Department of Medicine.
Department of Microbiology.
Int J Tuberc Lung Dis. 2018 Jan 1;22(1):93-99. doi: 10.5588/ijtld.17.0304.
Data on vitamin D deficiency in tuberculous meningitis (TBM) and its relationship with treatment outcomes are limited. Some of the beneficial effects of vitamin D might be mediated through interleukin-1β (IL-1β).
To assess the frequency of vitamin D deficiency among TBM patients, its association with treatment outcomes and correlation between vitamin D and IL-1β levels in cerebrospinal fluid (CSF).
We prospectively studied a consecutive sample of human immunodeficiency virus-negative patients with TBM treated at a hospital in southern India. We defined good outcome as survival without severe neurological disability. Serum total 25-hydroxy vitamin D (25[OH]D) and IL-1β levels in CSF were estimated on pretreatment samples.
We studied 40 patients with TBM; 22 (55%) patients had stage 3 disease. Treatment outcome was poor in 21 (53%) patients: 15 (38%) patients died and 6 (15%) had severe neurological disability. The overall mean serum 25(OH)D level was 32.30 ± 16.38 ng/ml. Ten (25%) patients had vitamin D deficiency (<20 ng/ml), and 12 (30%) patients had vitamin D insufficiency (20-30 ng/ml). However, pretreatment serum 25(OH)D levels did not differ significantly by outcome (good vs. poor outcome: 28.30 ± 14.96 vs. 35.92 ± 17.11 ng/ml, P = 0.141). Moreover, IL-1β levels in CSF did not correlate with serum 25(OH)D levels (Spearman's ρ 0.083, P = 0.609).
Vitamin D deficiency/insufficiency is common among patients with TBM. However, serum 25(OH)D levels are not associated with IL-1β levels in CSF or treatment outcome.
有关结核性脑膜炎（TBM）患者维生素 D 缺乏及其与治疗结果的关系的数据有限。维生素 D 的一些有益作用可能是通过白细胞介素-1β（IL-1β）介导的。
评估 TBM 患者维生素 D 缺乏的频率，及其与治疗结果的关系以及脑脊液（CSF）中维生素 D 与 IL-1β 水平之间的相关性。
我们前瞻性研究了在印度南部一家医院接受治疗的人类免疫缺陷病毒阴性 TBM 连续患者样本。我们将无严重神经功能障碍的生存定义为良好的预后。在治疗前样本中估计血清总 25-羟维生素 D（25[OH]D）和 CSF 中的 IL-1β 水平。
我们研究了 40 例 TBM 患者；22 例（55%）患者患有 3 期疾病。21 例（53%）患者的治疗结果不佳：15 例（38%）患者死亡，6 例（15%）患者有严重神经功能障碍。总体平均血清 25（OH）D 水平为 32.30 ± 16.38ng/ml。10 例（25%）患者存在维生素 D 缺乏症（<20ng/ml），12 例（30%）患者存在维生素 D 不足（20-30ng/ml）。然而，治疗前血清 25（OH）D 水平在结局上无显著差异（良好结局与不良结局：28.30 ± 14.96 vs. 35.92 ± 17.11ng/ml，P=0.141）。此外，CSF 中的 IL-1β 水平与血清 25（OH）D 水平不相关（Spearman's ρ 0.083，P=0.609）。
TBM 患者中维生素 D 缺乏/不足很常见。然而，血清 25（OH）D 水平与 CSF 中的 IL-1β 水平或治疗结果无关。
