The impact of glycated hemoglobin A1c levels on drug resistance development in diabetes mellitus-pulmonary tuberculosis patients: the mediating effect of C reactive protein levels

doi:10.19871/j.cnki.xfcrbzz.2025.05.003

Abstract

Abstract: Objective The objective of this study was to explore the mediating role of C reactive protein (CRP) levels in the relationship between glycated hemoglobin A1c (HbA1c) and the occurrence of drug-resistant pulmonary tuberculosis (DR-PTB) in patients with diabetes mellitus-pulmonary tuberculosis. Method A total of 352 patients diagnosed with Diabetes mellitus-pulmonary tuberculosis at Qingdao public health clinical center from 2022 to 2024 were included. To analyze the mediating effect of CRP levels in the relationship between HbA1c and DR-PTB occurrence, with validation performed using the bootstrap method. Result Among the patients, 85 cases (24.1%) were identified with DR-PTB. HbA1c showed positive correlations with CRP levels (r=0.459, P<0.01) and DR-PTB occurrence (r=0.359, P<0.01). CRP levels were also positively correlated with DR-PTB occurrence (r=0.441, P<0.01). Regression analysis indicated that both HbA1c control (β=0.81) and CRP levels (β=1.17) significantly influenced DR-PTB occurrence (P<0.001). The total effect of HbA1c on DR-PTB occurrence was 1.30, with a direct effect of 0.81. The mediating effect of CRP levels was 0.49, accounting for 37.69% of the total effect. Conclusion HbA1c and CRP levels are associated with DR-PTB occurrence in patients with diabetes mellitus-pulmonary tuberculosis,and there is a partial mediating effect of CRP levels between HbA1c and the occurrence of drug-resistant tuberculosis.

Key words: Diabetes mellitus-pulmonary tuberculosis, Glycated hemoglobin A1c, C reactive protein, Drug-resistant pulmonary tuberculosis, Mediating effect

CLC Number:

R521
R587.1

Li Wenshan, Ji Xueqin, Lin Mei, Qi Yan, Wang Wenli, Wang Chaoyi, Ding Xiao, Li Tongxia. The impact of glycated hemoglobin A1c levels on drug resistance development in diabetes mellitus-pulmonary tuberculosis patients: the mediating effect of C reactive protein levels[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(5): 12-16.

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