Weight gain during TB treatment linked to higher post-TB metabolic risk

Tuberculosis (TB) is an infectious disease that people often think of in terms of lungs and antibiotics, but growing evidence links surviving TB to later health problems like heart disease and diabetes. Yet researchers have paid less attention to what happens to a person’s body weight during TB treatment and how that change might affect health after treatment ends. To examine this, a team led by Argita D. Salindri followed a group of people in Tbilisi, Georgia, from 2019 to 2022 who had been successfully treated for pulmonary TB. The study enrolled 120 HIV-negative participants aged 16 and older with newly diagnosed, laboratory-confirmed pulmonary TB. The researchers focused on how participants’ body mass index (BMI) changed from the start to the completion of TB treatment and then tracked cardiometabolic health at the end of treatment and again at 6 and 12 months after treatment. By following people over time, the study aimed to connect changes in weight during treatment with later signs of metabolic trouble.

The key exposure in the study was the relative change in BMI during TB treatment, split into two groups using a cutoff of a 5% or greater relative increase versus less than a 5% relative increase. The main outcome was the prevalence of post-TB metabolic syndrome, defined as having three or more of these findings: elevated blood pressure, elevated triglycerides, low high-density lipoprotein (HDL), elevated glycated hemoglobin (HbA1c), and abdominal obesity. Participants were assessed at the end of treatment and at 6- and 12-month visits. The team used multilevel statistical models to estimate how BMI change related to post-TB metabolic syndrome. Among the 120 participants, those who gained at least 5% of their BMI during treatment had an adjusted risk of metabolic syndrome that was 2.07 times the risk of those with less than 5% BMI increase (95% confidence interval 1.07 to 4.01). In addition, the adjusted average post-TB HbA1c was 0.37 percentage points higher (95% CI 0.03 to 0.71) among the group with ≥5% BMI increase.

These findings suggest that weight gain during the course of TB treatment may influence the risk of developing cardiometabolic problems after treatment ends. If gaining weight while recovering from TB raises the chance of meeting criteria for metabolic syndrome, it could help explain why some TB survivors face higher rates of heart disease and diabetes later on. The study highlights specific measures to watch for after TB treatment — blood pressure, triglycerides, HDL, HbA1c, and waist size — because having three or more abnormalities in these areas defined metabolic syndrome in this work. The results do not show that weight gain is the only cause, but they do point to a potentially important link that clinicians, patients, and public health programs may want to consider when planning follow-up care. Further study will be needed to understand how to balance the benefits of nutritional recovery during TB treatment with possible longer-term cardiometabolic risks, and whether targeted monitoring or interventions after treatment could reduce those risks.