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血清 25-羟维生素 D 水平低:结核病的独立危险因素?

Low serum 25-hydroxyvitamin D level: an independent risk factor for tuberculosis?

机构信息

College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.

出版信息

Clin Nutr. 2014 Dec;33(6):1081-6. doi: 10.1016/j.clnu.2013.11.014. Epub 2013 Nov 26.

Abstract

BACKGROUND & AIMS: Vitamin D deficiency has been associated with an increased risk of tuberculosis (TB). Low serum vitamin D levels may also be associated with poor nutritional status in TB patients. Therefore, this study aimed at evaluating the association between low serum vitamin D level and TB, regardless of other nutritional factors.

METHODS

Baseline serum 25-hydroxyvitamin D (25(OH)D3) levels in TB patients were measured before treatment and 1 year after treatment onset using liquid chromatography-tandem mass spectrometry, and were compared with 25(OH)D3 levels in controls. Nutritional parameters were also measured in all subjects.

RESULTS

In total, 165 active pulmonary TB patients and 197 controls were included in the study. Significantly higher prevalence of 25(OH)D3 insufficiency (<20 ng/mL) and deficiency (<10 ng/mL) in TB patients was showed compared to controls. Serum 25(OH)D3 levels and nutritional parameters were significantly lower in untreated TB patients than in controls. One year after TB treatment onset, nutritional parameters significantly increased; however, serum 25(OH)D3 levels in TB patients showed no significant improvement compared to baseline.

CONCLUSIONS

These results suggest that a low serum 25(OH)D3 level might be a risk factor for TB, independent of nutritional status.

摘要

背景与目的

维生素 D 缺乏与结核病(TB)风险增加有关。血清维生素 D 水平低也可能与 TB 患者的营养状况不佳有关。因此,本研究旨在评估血清维生素 D 水平低与 TB 的关系,而不考虑其他营养因素。

方法

使用液相色谱-串联质谱法在治疗前和治疗开始后 1 年测量 TB 患者的基线血清 25-羟维生素 D(25(OH)D3)水平,并与对照组的 25(OH)D3 水平进行比较。所有受试者的营养参数也进行了测量。

结果

本研究共纳入 165 例活动性肺结核患者和 197 例对照。与对照组相比,TB 患者的 25(OH)D3 不足(<20ng/mL)和缺乏(<10ng/mL)发生率明显更高。未经治疗的 TB 患者的血清 25(OH)D3 水平和营养参数明显低于对照组。TB 治疗开始后 1 年,营养参数显著增加;然而,与基线相比,TB 患者的血清 25(OH)D3 水平没有显著改善。

结论

这些结果表明,低血清 25(OH)D3 水平可能是 TB 的一个危险因素,与营养状况无关。

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