Association of Vitamin D Deficiency and Newly Diagnosed Pulmonary Tuberculosis

Abstract

Introduction. 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. Methods. 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. Results. 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 ( P = 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. Conclusion. 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.

Association of Vitamin D Deficiency With Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis

“…The mean of the majority of studies included in our study showed a higher than set criteria of VDD [30,38,41]. Further, few studies showed a lower mean value of vitamin D, which didn't meet the set criteria of VDD [4,11,[20][21]28,31,37]. Some other studies did not mention the reference level.…”

“…Over the years, more and more studies focusing on exploring the relationship between vitamin D deficiency and TB have been conducted [11][12]. However, existing attempts to relate these two things have been made with conflicting results caused by the different study populations, underlying comorbidities such as HIV and renal disease.…”

“…The previous meta-analysis studies included cross-sectional and case-control studies, which assessed vitamin D status after the active TB disease diagnosis. The studies did not evaluate the efficacy of vitamin D supplementation in preventing TB [11][12]. Tuberculosis is now a global health problem, including in developed countries.…”

“…FIGURE 2: Meta-analysis showing the odds ratio of vitamin D deficiency in the tuberculosis group to the healthy control group[4,11,24,27,29,[32][33][34]37,[39][40][41] …”

Vitamin D, Thyroid Hormones and Cardiovascular Risk: Exploring the Components of This Novel Disease Triangle

“…A relationship between 25-hydroxyvitamin D hypovitaminosis and increased risk of developing different immune-related conditions and infectious diseases has been observed, and recently reviewed ( Charoenngam and Holick, 2020 ). In particular low 25(OH)D levels have been associated to psoriasis, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, tuberculosis, sepsis, respiratory infection, and also COVID-19 ( Ponsonby et al, 2005 ; Megna et al, 2020 ; Cristelo et al, 2021 ; Jaimni et al, 2021 ; Wald et al, 2021 ; Chetty and Chetty, 2021 ).…”