DOI: http://dx.doi.org/10.18203/2349-3933.ijam20195622

The study of correlation between vitamin D and tuberculosis in newly detected tuberculosis - pulmonary and extra pulmonary patients attending to K R hospital, Mysuru, Karnataka, India

Vandana Balgi, Sanjana J. M., Suneetha D. K., Amrudha Surendran, Chandrashekar G. S.

Abstract


Background: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which has posed a constant challenge to mankind in its treatment due to increasing resistance and longer duration of treatment. The newer approach is to look towards strengthening host immune system along with suppressing the organism.

 Aim of the study was to assess the existence of Vitamin D deficiency in TB patients and aid in the strategies and development of newer improvised approaches in the treatment of TB. Objectives of the study was to estimate vitamin D levels in Tuberculosis (pulmonary and extrapulmonary) patients, assess Correlation between vitamin D and   pulmonary tuberculosis and to assess correlation between Vitamin D and extrapulmonary Tuberculosis.

Methods: This is a descriptive cross-sectional study. The study consisted of 80 tuberculosis patients both extrapulmonary and pulmonary. Blood samples was analysed for Vitamin D levels and results were compared with age and sex matched controls. Results was analysed using SPSS software.

Results: The cases included patient in the age group of 18-60 year with the mean age being 42.34±14.65 year. Of the 80 tuberculosis patients 42 were diagnosed with pulmonary tuberculosis and 38 constituted extrapulmonary tuberculosis. The mean Vitamin D in cases was 24.82±12.33 and controls was 34.41±6.19. Among the cases 25 (31.3%) subjects had Vitamin D levels <20 pg/ml and none of the controls had levels <20 pg/ml. The mean Vitamin D level in pulmonary Tb patients was found to be 24.29±11.86 pg/ml and Extra-pulmonary Tb was 25.40±12.96 pg/ml. The unpaired t-test was statistically significant with p value of 0.005.

Conclusions: This study has emphasized on the presence of nutritional deficiency in TB patients and necessity to correct them to achieve a better cure rate.

Keywords


Extrapulmonary tuberculosis, Immunomodulatory effect, Tuberculosis, Vitamin D

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References


TB India 2017 Revised national tuberculosis control programme, Annual status report. Available at: https://tbcindia.gov.in/WriteReadData/TB%20India%202017.pdf . Accessed 28 Nov 2019.

Hayman J. Mycobacterium ulcerans: an infection from Jurassic time?. Lancet. 1984 Nov 3;324(8410):1015-6.

Barberis I, Bragazzi NL, Galluzzo L, Martini M. The history of tuberculosis: from the first historical records to the isolation of Koch's bacillus. J Preven Med Hyg. 2017 Mar;58(1):E9-12.

Murray JF, Schraufnagel DE, Hopewell PC. Treatment of tuberculosis. A historical perspective. Annals Am Thorac Soc. 2015 Dec;12(12):1749-59.

Martineau AR. Old wine in new bottles: vitamin D in the treatment and prevention of tuberculosis. Proceedings Nutr Soc. 2012 Feb;71(1):84-9.

Copping AM. Origin of vitamin D in cod-liver oil: vitamin D content of zooplankton. Biochem J. 1934;28(4):1516-20.

Schatz A, Bugle E, Waksman SA. Streptomycin, a Substance Exhibiting Antibiotic Activity Against Gram-Positive and Gram-Negative Bacteria.∗. Proceedings Soc Experiment Biol Med. 1944 Jan;55(1):66-9.

Khedkar DT, Chitnis UB, Bhawalkar JS, Mamulwar MS. Revised National Tuberculosis Control Program: Evolution, Achievements, and Challenges. Med J Dr. DY Patil Uni. 2014 Jan 1;7(1):5.

Brighenti S, Bergman P, Martinaeuar. Vitamin D and tuberculosis where next. JIM. 2018.

Herr C, Greulich T, Koczulla RA, Meyer S, Zakharkina T, Branscheidt M, et al. The role of vitamin D in pulmonary disease: COPD, asthma, infection, and cancer. Resp Res. 2011 Dec 1;12(1):31.

Karampini E, Rao D, Abiona S, Asuquo B, Stokes T. The incidence of vitamin d deficiency in patients newly diagnosed with tuberculosis in a south london hospital. Chest. 2011 Oct;140(4):785A.

Nnoaham KE, Clarke A. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Inter J Epidemiol. 2008 Feb 1;37(1):113-9.

Rajamanickam PK, Biswas SK, Kar G. A study on vitamin D status in tuberculosis. J Evolution Med Dental Sci-JEMDS. 2017 Sep 7;6(72):5083-7.

Rajamanickam PK, Biswas SK, Kar G. A study on vitamin d status in tuberculosis. JEMDS. 2017;6(72):5083-7.

Karoli R, Fatima J, Gupta SS, Shukla V, Moidurrehman, Manhar M. Vitamin D Deficiency in Medical Patients at a Teaching Hospital in North India. J Assoc Phys Ind. 2015 Jun;63(6):35-9.

Coussens A, Timms PM, Boucher BJ, Venton TR, Ashcroft AT, Skolimowska KH, et al. 1α, 25‐dihydroxyvitamin D3 inhibits matrix metalloproteinases induced by Mycobacterium tuberculosis infection. Immunol. 2009 Aug;127(4):539-48.

Martineau AR, Timms PM, Bothamley GH, Hanifa Y, Islam K, Claxton AP, et al. High-dose vitamin D3 during intensive-phase antimicrobial treatment of pulmonary tuberculosis: a double-blind randomised controlled trial. Lancet. 2011 Jan 15;377(9761):242-50.

Kearns MD, Tangpricha V. The role of vitamin D in tuberculosis. J Clini Translat Endocrinol. 2014 Dec;1(4):167-9.