Latent class analysis of inflammation and drug-induced liver injury phenotypes in older tuberculosis patients: associations with anxiety, depression, and insomnia.

INTRODUCTION

Anxiety, depression, and insomnia are common among older patients with tuberculosis (TB), yet their associations with inflammatory responses and drug-induced liver injury (DILI) remain insufficiently explored. This study aimed to identify distinct inflammation-DILI phenotypes in older TB patients and examine differences in anxiety, depression, and insomnia across subgroups.

METHODS

In this cross-sectional study, 251 older TB patients were evaluated. Serum inflammatory markers and liver function indicators were collected, along with standardized assessments of anxiety, depression, and insomnia. Latent class analysis (LCA) was employed to classify inflammation-DILI phenotypes, and multinomial logistic regression was used to explore associations between subgroup characteristics and mental health outcomes.

RESULTS

Three latent subgroups were identified: (1) moderate inflammation with normal liver function (83.2%), (2) mild inflammation with abnormal liver function (5.3%), and (3) severe inflammation with normal liver function (11.5%). Compared with the moderate inflammation group, the severe inflammation group exhibited significantly higher rates of anxiety, depression, and insomnia. Alcohol consumption was a significant risk factor for severe inflammation (P < 0.05), while smoking was associated with mild inflammation and abnormal liver function (P < 0.05).

CONCLUSION

Distinct inflammation-DILI phenotypes exist among older TB patients and are associated with varying psychological symptom burdens. Monitoring inflammatory markers, liver function, and mental health symptoms-especially insomnia, anxiety, and depression-may facilitate more personalized care in this vulnerable population.