Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Thanh Thai Street, District 10, Ho Chi Minh City, Vietnam.
BMC Infect Dis. 2010 Oct 25;10:306. doi: 10.1186/1471-2334-10-306.
Recent in vitro evidence suggests a link between vitamin D status and the risk of tuberculosis (TB). This study sought to examine the association between vitamin D status, parathyroid hormone (PTH) and the risk of TB in a Vietnamese population.
The study was designed as a matched case-control study, which involved 166 TB patients (113 men and 53 women), who were age-and-sex matched with 219 controls (113 men and 106 women). The average age of men and women was 49 and 50, respectively. TB was diagnosed by the presence of acid-fast bacilli on smears from sputum, and the isolation of M. tuberculosis. All patients were hospitalized for treatment in a TB specialist hospital. Controls were randomly drawn from the general community within the Ho Chi Minh, Vietnam. 25-hydroxyvitamin D [25(OH)D] and PTH was measured prior to treatment by an electrochemiluminescence immunoassay (ECLIA) on a Roche Elecsys. A serum level of 25(OH)D below 30 ng/mL was deemed to be vitamin D insufficient.
The prevalence of vitamin D insufficiency was 35.4% in men with TB and 19.5% in controls (P = 0.01). In women, there were no significant differences in serum 25(OH)D and serum PTH levels between TB patients and controls. The prevalence of vitamin D insufficiency in women with TB (45.3%) was not significantly different from those without TB (47.6%; P = 0.91). However, in both genders, serum calcium levels in TB patients were significantly lower than in non-TB individuals. Smoking (odds ratio [OR] 1.25; 95% confidence interval [CI] 1.10 - 14.7), reduced 25(OH)D (OR per standard deviation [SD]: 1.14; 95% CI 1.07 - 10.7) and increased PTH (OR per SD 1.13; 95% CI 1.05 - 10.4) were independently associated with increased risk of TB in men.
These results suggest that vitamin D insufficiency was a risk factor for tuberculosis in men, but not in women. However, it remains to be established whether the association is a causal relationship.
最近的体外证据表明，维生素 D 状态与结核病（TB）风险之间存在关联。本研究旨在研究越南人群中维生素 D 状态、甲状旁腺激素（PTH）与结核病风险之间的关系。
本研究设计为匹配病例对照研究，纳入 166 例结核病患者（113 名男性和 53 名女性），并按年龄和性别与 219 名对照（113 名男性和 106 名女性）匹配。男性和女性的平均年龄分别为 49 岁和 50 岁。通过痰涂片抗酸杆菌检查和结核分枝杆菌分离培养诊断结核病。所有患者均在结核病专科医院住院治疗。对照者随机从越南胡志明市的普通社区中抽取。采用罗氏 Elecsys 电化学发光免疫分析法（ECLIA）检测治疗前的 25-羟维生素 D [25(OH)D] 和 PTH。血清 25(OH)D 水平<30ng/mL 被认为是维生素 D 不足。
男性结核病患者维生素 D 不足的患病率为 35.4%，对照组为 19.5%（P=0.01）。女性结核病患者与对照组之间血清 25(OH)D 和血清 PTH 水平无显著差异。女性结核病患者维生素 D 不足的患病率（45.3%）与无结核病患者（47.6%）无显著差异（P=0.91）。然而，在两性中，结核病患者的血清钙水平均显著低于非结核病患者。吸烟（比值比[OR]1.25；95%置信区间[CI]1.10-14.7）、25(OH)D 减少（OR 每标准差[SD]：1.14；95% CI 1.07-10.7）和 PTH 增加（OR 每 SD 1.13；95% CI 1.05-10.4）均与男性结核病风险增加独立相关。
这些结果表明，维生素 D 不足是男性结核病的危险因素，但不是女性。然而，尚需确定这种关联是否存在因果关系。
