The association of oxidized abnormal lipids oxLDL and oxHDL with comorbidity of type 2 diabetes and pulmonary tuberculosis

Objectives Dyslipidemia has been shown to have a significant impact on type 2 diabetes mellitus (T2DM), atherosclerosis, and pulmonary tuberculosis (PTB), the pathological mechanisms underlying abnormal lipid profiles of these three disease categories remain unclear. This study aims to investigate the correlation between oxidized lipoproteins, specifically oxidized low-density lipoprotein (oxLDL) and oxidized high-density lipoprotein (oxHDL), and the comorbidity of T2DM and PTB（T2DM+PTB. Methods A total of 360 cases were prospectively included from June 2022 to June 2023, including 60 cases of the simple hyperlipidemia group, 100 cases of the PTB group, 100 cases of the T2DM group, and 100 cases of the T2DM+PTB group from the outpatient department of our center. Among them, the PTB group, T2DM group, and T2DM+PTB group were further divided into subgroups of normal blood lipids (40 cases) and hyperlipidemia (60 cases). Sixty healthy individuals were included as the control group. The age range of the participants was 35 to 70 years old. Venous blood was collected from each group to detect HbA1c, INS, FSG, CHOL, TG, HDL, LDL, ApoA I, and Apo B, and oxLDL levels were measured using ELISA. The differences in levels between groups were compared. Multivariate logistic regression analysis assessed the association between oxLDL and oxHDL levels with PTB and T2DM+PTB. Results Patients with T2DM hyperlipidemia subgroup and T2DM+PTB hyperlipidemia subgroup showed oxLDL levels more than twice as high and oxHDL levels more than four times higher than those in the control group. A simple hyperlipidemia group also exhibited oxLDL levels significantly higher than the control group. Correlation analysis revealed significant positive linear correlations between TG and LDL with oxLDL in both subgroups, while CHOL and LDL showed significant positive correlations with oxLDL in the PTB hyperlipidemia subgroup. TG levels were significantly positively correlated with oxHDL in all three hyperlipidemia subgroups. Multivariate logistic regression analysis revealed oxLDL levels exceeding twice those of the control group to be independent risk factors for PTB and T2DM+PTB, while oxHDL levels exceeding four times those of the control group were independent risk factors for PTB. Conclusion There are higher levels of oxLDL and oxHDL which may increase the risk of having both T2DM and PTB. It is suggested that we should clinically evaluate the significance of oxLDL levels that are more than twice the levels of the control group and oxHDL levels that are more than four times the levels of the control group. This will help us identify a threshold that can be used for further assessment of a pathological condition.