Purpose: Due to similar clinical, radiological, and pathological features, distinguishing tuberculosis (TB) from sarcoidosis can be challenging. We aimed to assess the significance of lipid levels and the triglyceride-glucose (TyG) index in differentiating TB from sarcoidosis.Methods: This retrospective observational study included 265 patients with newly diagnosed TB and 270 patients with sarcoidosis. Demographics and baseline levels of serum glucose, triglycerides (TG), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very-low-density lipoprotein (VLDL) were recorded. TyG indices were calculated separately. Data were compared between the TB and sarcoidosis groups using Chi-square and Student’s t-tests, and significant variables were assessed by logistic regression analysis. Discriminative ability was evaluated using receiver operating characteristic (ROC) analysis.Results: Males and younger individuals were more prevalent in TB (62% vs. 28%, p < 0.0001; 45.2 ± 17.1 vs. 48.8 ± 11.2 years, p = 0.004). Additionally, TG, total cholesterol, HDL, LDL, VLDL, and TyG index were significantly lower in the TB group (p < 0.0001 for all except HDL, where p = 0.001). Male sex, TG level, and TyG index were independent predictors for TB in logistic regression analysis. A cut-off value of 92.5 mg/dl for TG level predicted TB with 58% sensitivity and 80% specificity (AUC = 0.309, 95% CI 0.265-0.354). A cut-off value of 4.52 mg/dl for the TyG index predicted TB with 57% sensitivity and 80% specificity (AUC = 0.309, 95% CI = 0.265-0.354).Conclusion: TG level and TyG index appear to be hypothesis-generating biomarkers that may help explain metabolic differences between TB and sarcoidosis, rather than standalone diagnostic tools. Further prospective studies are warranted to clarify their potential adjunctive roles.
Abalı et al. (Tue,) studied this question.