Serum nutritional-metabolic recovery during tuberculosis treatment across BMI-defined undernutrition strata: A longitudinal proteomic reanalysis

In 30 adults with pulmonary tuberculosis, a 36-protein nutritional-metabolic serum summary axis increased from week 17 onward in both baseline BMI strata, despite no BMI-dependent interaction surviving correction.

• Why it matters: Undernutrition is a modifiable risk factor in tuberculosis, but it is unclear whether baseline BMI-defined undernutrition changes the systemic serum proteomic recovery trajectory during treatment.
• What they did: The study reanalysed longitudinal tandem-mass-tag serum proteomics at baseline and weeks 8, 17, 26, and 52, integrating three treatment-responsive modules into an exploratory, nonredundant 36-protein axis and testing BMI-by-time interactions.
• The result: Inflammatory/acute-phase and metal-handling/nutritional-immunity module scores declined, while lipid/apolipoprotein-transport, nutritional-carrier, and endocrine-immunometabolic scores increased; formal BMI-by-time interaction tests were not significant, and the BMI =18.5 kg/m2 stratum showed a non-significant axis difference (difference -1.34, 95% CI -2.76 to 0.08; p = .064).

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