units in group 2 patients. Conclusions. Insulin resistance in pulmonary tuberculosis patients was associated with severe course of the disease, severe clinical manifestations and impaired external respiration. Pro-atherogenic disorders of lipid metabolism in pulmonary tuberculosis patients with concurrent insulin resistance can be considered as the degree of endogenous intoxication.