Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, 576104, Manipal, Karnataka, India.
Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, 576104, Manipal, Karnataka, India.
Pulm Med. 2021 Jan 15;2021:5285841. doi: 10.1155/2021/5285841. eCollection 2021.
Vitamin D has a significant role in host immune defense against Mycobacterium tuberculosis. It has been suggested that pulmonary tuberculosis may be associated with lower levels of vitamin D. Present study was therefore undertaken to identify the association between vitamin D deficiency and pulmonary tuberculosis.
A case-control study was conducted in a tertiary care hospital from 2014 to 2016, including 50 adult newly diagnosed sputum positive pulmonary tuberculosis patients as cases and 50 age and sex-matched healthy participants as control groups. All participants in the study group had undergone detailed clinical examination and routine laboratory investigations, including vitamin D, calcium, and sputum for AFB. The clinical characteristics, X-ray findings, sputum AFB, and vitamin D levels were analyzed and compared with data obtained from healthy controls.
In both groups, the majority were men (88%). BMI was significantly (<0.0001∗) lower in the tuberculosis group (19.40 (17.20, 22.0) vs. 24.00 (22.50, 25.47)). Serum vitamin D levels were significantly lower ( = 0.012) in the tuberculosis group (19 (7.75, 27.25) ng/dl) as compared to the control group (25 (19.75, 32.00) ng/dl). Out of 50 TB patients, 27 (54%) had vitamin D deficiency, while among healthy controls, only 13 (26%) had vitamin D deficiency. Among vitamin D deficient PTB patients, 44% had 3+/hpf AFB in sputum smear examination.
The prevalence of vitamin D deficiency in pulmonary tuberculosis cases is very high. Hypovitaminosis D was associated with more severe clinical symptoms, higher sputum smear positivity, and extensive lesions in chest radiograph among pulmonary tuberculosis patients.
维生素 D 在宿主对结核分枝杆菌的免疫防御中具有重要作用。有研究表明,肺结核可能与维生素 D 水平较低有关。因此,本研究旨在确定维生素 D 缺乏与肺结核之间的关系。
本病例对照研究于 2014 年至 2016 年在一家三级医院进行,包括 50 例新诊断的痰阳性肺结核患者作为病例组和 50 名年龄和性别匹配的健康参与者作为对照组。所有研究组的参与者都接受了详细的临床检查和常规实验室检查,包括维生素 D、钙和痰 AFB。分析并比较了临床特征、X 线表现、痰 AFB 和维生素 D 水平与健康对照组的数据。
两组患者均以男性为主(88%)。肺结核组的 BMI 显著低于对照组(<0.0001∗)(19.40(17.20,22.0)vs. 24.00(22.50,25.47))。肺结核组血清维生素 D 水平显著低于对照组( = 0.012)(19(7.75,27.25)ng/dl 与 25(19.75,32.00)ng/dl)。50 例肺结核患者中,27 例(54%)有维生素 D 缺乏,而健康对照组中,只有 13 例(26%)有维生素 D 缺乏。在维生素 D 缺乏的肺结核患者中,44%的痰液涂片检查中 3+/hpf AFB。
肺结核患者维生素 D 缺乏的患病率非常高。维生素 D 缺乏症与肺结核患者更严重的临床症状、更高的痰涂片阳性率和胸部 X 线广泛病变有关。