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Mamadapur VK, Nagaraju S, Prabhu MM. Comparative Study of Vitamin D Levels in Newly Diagnosed Tuberculosis and a Normal Population. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:685. [PMID: 38792867 PMCID: PMC11122980 DOI: 10.3390/medicina60050685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Tuberculosis (TB) is an ancient disease caused by Mycobacterium tuberculosis, a member of the Mycobacterium tuberculosis complex. It contributes to significant morbidity and mortality. Treatment of TB poses a considerable challenge because of emerging drug resistance and the longer duration of therapy. Various past studies, both in vitro and in vivo, have established the role of vitamin D in the pathogenesis and treatment of TB. Results of in vivo studies are inconsistent, and this study aims to determine vitamin D levels and their association with newly diagnosed TB (pulmonary and extrapulmonary) cases and normal populations. Material and Methods: A Prospective Case-Control study with 116 subjects (58 cases and 58 controls) was conducted over two years. 29 cases of pulmonary TB and 29 cases of extrapulmonary TB constituted 58 cases of TB. Vitamin D levels were measured and compared in both the cases and controls. Data analysis was carried out using SPSS software 22.0. Results: The prevalence of vitamin D deficiency was 68.96% in the cases, while it was 51.72% in the controls. The reported median and quartile of serum vitamin D levels were 14.35 ng/mL (8.65, 25.48) in the TB group and 19.08 ng/mL (13.92, 26.17) in the control group. There was a significant statistical difference between the TB and non-TB populations with a p-value of 0.029 on the Mann-Whitney test. Conclusion: Vitamin D deficiency was more prevalent in individuals with TB than those without TB.
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Affiliation(s)
| | - Shreesha Nagaraju
- Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
| | - Mukhyaprana M. Prabhu
- Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
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Cai L, Hou S, Huang Y, Liu S, Huang X, Yin X, Jiang N, Tong Y. The Potential Role of Vitamin D in the Development of Tuberculosis in Chinese Han Population: One Case-Control Study. Front Med (Lausanne) 2022; 9:849651. [PMID: 35957850 PMCID: PMC9358990 DOI: 10.3389/fmed.2022.849651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aims:Spinal serum 25-hydroxyvitamin D [25[OH]D] status plays an important role in mediating innate immune responses by acting as a cofactor for induction of antimycobacterial activity and is thus involved in the development of Tuberculosis (TB). Results reported regarding the association of vitamin D with TB remained controversial. We aimed to identify any common association between 25[OH]D status and TB in the Chinese Han population.Methods280 subjects (70 TB patients and 210 matched controls) were recruited. TB cases were diagnosed based on the presence of acid-fast bacilli on smears from sputum and MTB isolation. Healthy controls were randomly selected from four local community-based populations. 25[OH]D was detected by electrochemiluminescence immunoassay (ECLIA) on Roche Elecsys before the initial treatment. Multivariable logistic regression analysis was used to examine the association of Vitamin D with TB.ResultsThere was no significant difference in the serum vitamin D level between total cases and controls, but we found a strong tendency toward a higher serum vitamin D level in male population (P < 0.05) with TB but not in females. High serum vitamin D increased the risk of TB in the Chinese Han population (OR = 1.035, 95%CI: 1.001–1.070, P < 0.05). The serum vitamin D level was significantly decreased with age increasing in cases and controls (all P < 0.001).ConclusionsHigh serum vitamin D may be an independent risk factor for TB in the Chinese Han population.
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Affiliation(s)
- Li Cai
- Wuhan Center for Disease Control and Prevention, Wuhan, China
- School of Public Health, Wuhan University, Wuhan, China
| | - Shuangyi Hou
- Center for Disease Control and Prevention, Wuhan, China
| | - Yadong Huang
- Center for Disease Control and Prevention, Wuhan, China
| | - Shuang Liu
- Center for Disease Control and Prevention, Wuhan, China
| | - Xibao Huang
- Center for Disease Control and Prevention, Wuhan, China
| | - Xiaoxv Yin
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Nan Jiang
| | - Yeqing Tong
- Center for Disease Control and Prevention, Wuhan, China
- *Correspondence: Yeqing Tong
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Impact of Vitamin D in Prophylaxis and Treatment in Tuberculosis Patients. Int J Mol Sci 2022; 23:ijms23073860. [PMID: 35409219 PMCID: PMC8999210 DOI: 10.3390/ijms23073860] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
Vitamin D plays a crucial role in many infectious diseases, such as tuberculosis (TB), that remains one of the world’s top infectious killers with 1.5 million deaths from TB in 2021. Vitamin D suppresses the replication of Mycobacterium tuberculosis in vitro and showed a promising role in TB management as a result of its connection with oxidative balance. Our review encourages the possible in vivo benefit of a joint administration with other vitamins, such as vitamin A, which share a known antimycobacterial action with vitamin D. However, considering the low incidence of side effects even at high dosages and its low cost, it would be advisable to assess vitamin D level both in patients with active TB and high-risk groups and administer it, at least to reach sufficiency levels.
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Acen EL, Biraro IA, Bbuye M, Kateete DP, Joloba ML, Worodria W. Hypovitaminosis D among newly diagnosed pulmonary TB patients and their household contacts in Uganda. Sci Rep 2022; 12:5296. [PMID: 35351933 PMCID: PMC8964708 DOI: 10.1038/s41598-022-09375-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/22/2022] [Indexed: 11/29/2022] Open
Abstract
An estimated one billion people globally live with hypovitaminosis D. Studies have indicated that vitamin D deficiency is a risk factor for active tuberculosis (TB) disease. The aim of this study was to determine the association between vitamin D deficiency and TB status among patients with active TB, latent TB infection (LTBI) and those without TB infection. In a cross-sectional study of active TB patients, LTBI, QuantiFERON GOLD testpositive and (QFN+TST+) household contact and controls QuantiFERON GOLD testnegative (QFN-TST-) samples vitamin D levels were compared. Vitamin D status was determined by measurement of total vitamin D levels with 56 samples of active TB patients, 17 with LTBI, and 22 without TB infection using electrochemiluminescence. The median interquartile range (IQR) age of the study participants was 28 (20-35) years, and the majority (63%) were females. The median (IQR) vitamin D levels were 18 ng/ml (14-24). All groups had vitamin D hypovitaminosis with significantly lower levels among active TB patients (17 ng/ml, 13, 2) than among LTBI individuals (23 ng/ml 16-29) and those without TB infection (22 ng/ml, 17-28).
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Affiliation(s)
- Ester Lilian Acen
- Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Irene Andia Biraro
- Department of Internal Medicine, School of Medicine, College of Health Sciences Unit Makerere University, Kampala, Uganda
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Mudarshiru Bbuye
- Makerere Lung Institute College of Health Sciences Makerere University, Kampala, Uganda
| | - David Patrick Kateete
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses L Joloba
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - William Worodria
- Pulmonary Division, Department of Medicine, Mulago National Referral Hospital, Kampala, Uganda
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Patti G, Pellegrino C, Ricciardi A, Novara R, Cotugno S, Papagni R, Guido G, Totaro V, De Iaco G, Romanelli F, Stolfa S, Minardi ML, Ronga L, Fato I, Lattanzio R, Bavaro DF, Gualano G, Sarmati L, Saracino A, Palmieri F, Di Gennaro F. Potential Role of Vitamins A, B, C, D and E in TB Treatment and Prevention: A Narrative Review. Antibiotics (Basel) 2021; 10:1354. [PMID: 34827292 PMCID: PMC8614960 DOI: 10.3390/antibiotics10111354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 10/31/2021] [Accepted: 11/04/2021] [Indexed: 12/26/2022] Open
Abstract
(1) Background: Tuberculosis (TB) is one of the world's top infectious killers, in fact every year 10 million people fall ill with TB and 1.5 million people die from TB. Vitamins have an important role in vital functions, due to their anti-oxidant, pro-oxidant, anti-inflammatory effects and to metabolic functions. The aim of this review is to discuss and summarize the evidence and still open questions regarding vitamin supplementation as a prophylactic measure in those who are at high risk of Mycobacterium tuberculosis (MTB) infection and active TB; (2) Methods: We conducted a search on PubMed, Scopus, Google Scholar, EMBASE, Cochrane Library and WHO websites starting from March 1950 to September 2021, in order to identify articles discussing the role of Vitamins A, B, C, D and E and Tuberculosis; (3) Results: Supplementation with multiple micronutrients (including zinc) rather than vitamin A alone may be more beneficial in TB. The WHO recommend Pyridoxine (vitamin B6) when high-dose isoniazid is administered. High concentrations of vitamin C sterilize drug-susceptible, MDR and extensively drug-resistant MTB cultures and prevent the emergence of drug persisters; Vitamin D suppresses the replication of mycobacterium in vitro while VE showed a promising role in TB management as a result of its connection with oxidative balance; (4) Conclusions: Our review suggests and encourages the use of vitamins in TB patients. In fact, their use may improve outcomes by helping both nutritionally and by interacting directly and/or indirectly with MTB. Several and more comprehensive trials are needed to reinforce these suggestions.
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Affiliation(s)
- Giulia Patti
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Carmen Pellegrino
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Aurelia Ricciardi
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Roberta Novara
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Sergio Cotugno
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Roberta Papagni
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Giacomo Guido
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Valentina Totaro
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Giuseppina De Iaco
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Federica Romanelli
- Microbiology and Virology Unit, University of Bari, University Hospital Policlinico, 70124 Bari, Italy; (F.R.); (S.S.); (L.R.)
| | - Stefania Stolfa
- Microbiology and Virology Unit, University of Bari, University Hospital Policlinico, 70124 Bari, Italy; (F.R.); (S.S.); (L.R.)
| | - Maria Letizia Minardi
- Infectious Diseases Clinic, University Hospital “Tor Vergata”, Department of Systems Medicine, University of Rome Tor Vergata, 00173 Rome, Italy; (M.L.M.); (I.F.); (L.S.)
| | - Luigi Ronga
- Microbiology and Virology Unit, University of Bari, University Hospital Policlinico, 70124 Bari, Italy; (F.R.); (S.S.); (L.R.)
| | - Ilenia Fato
- Infectious Diseases Clinic, University Hospital “Tor Vergata”, Department of Systems Medicine, University of Rome Tor Vergata, 00173 Rome, Italy; (M.L.M.); (I.F.); (L.S.)
| | - Rossana Lattanzio
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Davide Fiore Bavaro
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Gina Gualano
- National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00161 Rome, Italy;
| | - Loredana Sarmati
- Infectious Diseases Clinic, University Hospital “Tor Vergata”, Department of Systems Medicine, University of Rome Tor Vergata, 00173 Rome, Italy; (M.L.M.); (I.F.); (L.S.)
| | - Annalisa Saracino
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
| | - Fabrizio Palmieri
- National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00161 Rome, Italy;
| | - Francesco Di Gennaro
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy; (G.P.); (C.P.); (A.R.); (R.N.); (S.C.); (R.P.); (G.G.); (V.T.); (G.D.I.); (R.L.); (D.F.B.); (A.S.); (F.D.G.)
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Kafle S, Basnet AK, Karki K, Thapa Magar M, Shrestha S, Yadav RS. Association of Vitamin D Deficiency With Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis. Cureus 2021; 13:e17883. [PMID: 34660082 PMCID: PMC8504877 DOI: 10.7759/cureus.17883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 11/29/2022] Open
Abstract
Pulmonary tuberculosis, caused by Mycobacterium tuberculosis, is a significant public health issue, especially in developing countries, affecting millions of people every year. Despite the development of many antitubercular antibiotics and increased awareness of preventive methods, it is still a major cause of mortality worldwide. Vitamin D, a micronutrient known to have a major role in bone and calcium metabolism, has also shown its immunomodulatory effects to suppress mycobacterial growth. We conducted a systematic review and meta-analysis of the available evidence to explore the association between vitamin D levels and tuberculosis. We performed a systematic search for articles from inception to May 2021 in multiple databases. We included 26 studies in our qualitative synthesis and 12 studies in meta-analysis or quantitative synthesis. In our meta-analysis, we used a random-effect model to calculate the odds ratio (OR) of vitamin D deficiency in tuberculosis patients compared to the healthy controls. On pooled analysis, we found that the odds of the participants having vitamin D deficiency was 3.23 times more in tuberculosis patients compared to the healthy group (OR=3.23, CI = 1.91-5.45, p<0.0001). Thus, we concluded that there is an association between low levels of vitamin D and tuberculosis infections. We suggest conducting long-term prospective cohort studies in tuberculosis endemic countries to better understand the causal relationship between vitamin D deficiency and tuberculosis.
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Affiliation(s)
- Sunam Kafle
- Internal Medicine, College of Medical Sciences, Bharatpur, NPL
| | | | - Kumar Karki
- Internal Medicine, National Medical College, Birgunj, NPL
| | | | - Shumneva Shrestha
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, NPL
| | - Randhir S Yadav
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, NPL
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Gadallah D, Sedky A, Esmaeel HM. Vitamin D among Patients of Pulmonary and Extrapulmonary Tuberculosis: A Prospective Case-control Study. CURRENT RESPIRATORY MEDICINE REVIEWS 2020. [DOI: 10.2174/1573398x16999200626160349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Vitamin D has an essential role in enhancing the immune system to fight
and destroy bacteria. People with vitamin D deficiency are highly liable to develop active pulmonary
and extrapulmonary tuberculosis.
Objective:
: To evaluate the serum level of vitamin D among patients with pulmonary and
extrapulmonary tuberculosis.
Patients and Methods:
A case-control prospective study was conducted among patients with
pulmonary and extrapulmonary tuberculosis and asymptomatic persons (controls). The study
included 80 participants, 50 were TB patients, while 30 were controls. Vitamin D 1, 25(OH) assay
was done for all.
Results:
Vitamin D assay of the included subjects revealed that 52 patients were vitamin D deficient,
7 patients had insufficient vitamin D and 21 had normal serum levels. Of the extrapulmonary TB
patients, 35 (100%) had vitamin D deficiency, in pulmonary TB patients, 15 (100%) were vitamin D
deficient. While 2 study subjects (6.7%) in the control group were deficient of vitamin D, 7 (23.3%)
had insufficient vitamin D and 21cases had normal vitamin D levels. There was a statistically
significant relationship between pulmonary and extrapulmonary TB cases and vitamin D deficiency
(P< 0.001).
Conclusion:
Vitamin D deficiency was found among pulmonary and extrapulmonary tuberculosis
patients especially among female patients and patients in rural residence. The current study needs
additional work to evaluate the value of adding vitamin D to the TB treatment regimen.
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Affiliation(s)
- Doaa Gadallah
- Department of Chest Diseases, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ahmed Sedky
- Department of Clinical Pathology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hend Mohamed Esmaeel
- Department of Chest Diseases, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
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