School of Public Health, Hangzhou Medical College, Hangzhou, China.
Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
Ann Med. 2024 Dec;56(1):2396566. doi: 10.1080/07853890.2024.2396566. Epub 2024 Sep 2.
Several studies have suggested an association between vitamin deficiency and the development of tuberculosis; however, the precise impact remains unclear. This study aimed to elucidate the relationship between distinct vitamin statuses and the occurrence of tuberculosis.
Retrieval was conducted using several databases without language restrictions to capture the eligible studies on tuberculosis and vitamin status. Pooled odds ratios (ORs), relative risks (RRs), and hazard ratios (HRs) were used with 95% confidence intervals (CIs) to clarify the relationship between the different vitamin statuses (A, B, D, and E) and the occurrence of tuberculosis. Subgroup analysis, sensitivity analysis, meta-regression analysis, and Galbraith plot were performed to determine sources of heterogeneity. Potential publication biases were detected using Begg's test, Egger's test, and the trim-and-fill test.
We identified 10,266 original records from our database searches, and 69 eligible studies were considered in this study. The random-effect model showed that people with tuberculosis may exhibit vitamin A deficiency (OR = 10.66, 95%CI: 2.61-43.63, = .001), while limited cohort studies showed that vitamin A supplementation may reduce tuberculosis occurrence. Additionally, vitamin D deficiency was identified as a risk factor for tuberculosis development (RR = 1.69, 95%CI: 1.06-2.67, = .026), and people with tuberculosis generally had lower vitamin D levels (OR = 2.19, 95%CI: 1.76-2.73, < .001) compared to other groups. No publication bias was detected.
This meta-analysis indicated that people with tuberculosis exhibited low levels of vitamins A and D, while vitamin D deficiency was identified as a risk factor for tuberculosis. More randomized controlled interventions at the community levels should be recommended to determine the association between specific vitamin supplementation and tuberculosis onset.
多项研究表明，维生素缺乏与结核病的发生之间存在关联，但确切的影响尚不清楚。本研究旨在阐明不同维生素状态与结核病发生之间的关系。
通过几个数据库进行检索，不限制语言，以获取有关结核病和维生素状态的合格研究。使用合并优势比（ORs）、相对风险（RRs）和风险比（HRs），并结合 95%置信区间（CIs），来阐明不同维生素状态（A、B、D 和 E）与结核病发生之间的关系。进行亚组分析、敏感性分析、meta 回归分析和 Galbraith 图分析，以确定异质性的来源。使用 Begg 检验、Egger 检验和修剪和填充检验来检测潜在的发表偏倚。
我们从数据库检索中确定了 10266 条原始记录，并在本研究中考虑了 69 项合格研究。随机效应模型显示，结核病患者可能存在维生素 A 缺乏（OR=10.66，95%CI：2.61-43.63，=0.001），而有限的队列研究表明，维生素 A 补充可能会降低结核病的发生。此外，维生素 D 缺乏被确定为结核病发展的危险因素（RR=1.69，95%CI：1.06-2.67，=0.026），且结核病患者的维生素 D 水平通常较低（OR=2.19，95%CI：1.76-2.73，<0.001）。未发现发表偏倚。
本荟萃分析表明，结核病患者存在维生素 A 和 D 水平低的情况，而维生素 D 缺乏被确定为结核病的危险因素。应推荐在社区层面开展更多的随机对照干预措施，以确定特定维生素补充与结核病发病之间的关系。
