Zhang Ye, Zhu Hui, Yang Xinting, Guo Shaochen, Liang Qingtao, Lu Yu, Chen Xiaoyou
Beijing Key Laboratory of Drug Resistance Tuberculosis Research, Beijing Chest Hospital, Capital Medical University Beijing Tuberculosis and Thoracic Tumor Research Institute Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2018 Jul;97(30):e11732. doi: 10.1097/MD.0000000000011732.
Vitamin D is associated with the susceptibility of tuberculosis and might have an adjunctive effect on anti-tuberculosis treatment. This study aims to investigate the association of vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms with susceptibility and severity to multidrug-resistant tuberculosis (MDR-TB) in comparison with drug-sensitive tuberculosis (DS-TB) and health controls in China.A total of 180 patients with pulmonary TB (128 DS-TB, 52 MDR-TB) and 59 healthy controls were enrolled into 3 groups. Vitamin D levels and VDR genotypes at FokI, BsmI, ApaI, and TaqI sites of all the participants and clinical characteristics of patients with TB were measured and collected.Statistical analysis revealed that vitamin D levels were lower in both TB groups. Patients with TB with bilateral lesions and patients with MDR-TB with extrapulmonary TB had lower vitamin D levels. The frequencies of ff genotype and f allele were higher in both TB groups. Patients with Ff genotype and ff genotype had lower proportion of extrapulmonary TB. Patients with ff genotype had higher proportion of retreatment. Male patients with ff genotype had higher proportion of cavity formation. Patients with DS-TB with AA genotype had higher proportion of cavity formation.Our findings demonstrate that vitamin D deficiency and ff genotype may be the risk factors of TB in Chinese population. In addition, patients with TB with lower level of vitamin D may have a greater risk of bilateral lesions and extrapulmonary TB. VDR genotypes may be associated with TB clinical characteristics.
维生素D与结核病易感性相关,可能对抗结核治疗有辅助作用。本研究旨在比较中国耐多药结核病(MDR-TB)与药物敏感结核病(DS-TB)及健康对照,探讨维生素D缺乏和维生素D受体(VDR)基因多态性与MDR-TB易感性及严重程度的关系。共180例肺结核患者(128例DS-TB,52例MDR-TB)和59名健康对照被纳入3组。检测并收集了所有参与者FokI、BsmI、ApaI和TaqI位点的维生素D水平、VDR基因型以及结核病患者的临床特征。统计分析显示,两个结核病组的维生素D水平均较低。双侧病变的结核病患者和合并肺外结核的MDR-TB患者维生素D水平较低。两个结核病组中ff基因型和f等位基因的频率均较高。Ff基因型和ff基因型患者肺外结核比例较低。ff基因型患者复治比例较高。ff基因型男性患者空洞形成比例较高。AA基因型的DS-TB患者空洞形成比例较高。我们的研究结果表明,维生素D缺乏和ff基因型可能是中国人群结核病的危险因素。此外,维生素D水平较低的结核病患者双侧病变和肺外结核的风险可能更大。VDR基因型可能与结核病临床特征有关。