Type 2 Diabetes Impacts the Efficacy of Syphilis Treatment and is a Risk Factor for Late Syphilis: A Retrospective Cohort Study

Authors

  • Yijie Tang Department of Clinical Laboratory Medicine, Shanghai Skin disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Mengxiao Wu Department of Biochemistry, School of Basic medical science, Fudan University, Shanghai, China
  • Wenwen Xu Department of Clinical Laboratory Medicine, Shanghai Skin disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Jiajie Yu Department of Clinical Laboratory Medicine, Shanghai Skin disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Dandan Yang Department of Clinical Laboratory Medicine, Shanghai Skin disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Jiaqin Zhang Department of Clinical Laboratory Medicine, Shanghai Skin disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Lingyun Shen Department of Clinical Laboratory Medicine, Shanghai Skin disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Qinghui Xie Department of Clinical Laboratory Medicine, Shanghai Skin disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Qingqiong Luo Department of Clinical Laboratory Medicine, Shanghai Skin disease Hospital, School of Medicine, Tongji University, Shanghai, China

DOI:

https://doi.org/10.2340/actadv.v105.42210

Keywords:

diabetes, syphilis, cohort study, risk

Abstract

This study examined the relationship between type 2 diabetes and late syphilis. A retrospective analysis was conducted, including 96 syphilis patients with type 2 diabetes and 122 matched non-diabetic syphilis controls. The development of late-stage syphilis and responses to initial treatment were monitored over a 2-year period. Stratified logistic regression was used to assess whether diabetes increased the risk of late syphilis. Differences in initial treatment responses between the 2 groups were evaluated using χ2 tests and Kaplan–Meier curves. The cohort study confirmed that the serological cure rate within 12 months was significantly lower in diabetic syphilis patients. Type 2 diabetes significantly impacts the efficacy of syphilis treatment and is a risk factor for late syphilis.

Downloads

Download data is not yet available.

References

Elendu C, Amaechi DC, Elendu ID, Elendu TC, Amaechi EC, Usoro EU, et al. Global perspectives on the burden of sexually transmitted diseases: a narrative review. Medicine 2024; 103: e38199.

https://doi.org/10.1097/MD.0000000000038199 DOI: https://doi.org/10.1097/MD.0000000000038199

Plagens-Rotman K, Jarząbek-Bielecka G, Merks P, Kędzia W, Czarnecka-Operacz M. Syphilis: then and now. Postepy Dermatol Alergol 2021; 38: 550–554. http://doi.org/10.5114/ada.2021.108930 DOI: https://doi.org/10.5114/ada.2021.108930

Whiting C, Schwartzman G, Khachemoune A. Syphilis in dermatology: recognition and management. Am J Clin Dermatol 2023; 24: 287–297. http://doi.org/10.1007/s40257-022-00755-3 DOI: https://doi.org/10.1007/s40257-022-00755-3

O’Byrne P, MacPherson P. Clinical updates syphilis. London: BMJ Publishing Group; 2019. http://doi.org/10.1136/bmj.l4159 DOI: https://doi.org/10.1136/bmj.l4159

Clement ME, Okeke NL, Hicks CB Treatment of syphilis: a systematic review. JAMA 2014; 312: 1905–1917. http://doi.org/10.1001/jama.2014.13259 DOI: https://doi.org/10.1001/jama.2014.13259

Workowski KA, Berman SM. Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines. Clin Infect Dis 2011; 53: S59–S63. http://doi.org/10.1093/cid/cir694 DOI: https://doi.org/10.1093/cid/cir694

Seña AC, Zhang X-H, Li T, Zheng H-P, Yang B, Yang L-G, et al. A systematic review of syphilis serological treatment outcomes in HIV-infected and HIV-uninfected persons: rethinking the significance of serological non-responsiveness and the serofast state after therapy. BMC Infect Dis 2015; 15: 1–15. http://doi.org/10.1186/s12879-015-1209-0 DOI: https://doi.org/10.1186/s12879-015-1209-0

Shah BR, Hux JE Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care 2003; 26: 510–513. http://doi.org/10.2337/diacare.26.2.510 DOI: https://doi.org/10.2337/diacare.26.2.510

Zoppini G, Fedeli U, Schievano E, Dauriz M, Targher G, Bonora E, et al. Mortality from infectious diseases in diabetes. Nutr Metab Cardiovasc Dis 2018; 28: 444–450. http://doi.org/10.1016/j.numecd.2017.12.007 DOI: https://doi.org/10.1016/j.numecd.2017.12.007

Yang T, Tong M, Xi Y, Guo X, Chen Y, Zhang Y, et al. Association between neurosyphilis and diabetes mellitus: resurgence of an old problem. J Diabetes 2014; 6: 403–408. http://doi.org/10.1111/1753-0407.12119 DOI: https://doi.org/10.1111/1753-0407.12119

Tuddenham S, Hamill MM, Ghanem KG. Diagnosis and treatment of sexually transmitted infections: a review. JAMA 2022; 327: 161–172. http://doi.org/10.1001/jama.2021.23487 DOI: https://doi.org/10.1001/jama.2021.23487

American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: standards of care in diabetes – 2024. Diabetes Care 2024; 47: S20–S42. http://doi.org/10.2337/dc24-S002 DOI: https://doi.org/10.2337/dc24-S002

Wang Q. Guidelines for diagnosis and treatment of syphilis, gonorrhea and genital chlamydia trachomatis infection (2020). Chin J Dermatol 2020; 53: 168–179. http://doi.org/10.35541/cjd.20190808 DOI: https://doi.org/10.35541/cjd.20190808

Carey IM, Critchley JA, Chaudhry UA, DeWilde S, Limb ES, Bowen L, et al. Contribution of infection to mortality in people with type 2 diabetes: a population-based cohort study using electronic records. Lancet Reg Health Eur 2025; 48: 101147. http://doi.org/10.1016/j.lanepe.2024.101147 DOI: https://doi.org/10.1016/j.lanepe.2024.101147

Mor A, Dekkers OM, Nielsen JS, Beck-Nielsen H, Sørensen HT, Thomsen RW. Impact of glycemic control on risk of infections in patients with type 2 diabetes: a population-based cohort study. Am J Epidemiol 2017; 186: 227–236. http://doi.org/10.1093/aje/kwx049 DOI: https://doi.org/10.1093/aje/kwx049

Hines A, Alavi A, Davis MD. Cutaneous manifestations of diabetes. Med Clin 2021; 105: 681–697. http://doi.org/10.1016/j.mcna.2021.04.008 DOI: https://doi.org/10.1016/j.mcna.2021.04.008

Rosenbloom J. The relation between diabetes mellitus and clinical syphilis. J Am Med Assoc 1917; 68: 1232–1234. https://jamanetwork.com/journals/jama/article-abstract/442004 DOI: https://doi.org/10.1001/jama.1917.04270040220005

Wang F, Ge H, Su X, Wang R, Zeng J, Miao J. High HbA 1c level is correlated with blood–brain barrier disruption in syphilis patients. Neurol Sci 2020; 41: 83–90.

https://doi.org/10.1007/s10072-019-04031-x DOI: https://doi.org/10.1007/s10072-019-04031-x

Li W, Luo C, Xie X, Xiao Y, Zhao F, Cai J, et al. Identification of key genes and pathways in syphilis combined with diabetes: a bioinformatics study. AMB Express 2020; 10: 1–10.

https://doi.org/10.1186/s13568-020-01009-3 DOI: https://doi.org/10.1186/s13568-020-01009-3

Luo Z, Zhu L, Ding Y, Yuan J, Li W, Wu Q, et al. Factors associated with syphilis treatment failure and reinfection: a longitudinal cohort study in Shenzhen, China. BMC Infect Dis 2017; 17: 1–5.

https://doi.org/10.1186/s12879-017-2715-z DOI: https://doi.org/10.1186/s12879-017-2715-z

Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, Lönnroth K, et al. The impact of diabetes on tuberculosis treatment outcomes: a systematic review. BMC Med 2011; 9: 1–15.

https://doi.org/10.1186/1741-7015-9-81 DOI: https://doi.org/10.1186/1741-7015-9-81

Xiao Y, Chen M-J, Shen X, Lin L-R, Liu L-L, Yang T-C, et al. Metabolic disorders in patients with central nervous system infections: associations with neurosyphilis. Eur Neurol 2019; 81: 270–277. http://doi.org/10.1159/000503626 DOI: https://doi.org/10.1159/000503626

Spiller F, Carlos D, Souto FO, De Freitas A, Soares FS, Vieira SM, et al. α1-Acid glycoprotein decreases neutrophil migration and increases susceptibility to sepsis in diabetic mice. Diabetes 2012; 61: 1584–1591. DOI: https://doi.org/10.2337/db11-0825

https://doi.org/10.2337/db11-1613. DOI: https://doi.org/10.2337/db11-1613

Kim JH, Park K, Lee SB, Kang S, Park JS, Ahn CW, et al. Relationship between natural killer cell activity and glucose control in patients with type 2 diabetes and prediabetes. J Diabetes Investig 2019; 10: 1223–1228.

https://doi.org/10.1111/jdi.13002 DOI: https://doi.org/10.1111/jdi.13002

Jagannathan-Bogdan M, McDonnell ME, Shin H, Rehman Q, Hasturk H, Apovian CM, et al. Elevated proinflammatory cytokine production by a skewed T cell compartment requires monocytes and promotes inflammation in type 2 diabetes. J Immunol 2011; 186: 1162–1172.

https://doi.org/10.4049/jimmunol.1002615 DOI: https://doi.org/10.4049/jimmunol.1002615

Carlson JA, Dabiri G, Cribier B, Sell S. The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity. Am J Dermatopathol 2011; 33: 433–460.

https://doi.org/10.1097/DAD.0b013e3181e8b587 DOI: https://doi.org/10.1097/DAD.0b013e3181e8b587

Shook JC, Genito CJ, Darwitz BP, Tyson KJ, Velez AZ, Bridwell SK, et al. Diabetes potentiates the emergence and expansion of antibiotic resistance. Sci Adv 2025; 11: eads1591.

https://doi.org/10.1126/sciadv.ads1591 DOI: https://doi.org/10.1126/sciadv.ads1591

Watanabe M, Balena A, Masi D, Tozzi R, Risi R, Caputi A, et al. Rapid weight loss, central obesity improvement and blood glucose reduction are associated with a stronger adaptive immune response following COVID-19 mRNA vaccine. Vaccines 2022; 10: 79.

https://doi.org/10.3390/vaccines10010079 DOI: https://doi.org/10.3390/vaccines10010079

Seidelman JL, Mantyh CR, Anderson DJ. Surgical site infection prevention: a review. JAMA 2023; 329: 244–52.

https://doi.org/10.1001/jama.2022.24075 DOI: https://doi.org/10.1001/jama.2022.24075

Ma J, Zhao X, Su Q, Dang W, Zhang X, Yuan X, et al. Effect of early intensive insulin therapy on immune function of aged patients with severe trauma. J Huazhong Univ Sci Technolog Med Sci 2012; 32: 400–404.

https://doi.org/10.1007/s11596-012-0069-8 DOI: https://doi.org/10.1007/s11596-012-0069-8

Downloads

Additional Files

Published

2025-04-08

How to Cite

Tang, Y., Wu, M., Xu, W., Yu, J., Yang, D., Zhang, J., … Luo, Q. (2025). Type 2 Diabetes Impacts the Efficacy of Syphilis Treatment and is a Risk Factor for Late Syphilis: A Retrospective Cohort Study. Acta Dermato-Venereologica, 105, adv42210. https://doi.org/10.2340/actadv.v105.42210

Issue

Vol. 105 (2025)

Section

Articles

Categories

License

Copyright (c) 2025 Yijie Tang, Mengxiao Wu, Wenwen Xu, Jiajie Yu, Dandan Yang, Jiaqin Zhang, Lingyun Shen, Qinghui Xie, Qingqiong Luo

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.

Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.

Crossref
Scopus
Google Scholar
Europe PMC