Serum sestrin 2 and fetuin-A are associated with early pleural involvement in patients with pulmonary tuberculosis: a cross-sectional study.

Background: Tuberculous pleuritis is the second most common extrapulmonary tuberculosis. Its prompt diagnosis and appropriate management are essential to decrease the morbidity and mortality of affected patients. We aimed to assess whether the serum sestrin 2 and fetuin-A levels can be used to diagnose early pleural involvement in patients with pulmonary tuberculosis.

Methods: We performed a cross-sectional study and enrolled patients with pulmonary tuberculosis between October 2020 and October 2022. Their demographics and clinical characteristics were recorded. The serum sestrin 2 and fetuin-A levels were detected. Early pleural involvement was determined by a chest computed tomography (CT) scan. Patients were assigned into two groups: pleural involvement versus nonpleural involvement. The characteristics of the two groups were compared. Multivariate logistic regression analysis was performed to study the relationships between the serum sestrin 2 and fetuin-A levels with pleural involvement under potential confounders. Receiver operating characteristic (ROC) curve analysis was used to examine the performance of sestrin 2 and fetuin-A determination to diagnose pleural involvement.

Results: We enrolled 136 pulmonary tuberculosis patients, with a mean age of 50.4 (±7.3) years old, including 79 (58.1%) males. There were 89 and 47 patients with or without pleural involvement, respectively. The baseline demographics and clinical characteristics were comparable between the two groups. Compared with the patients without pleural involvement, those with pleural involvement had a higher serum sestrin 2 level but a lower serum fetuin-A level (both P<0.05). Multivariate logistic regression analysis confirmed the association of serum sestrin 2 and fetuin-A levels with pleural involvement. In addition, ROC curve analyses demonstrated that sestrin 2 and fetuin-A alone had a high sensitivity, but the combination of these two measurements had the best performance to detect pleural involvement.

Conclusions: High sestrin 2 and low fetuin-A serum levels can be used to evaluate early pleural involvement in patients with pulmonary tuberculosis.