Key Factors Influencing Liver Function Injury in Elderly Patients with Newly Diagnosed Pulmonary Tuberculosis Complicated by Diabetes after Antituberculosis Treatment

• Published in: The American journal of tropical medicine and hygiene Vol. 112; no. 1; pp. 135 - 142
• Main Authors: Ma, Liangliang, Fan, Henghua
• Format: Journal Article
• Language: English
• Published: United States Institute of Tropical Medicine 08.01.2025
• Subjects: Aged; Aged, 80 and over; Alanine Transaminase - blood; Antitubercular Agents - adverse effects; Antitubercular Agents - therapeutic use; Aspartate Aminotransferases - blood; Bilirubin - blood; Chemical and Drug Induced Liver Injury - etiology; Diabetes; Diabetes Complications - drug therapy; Diabetes Mellitus - drug therapy; Female; Humans; Liver; Liver - drug effects; Liver - pathology; Liver Function Tests; Male; Middle Aged; Multivariate analysis; Older people; Risk Factors; Tuberculosis; Tuberculosis, Pulmonary - complications; Tuberculosis, Pulmonary - drug therapy
• ISSN: 0002-9637; 1476-1645; 1476-1645
• DOI: 10.4269/ajtmh.24-0248

This study addressed the factors influencing liver injury in elderly patients newly diagnosed with pulmonary tuberculosis and diabetes after antituberculosis treatment. From January 2021 to June 2023, 218 elderly patients with early treatment of pulmonary tuberculosis ( N = 218) combined with diabetes ( N = 218) were collected as research subjects. All patients were treated with the same antituberculosis treatment regimen and were divided into a nonhepatotoxicity group ( N = 92) and a hepatotoxicity group ( N = 126) according to whether drug-induced liver injury occurred within 3 months after taking tuberculosis drugs. The levels of alanine aminotransferase and aspartate aminotransferase, total bilirubin, direct bilirubin, indirect bilirubin, albumin, lipoprotein(a), prothrombin time, and hemoglobin A1c (HbA1c) were detected by biochemical analyzer. The extent of pulmonary tuberculosis lesions was examined by computed tomography imaging. Influencing factors of antituberculosis drug-induced liver injury were analyzed by logistic multivariate analysis. The hepatotoxicity group exhibited a higher average age than the nonhepatotoxicity group ( P <0.05). Additionally, there was a greater prevalence of patients with a history of alcohol consumption in the hepatotoxicity group than in the nonhepatotoxicity group ( P <0.05). And the hepatotoxicity group showed a greater extent of tuberculosis lesions ( P <0.05). Logistic multivariate analysis identified advanced age, body mass index of <18.5, lesion range of ≥2 lung lobes, history of alcohol consumption, and HbA1c of ≥8% as relevant factors associated with liver function impairment in older adults patients undergoing early treatment of pulmonary tuberculosis combined with diabetes after antituberculosis therapy. These findings underscore the importance of monitoring and addressing these factors during antituberculosis therapy in the elderly population to mitigate the risk of liver function impairment.