Sex influences the association between haemostasis and the extent of lung lesions in tuberculosis |
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| Authors: | Wenling Tan Adiilah K Soodeen-Lalloo Yue Chu Weijie Xu Fengfang Chen Jie Zhang Wei Sha Jin Huang Guanghong Yang Lianhua Qin Jie Wang Xiaochen Huang Jingyun Shi Yonghong Feng |
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| Institution: | 1.Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai,China;2.Department of Radiology, Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai,China;3.Department of Clinical Laboratory Medicine, Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai,China;4.Key Laboratory of Environment Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health,Guizhou Medical University,Guiyang,China;5.Department of Epidemiology and Biostatistics,Tongji University School of Medicine,Shanghai,China;6.Clinic and Research Centre of Tuberculosis, Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai,China |
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| Abstract: | BackgroundWorldwide tuberculosis (TB) reports show a male bias in morbidity; however, the differences in pathogenesis between men and women with TB, as well as the mechanisms associated with such differences, are poorly investigated. We hypothesized that comparison of the degree of lung injury and clinical indices of well-matched men and women with newly diagnosed TB, and statistical analysis of the correlation between these indices and the extent of lung lesions, can provide insights into the mechanism of gender bias in TB.MethodsWe evaluated the acid-fast bacilli grading of sputum samples and compiled computed tomography (CT) data of the age-matched, newly diagnosed male and female TB patients without history of smoking or comorbidities. Inflammatory biomarker levels and routine haematological and coagulation-associated parameters were compared. Binary logistic regression analysis was used to define the association between the indices and lung lesions, and the influence of sex adjustment.ResultsWomen with TB have a longer delay in seeking healthcare than men after onset of the TB-associated symptoms. Men with TB have significantly more severe lung lesions (cavities and healing-associated features) and higher bacterial counts compared to women with TB. Scoring of the CT images before and after anti-TB treatment showed a faster response to therapy in women than in men. Coagulation- and platelet-associated indices were in models from multivariate regression analysis with groups of males or females with TB or in combination. In univariate regression analysis, lower lymphocyte counts were associated with both cavity and more bacterial counts, independent of sex, age and BMI. The association of international normalized ratios (INR), prothrombin times (PTs), mean platelet volumes (MPVs) and fibrinogen (FIB) level with lung lesions was mostly influenced by sex adjustment.ConclusionsSex influences the association between haemostasis and extent of TB lung lesions, which may be one mechanism involved in sex bias in TB pathogenesis. |
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