Metabolic Syndrome Outcomes Among Patients with Tuberculosis in Tanzania

PROJECT SUMMARY The prevalence of noncommunicable diseases such as diabetes and metabolic syndrome is increasing in settings where infectious diseases like tuberculosis (TB) are common. There is a clear bidirectional interaction between diabetes and TB. However, less is known about the intersection of TB and metabolic syndrome, a multifaceted condition of which glucose dysregulation is one component. The proposed K23 work seeks to go beyond unidimensional glycemic measures in order to gain a more comprehensive understanding of the metabolic profiles of people with TB and how metabolic parameters change over the course of TB treatment. To do this we will leverage an ongoing prospective cohort of adults newly diagnosed with TB in Tanzania. We will focus on the group with newly recognized pre-diabetes at the time of TB diagnosis, since our prior work has demonstrated that this subpopulation is heterogeneous, and this health state is dynamic. In Aim 1 we will measure and describe a set of blood-based and anthropometric metabolic markers and characterize TB severity at the time of TB diagnosis, testing the hypothesis that metabolic syndrome is directly associated with TB severity. In Aim 2 we will measure and describe metabolic outcomes at completion of TB treatment and identify risk factors for different metabolic outcomes. Dr. Alkabab is committed to improving health by advancing understanding of the biologic interplay between communicable and non-communicable diseases and developing interventions that address both in an integrated manner. She is in an extraordinarily supportive research environment within the Division of Infectious Diseases, Department of Medicine at the Medical University of South Carolina. To accomplish the proposed work and transition to research independence, the applicant has assembled a mentoring team with decades of experience in relevant disciplines to guide her. Training in advanced statistics, the science of diabetes and metabolism, human subjects research, and grant writing will provide a strong foundation for success.