CD4 and Its Relevance to Advanced Glycation End Products in Tuberculosis Patients with Co-morbidity Diabetes


  • Sry Suryani Widjaja Biochemistry Department, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
  • - Rusdiana Biochemistry Department, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
  • Maya Savira Physiology Department, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia



Diabetes, TBs, CD4, AGEs


BACKGROUND: Tuberculosis (TB) is one of the most common infectious diseases found in developing countries. One of the risk factors for TB is diabetes, a chronic metabolic disorder characterised by hyperglycemia. The altered in glucose metabolism will cause dysfunction of phagocyte and antibacterial that furthermore impaired activation of natural killer cells, dendritic cells. These together will alter the balance of T-cell immunity. Under hyperglycemic conditions, AGEs (advanced glycation end products) was increasingly formed and was believed to play a role in cell dysfunctions and diabetic complications. The CD4 deficiency will alter the immunity status in diabetes and TB with co-morbidity diabetes.

AIM: This aim of this study was to evaluate CD4, and it’s relevant to Advanced Glycation End Products (AGEs) in TB with co-morbidity diabetes.

METHODS: This is a case-control study with a total of 80 patients (40 diabetes and 40 TB with co-morbidity diabetes were recruited from Murni Teguh memorial Hospital Medan after ethical approval from Health Research Ethical Committee. The CD4, AGEs, Blood glucose and HbA1C were measured.

RESULTS: There was no statistical difference of CD4, HbA1C and blood glucose within diabetes and TB with co-morbidity diabetes but BMI (p = 0.009) and AGEs (p = 0.001) did. The CD4 below 500 were seen in 15% diabetes and 25% in TB with co-morbidity diabetes but did not show statistical significance difference (p = 0.07). No correlation was found between CD4 and AGEs in TB with co-morbidity diabetes (p = 0.44).

CONCLUSION: The CD4 was not correlated significantly with AGEs.


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Atkins RC, Zimmet P. Diabetic kidney disease: Act now or pay later. Saudi J Kidney Dus Transpl 2012; 21:217-21.

Mark A, Joshua A, Thomas FL, Francesco C. Diabetes and vascular disease: pathophysiology clinical consequences, and medical therapy: part I. Circulation. 2003. PMid:14517147

Alberti KG, Zimmet PF. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabetic medicine. 1998; 15(7):539-53.<539::AID-DIA668>3.0.CO;2-S

Dobler CC, Flack JR, Marks GB. Risk of Tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study. BMJ Open. 2012; 2:e000666. PMid:22331390 PMCid:PMC3282295

Young F, Wotton CJ, Critchley JA et al. Increased risk of Tuberculosis disease in people with diabetes mellitus: record-linkage study in a UK population. J Epidemiol Community Health. 2012; 66:519–23. PMid:21109542

Leung CC, Lam TH, Chan WM et al. Diabetic control and risk of Tuberculosis: a cohort study. Am J Epidemiol. 2008; 167:1486–94. PMid:18400769

Perez A, Brown HS III, Restrepo BI. Association between Tuberculosis and diabetes in the Mexican border and non-border regions of Texas. Am J Trop Med Hyg. 2006; 74:604–11. PMid:16606993 PMCid:PMC1464139

WHO. Global TBs Report 2013. Geneva: World Health Organisation, 2013. URL

Restrepo BI, Camerlin AJ, Rahbar MH et al. Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed Tuberculosis cases. Bull World Health Organ. 2011; 89:352–9. PMid:21556303 PMCid:PMC3089389

Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: Pathogenesis, management, and relationship to glycaemic control. Diabetes Metab Res Rev. 2007; 23:3–13. PMid:16960917

Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: Convergence of two epidemics. Lancet Infect Dis. 2009; 9:737–46.

Ruslami R, Aarniutse RE, Alisjahbana B, van der Ven AJ, van Crevel R. Implications of the global increase of diabetes for Tuberculosis control and patient care. Trop Med Int Health. 2010; 15:1289–99. PMid:20955495

Baker MA, Harries AD, Jeon CY et al. The impact of diabetes on Tuberculosis treatment outcomes: a systematic review. BMC Med. 2011; 9:81. PMid:21722362 PMCid:PMC3155828

Magee MJ, Foote M, Maggio DM et al. Diabetes mellitus and risk of all-cause mortality among patients with Tuberculosis in the state of Georgia, 2009–2012. Ann Epidemiol. 2014; 24:369–75. PMid:24613196 PMCid:PMC4011933

Kelly H, Jodie M, Tahnee Br, Brenda G, Rush C and Natkunam K. Immunological mechanisms contributing to the double burden of diabetes and intracellular bacterial infections. Immunology. 2014; 144:171-185.

Kerstin Nowotny, Tobias Jung, Annika Höhn, Daniela Weber and Tilman Grune. Advanced Glycation End Products and Oxidative Stress in Type 2 Diabetes Mellitus. Biomolecules. 2015; 5:194-222. PMid:25786107 PMCid:PMC4384119

Darrah PA, Patel DT, De Luca PM, Lindsay RW, Davey DF, Flynn BJ, Hoff ST, Andersen P, Reed SG, Morris SL, Roederer M. Multifunctional T H 1 cells define a correlate of vaccine-mediated protection against Leishmania major. Nature medicine. 2007; 13(7):843. PMid:17558415

Ciuffreda, D. et al. Polyfunctional HCV-specific T-cell responses are associated with effective control of HCV replication. Eur J Immunol. 2008; 38:2665–77. PMid:18958874

Kannanganat S, Kapogiannis BG, Ibegbu C, Chennareddi L, Goepfert P, Robinson HL, Lennox J, Amara RR. Human immunodeficiency virus type 1 controllers but not noncontrollers maintain CD4 T cells coexpressing three cytokines. Journal of virology. 2007; 81(21):12071-6. PMid:17728221 PMCid:PMC2168799

Kalsdorf B, Scriba TJ, Wood K, Day CL, Dheda K, Dawson R, Hanekom WA, Lange C, Wilkinson RJ. HIV-1 infection impairs the bronchoalveolar T-cell response to mycobacteria. American journal of respiratory and critical care medicine. 2009; 180(12):1262-70. PMid:19797156 PMCid:PMC2796736

Day CL, Abrahams DA, Lerumo L, van Rensburg EJ, Stone L, O'rie T, Pienaar B, de Kock M, Kaplan G, Mahomed H, Dheda K. Functional capacity of Mycobacterium tuberculosis-specific T cell responses in humans is associated with mycobacterial load. The Journal of Immunology. 2011:1101122.

Hull MW, Phillips P, Montaner JS. Changing global epidemiology of pulmonary manifestations of HIV/AIDS. Chest. 2008; 134(6):1287-98. PMid:19059959

Helen V, Uribarri. Advanced Glycation End Products (AGE) and Diabetes: Cause, Effect, or Both? Curr Diab Rep. 2014; 14(1):453. PMid:24292971 PMCid:PMC3903318

Ann SB. The Epidemic of Obesity and Diabetes Trends and Treatments. Tex Heart Inst J. 2011; 38(2):142–144.



How to Cite

Widjaja SS, Rusdiana -, Savira M. CD4 and Its Relevance to Advanced Glycation End Products in Tuberculosis Patients with Co-morbidity Diabetes. Open Access Maced J Med Sci [Internet]. 2018 Nov. 23 [cited 2024 Feb. 26];6(11):2115-8. Available from:



B - Clinical Sciences

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