The Indian Journal of Nutrition and Dietetics

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Assessment of Serum Vitamin D Levels in Patients with Pulmonary Tuberculosis-A Comparative Cross Sectional Study in a Teritiary Care Centre in Kolar


Affiliations
1 Division of Internal Medicine, Sri Deveraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka - 563 101, India
2 Division of Biochemistry, Sri Deveraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka - 563 101, India
     

   Subscribe/Renew Journal


Tuberculosis remains as one of the deadliest disease affecting humankind and vitamin D deficiency is a global health problem. The evidence is increasingly pointing towards increased susceptibility to TB among individuals with vitamin D deficiency and worse disease progression if infected with TB. Hence the current study was undertaken to assess the prevalence of vitamin D deficiency in patients with pulmonary tuberculosis and to compare it with non-tuberculosis cases. This study was a comparative cross-sectional study conducted in R.L. Jalappa hospital among 100 individuals divided into two groups. Group 1 consisted of 70 sputum positive pulmonary TB case and group 2 consisted of 30 community healthy controls matched for age and gender. The subjects were investigated for biochemical parameters and serum vitamin D level using Electro-chemiluminescence Immuno Assay (ECLIA). The mean age of TB and non-TB cases was 52.53 ± 15.68 years and 56.07 ± 10.06 years respectively. Mean vitamin D level in the study population were 29.51± 28.19 ng/ml. Vitamin D deficiency was found in 54 (77.14%) cases with TB and in 10 (33.33%) non-TB cases. The mean difference in serum albumin (3.89 ± 0.89 g/dl vs 3.42 ± 0.76 g/dl); calcium levels (7.3 ± 1.59 mg/dl vs 8.5 ± 1.37 mg/dl) and vitamin D level (22.02 ± 23.8 ng/ml vs 47 ± 30.22 ng/ml) were statistically significant (p value < 0.01) across the group. This study concludes that vitamin D deficiency is associated with an increased prevalence of tuberculosis. This recommends the screening for vitamin D deficiency and encourages vitamin D supplementation for all tuberculosis patients.

Keywords

Vitamin D Deficiency, Tuberculosis, Non-Tuberculosis, Immunity, Vitamin D2.
User
Notifications

  • Liu, P.T., Stenger, S., Tang, D.H. and Modlin, R.L. Cutting edge: vitamin D mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J. Immunol., 2007, 179, 2060-2063.

  • Borucki, K., Schreiner, R., Dierkes, J., Jachau, K., Krause, D., Westphal, S., Wurst, F. M., Luley, C. and Schmidt-Gayk, H. Detection of recent ethanol intake with new markers: Comparison of fatty acid ethyl esters in serum and of ethyl glucuronide and the ratio of 5-hydroxytryptophol to 5-hydroxyindole acetic acid in urine. Alcohol Clin. Exp. Res., 2005, 29, 781-787.

  • Workineh, M., Mathewos, B., Moges, B., Gize, A., Getie, S., Stendahl, O., Thomas Schon. and Ebba Abate. Vitamin D deficiency among newly diagnosed tuberculosis patients and their household contacts: A comparative cross-sectional study. Arch. Public Health, 2017, 75, 25.

  • Thacher, T.D. and Clarke, B.L. Vitamin D insufficiency. Mayo Clin. Proc., 2011, 86, 50-60.

  • Rook, G.A., Steele, J., Fraher, L., Barker, S., Karmali, R., O’Riordan, J. and Stanford, J. Vitamin D3, gamma interferon and control of proliferation of Mycobacterium tuberculosis by human monocytes. Immunol., 1986, 57, 159-163.

  • Crowle, A.J., Ross, E.J. and May, M.H. Inhibition by 1,25(OH)2-vitamin D3 of the multiplication of virulent tubercle bacilli in cultured human macrophages. Infect Immun., 1987, 55, 2945-2950.

  • Autier, P., Boniol, M., Pizot, C. and Mullie, P. Vitamin D status and ill health: A systematic review. Lancet Diabet. Endocrinol., 2014, 2, 76-89.

  • Yuvaraj, B., Sridhar, M.G., Kumar, S.V. and Kadhiravan, T. Association of serum vitamin D levels with bacterial load in pulmonary tuberculosis patients. Tuberc. Respir Dis., (Seoul). 2016, 79, 153-157.

  • Talat, N., Perry, S., Parsonnet, J., Dawood, G. and Hussain R. Vitamin D deficiency and tuberculosis progression. Emerg. Infect. Dis., 2010, 16, 853-855.

  • Sita-Lumsden, A., Lapthorn, G., Swaminathan, R. and Milburn, H.J. Reactivation of tuberculosis and vitamin D deficiency: The contribution of diet and exposure to sunlight. Thorax., 2007, 62, 1003-1007.

  • Nnoaham, K.E. and Clarke, A. Low serum vitamin D levels and tuberculosis: A systematic review and meta-analysis. Int. J. Epidemiol., 2008, 37, 113-119.

  • Lemire, J.M. Immunomodulatory role of 1,25-dihydroxyvitamin D3. J. Cell Biochem., 1992, 49, 26-31.

  • Rachez, C. and Freedman, LP. Mechanisms of gene regulation by vitamin D(3) receptor:

  • A network of coactivator interactions. Gene., 2000, 246, 9-21.

  • Reichel, H., Koeffler, H.P., Tobler, A. and Norman, A.W. 1 alpha,25-Dihydroxyvitamin D3 inhibits gamma-interferon synthesis by normal human peripheral blood lymphocytes. Proc. Natl. Acad. Sci. U S A. 1987, 84, 3385-3389.

  • Kearns, M.D. and Tangpricha, V. The role of vitamin D in tuberculosis. J. Clin. Transl. Endocrinol., 2014, 1, 67-69.

  • Martineau, A.R., Wilkinson, R.J., Wilkinson, K.A., Newton, S.M., Kampmann, B., Hall, B.M., Geoffrey E. Packe, Robert N. Davidson, Sandra M. Eldridge, Zoë J. Maunsell, Sandra J. Rainbow, Jacqueline L. Berry, Christopher J. Griffiths. A single dose of vitamin D enhances immunity to mycobacteria. Am. J. Respir. Crit. Care Med., 2007, 176, 208-213.

  • Nursyam, E.W., Amin, Z. and Rumende, C.M. The effect of vitamin D as supplementary treatment in patients with moderately advanced pulmonary tuberculous lesion. Acta. Med. Indones., 2006, 38, 3-5.

  • Coussens, A.K., Wilkinson, R.J., Hanifa, Y., Nikolayevskyy, V., Elkington, P.T., Islam, K., Peter M. Timms, Timothy R. Venton, Graham H. Bothamley, Geoffrey E. Packe, Mathina Darmalingam, Robert N. Davidson, Heather J. Milburn, Lucy V. Baker, Richard D. Barker, Charles A. Mein, Leena Bhaw-Rosun, Rosamond Nuamah, Douglas B. Young, Francis A. Drobniewski, Christopher J. Griffiths, Adrian R. Martineau. Vitamin D accelerates resolution of inflammatory responses during tuberculosis treatment. Proc. Natl. Acad. Sci. USA., 2012, 109, 15449-15454.

  • Mily, A., Rekha, R.S., Kamal, S.M., Akhtar, E., Sarker, P., Rahim, Z., Gudmundur H. Gudmundsson, Birgitta Agerberth, Rubhana Raqib. Oral intake of phenylbutyrate with or without vitamin D3 upregulates the cathelicidin LL-37 in human macrophages: a dose finding study for treatment of tuberculosis. BMC Pulm. Med., 2013, 13, 23.

  • Kim, J.H., Park, J.S., Cho, Y.J., Yoon, H.I., Song, J.H., Lee, C.T, Jae Ho Lee. Low serum 25-hydroxyvitamin D level: An independent risk factor for tuberculosis? Clini. Nutr., 2014, 33, 1081-1086.

  • Wejse, C., Olesen, R., Rabna, P., Kaestel, P., Gustafson, P., Aaby, P., Paul L. Andersen, Henning Glerup, Morten Sodemann. Serum 25-hydroxyvitamin D in a West African population of tuberculosis patients and unmatched healthy controls. Am. J. Clin. Nutr., 2007, 86, 1376-1383.

  • Hong, J.Y., Kim, S.Y., Chung, K.S., Kim, E.Y., Jung, J.Y., Park, M.S., Kim, Y, S., Kim, S. K., Chang , J. and Kang, Y. A. Association between vitamin D deficiency and tuberculosis in a Korean population. Int. J. Tuberc. Lung. Dis., 2014, 18, 73-78.

  • Ho-Pham, L.T., Nguyen, N.D., Nguyen, T.T., Nguyen, D.H., Bui, P.K., Nguyen, V.N. and Nguyen, T.V. Association between vitamin D insufficiency and tuberculosis in a Vietnamese population. BMC Infect. Dis., 2010, 10, 306.

  • Panwar, A., Garg, R.K., Malhotra, H.S., Jain, A., Singh, A.K., Prakash, S., Neeraj Kumar, Rajiv Garg, Abbas Ali Mahdi, Rajesh Verma and Praveen Kumar Sharma. 25-hydroxy vitamin D, vitamin D receptor and toll-like receptor 2 polymorphisms in spinal tuberculosis: A case-control study. Med (Baltimore), 2016, 95, 3418 25. Joshi, L., Ponnana, M., Penmetsa, S.R., Nallari, P., Valluri, V. and Gaddam, S. Serum vitamin D levels and VDR polymorphisms (BsmI and FokI) in patients and their household contacts susceptible to tuberculosis. Scand. J. Immunol., 2014, 79, 113-119.

  • Tessema, B., Moges, F., Habte, D., Hiruy, N., Yismaw, S., Melkieneh, K., Yewulsew Kassie, Belaineh Girma, Muluken Melese, and Pedro G. Suarez. Vitamin D deficiency among smear positive pulmonary tuberculosis patients and their tuberculosis negative household contacts in Northwest Ethiopia: a case-control study. Ann. Clin. Microbiol. Antimicrob., 2017, 16, 36.

  • Ramkumar, V., Raja K., Subramaniam, S. and Rajkumar, S. A study of serum vitamin D levels in newly diagnosed pulmonary tuberculosis. J. Med. Sci. Clin. Res., 2018, 6, 31974-31980.

  • Muthuraj, M., Kamatchiyammal, S., Usharan, B., Manupriya, S., Ayyappan, A.N. and Divyalakshmi, K. Serum zinc, calcium and albumin levels in pulmonary tuberculosis patients co-infected with HIV. Glob. J. Biotechnol. Biochem., 2010, 5, 27-35.


Abstract Views: 275

PDF Views: 1




  • Assessment of Serum Vitamin D Levels in Patients with Pulmonary Tuberculosis-A Comparative Cross Sectional Study in a Teritiary Care Centre in Kolar

Abstract Views: 275  |  PDF Views: 1

Authors

Maharaj L. S. Y. M. J.
Division of Internal Medicine, Sri Deveraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka - 563 101, India
Lakshmaiah V.
Division of Internal Medicine, Sri Deveraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka - 563 101, India
Shashidhar K. N.
Division of Biochemistry, Sri Deveraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka - 563 101, India

Abstract


Tuberculosis remains as one of the deadliest disease affecting humankind and vitamin D deficiency is a global health problem. The evidence is increasingly pointing towards increased susceptibility to TB among individuals with vitamin D deficiency and worse disease progression if infected with TB. Hence the current study was undertaken to assess the prevalence of vitamin D deficiency in patients with pulmonary tuberculosis and to compare it with non-tuberculosis cases. This study was a comparative cross-sectional study conducted in R.L. Jalappa hospital among 100 individuals divided into two groups. Group 1 consisted of 70 sputum positive pulmonary TB case and group 2 consisted of 30 community healthy controls matched for age and gender. The subjects were investigated for biochemical parameters and serum vitamin D level using Electro-chemiluminescence Immuno Assay (ECLIA). The mean age of TB and non-TB cases was 52.53 ± 15.68 years and 56.07 ± 10.06 years respectively. Mean vitamin D level in the study population were 29.51± 28.19 ng/ml. Vitamin D deficiency was found in 54 (77.14%) cases with TB and in 10 (33.33%) non-TB cases. The mean difference in serum albumin (3.89 ± 0.89 g/dl vs 3.42 ± 0.76 g/dl); calcium levels (7.3 ± 1.59 mg/dl vs 8.5 ± 1.37 mg/dl) and vitamin D level (22.02 ± 23.8 ng/ml vs 47 ± 30.22 ng/ml) were statistically significant (p value < 0.01) across the group. This study concludes that vitamin D deficiency is associated with an increased prevalence of tuberculosis. This recommends the screening for vitamin D deficiency and encourages vitamin D supplementation for all tuberculosis patients.

Keywords


Vitamin D Deficiency, Tuberculosis, Non-Tuberculosis, Immunity, Vitamin D2.

References





DOI: https://doi.org/10.21048/ijnd.2020.57.3.25246