Diagnostic Predictors of MDR-TB Using Biomarkers sCD14, PGLYRP2, and FG? in Populations with and without Diabetes Mellitus
Keywords:
Multidrug-Resistant Tuberculosis (MDR-TB), Serum Biomarkers, Diabetes Mellitus, Diagnostic PredictorsAbstract
OBJECTIVE: To analyze differences in biomarkers (sCD14, PGLYRP2, and FG?) as diagnostic predictors of MDR-TB with and without diabetes mellitus comorbidity in Manado, Indonesia.
METHODOLOGY: A cross-sectional study was conducted from February to December 2025 at Prof. Dr. RD Kandou General Hospital and a community health center. A total of 180 respondents were divided into three groups: TB-DM (n=45), MDR-TB (n=45), and healthy controls (n=90). MDR-TB diagnosis was confirmed via Gene Xpert MTB/RIF and/or drug sensitivity testing, while TB-DM included pulmonary tuberculosis patients with comorbid diabetes mellitus. Biomarker levels were measured using a sandwich ELISA. Statistical analysis employed one-way ANOVA (?=0.05) with Levene's test for homogeneity, using SPSS version 25.0.
RESULTS: Variances were homogeneous across all biomarkers (p>0.05). sCD14 levels differed significantly between groups (F=3.112; p=0.035), with MDR-TB at 102.89±29.45 ng/mL, TB-DM at 77.42±42.31 ng/mL, and controls at 108.52±14.23 ng/mL. PGLYRP2 demonstrated the strongest intergroup difference (F=14.496; p<0.001), showing a consistent gradient: MDR-TB (5.12±1.08 ng/mL), controls (4.21±1.12 ng/mL), and TB-DM (2.73±0.52 ng/mL). FG? showed no significant difference (F=0.999; p=0.377).
CONCLUSION: PGLYRP2 emerged as the most promising biomarker for differentiating MDR-TB from other groups, exhibiting a clear gradient pattern. sCD14 demonstrated significant heterogeneity, particularly in TB-DM, suggesting its potential relevance in comorbid conditions. FG? showed no discriminatory value across the studied groups.
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