Adult ; Antitubercular Agents/therapeutic use ; Biomarkers/blood ; Chi-Square Distribution ; Female ; Health Surveys ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Severity of Illness Index ; Treatment Outcome ; Tuberculosis/diagnosis ; Tuberculosis/drug therapy ; Tuberculosis/epidemiology* ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D Deficiency/blood ; Vitamin D Deficiency/diagnosis ; Vitamin D Deficiency/epidemiology* ; Young Adult
Keywords
TB ; vitamin D deficiency
Abstract
BACKGROUND: Several in vitro studies have been conducted regarding the immunomodulatory and mycobactericidal roles of vitamin D in tuberculous infection. However, discrepancies exist among epidemiological studies. We compared vitamin D deficiency between patients with tuberculosis (TB) and healthy control subjects and identified risk factors for vitamin D deficiency.
METHOD: This was an age- and sex-matched case-control analysis of 94 TB cohort and 282 Korean national survey participants.
RESULTS: The median baseline 25-hydroxyvitamin D (25[OH]D) level in the TB group (9.86 ng/ml, IQR 7.19–14.15) was lower than in controls (16.03 ng/ml, IQR 12.38–20.30, P < 0.001). The prevalence of severe vitamin D deficiency was higher in patients with TB (51.1%) than in controls (8.2%, P = 0.001). The median 25(OH)D level increased from 11.40 ng/ml (IQR 7.85–15.73) to 13.18 ng/ml (IQR 10.60–19.71) after treatment completion (P = 0.037). On multivariate analysis, presence of TB and history of TB were independently associated with severe vitamin D deficiency.
CONCLUSION: Patients with TB had a higher prevalence of vitamin D deficiency than control subjects in a Korean population. The median 25(OH)D level increased after TB treatment. Further studies are needed to establish a causal relationship.