Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Int J Tuberc Lung Dis. 2014 Jan;18(1):73-8. doi: 10.5588/ijtld.13.0536.
Several in vitro studies have been conducted regarding the immunomodulatory and mycobactericidal roles of vitamin D in tuberculous infection. However, discrepancies exist among epidemiological studies. We compared vitamin D deficiency between patients with tuberculosis (TB) and healthy control subjects and identified risk factors for vitamin D deficiency.
This was an age- and sex-matched case-control analysis of 94 TB cohort and 282 Korean national survey participants.
The median baseline 25-hydroxyvitamin D (25[OH]D) level in the TB group (9.86 ng/ml, IQR 7.19-14.15) was lower than in controls (16.03 ng/ml, IQR 12.38-20.30, P < 0.001). The prevalence of severe vitamin D deficiency was higher in patients with TB (51.1%) than in controls (8.2%, P = 0.001). The median 25(OH)D level increased from 11.40 ng/ml (IQR 7.85-15.73) to 13.18 ng/ml (IQR 10.60-19.71) after treatment completion (P = 0.037). On multivariate analysis, presence of TB and history of TB were independently associated with severe vitamin D deficiency.
Patients with TB had a higher prevalence of vitamin D deficiency than control subjects in a Korean population. The median 25(OH)D level increased after TB treatment. Further studies are needed to establish a causal relationship.
已有多项体外研究探讨了维生素 D 在结核感染中的免疫调节和抗分枝杆菌作用。然而,流行病学研究结果存在差异。我们比较了结核患者(TB)和健康对照者之间维生素 D 缺乏的情况,并确定了维生素 D 缺乏的危险因素。
这是一项年龄和性别匹配的病例对照分析,纳入了 94 例 TB 队列患者和 282 名韩国全国调查参与者。
TB 组的中位基线 25-羟维生素 D(25[OH]D)水平(9.86ng/ml,IQR 7.19-14.15)低于对照组(16.03ng/ml,IQR 12.38-20.30,P<0.001)。TB 患者严重维生素 D 缺乏的患病率(51.1%)高于对照组(8.2%,P=0.001)。治疗完成后,25(OH)D 水平中位数从 11.40ng/ml(IQR 7.85-15.73)增加到 13.18ng/ml(IQR 10.60-19.71)(P=0.037)。多变量分析显示,TB 的存在和 TB 病史与严重维生素 D 缺乏独立相关。
在韩国人群中,TB 患者的维生素 D 缺乏患病率高于对照组。TB 治疗后 25(OH)D 水平升高。需要进一步研究以确定因果关系。