Severe hypovitaminosis D in active tuberculosis patients and its predictors

Qiuzhen Wang*, Yufeng Liu, Yan Ma, Lei Han, Mei Dou, Yue Zou, Limei Sun, Hong Tian, Tongxia Li, Guofeng Jiang, Baoli Du, Tingyan Kou, Jiaqi Song, Frans J. Kok, Evert G. Schouten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

Background & aims: Tuberculosis (TB) patients have a significant vitamin D deficiency (VDD) endemic, which may be closely related to the onset and progress of the disease. The comorbidity of diabetes (DM) and TB has posed an increasing challenge in recent years. However, the influence of DM on TB and the possible mechanism are still uncertain. We carried out this study to identify the nutritional status of vitamin D (VD) in TB patients in a northern city in China (latitude 36° N) and investigate the possible predictors of severe vitamin D deficiency (SVDD). Methods: A cross-sectional study including 461 active TB patients (192 with and 269 without DM) were randomly selected from Qingdao Chest Hospital from June 2015 to August 2016. We measured serum 25 hydroxyvitamin D [25(OH)D], and investigated the association between sociodemographic, dietary intake, DM, body mass index (BMI), severity of initial TB signs and symptoms (TB score) and VD status. Multivariate logistic regression analysis was used to define the possible predictors of SVDD. Results: The median serum 25(OH)D concentration was 8.50 ng/mL. Of the 461 TB patients included, 383 (83.1%) had VDD [25(OH)D < 20 ng/mL], and 217 (47.1%) had SVDD [25(OH)D < 8 ng/mL]. The variables associated with serum 25(OH)D concentrations were DM, outdoor activity level, TB score and BMI (p < 0.05). Patients with severe TB score had nearly 5 fold higher risk of having SVDD compared with those in mild subgroup [OR (95% CI) = 4.919 (2.644-9.150), p < 0.001]. Low outdoor activity level also increased the odds of SVDD, while DM and high fish consumption showed protect effects. Conclusions: Severe hypovitaminosis D is prevalent in active TB patients, and the main predictors of SVDD were severe TB score, low outdoor activity, inadequate fish consumption. Lowered serum 25(OH)D may be associated with increased risk of TB in DM.

Original languageEnglish
Pages (from-to)1034-1040
JournalClinical Nutrition
Volume37
Issue number3
Early online date30 Jan 2017
DOIs
Publication statusPublished - Jun 2018

Fingerprint

Tuberculosis
Vitamin D Deficiency
Serum
Vitamin D
Fishes
Body Mass Index
Nutritional Status
Signs and Symptoms
Comorbidity
China
Thorax
Cross-Sectional Studies
Logistic Models
Regression Analysis

Keywords

  • Diabetes
  • Fish consumption
  • Outdoor activity
  • Serum 25(OH)D
  • Severe vitamin D deficiency
  • Tuberculosis

Cite this

Wang, Q., Liu, Y., Ma, Y., Han, L., Dou, M., Zou, Y., ... Schouten, E. G. (2018). Severe hypovitaminosis D in active tuberculosis patients and its predictors. Clinical Nutrition, 37(3), 1034-1040. https://doi.org/10.1016/j.clnu.2017.04.018
Wang, Qiuzhen ; Liu, Yufeng ; Ma, Yan ; Han, Lei ; Dou, Mei ; Zou, Yue ; Sun, Limei ; Tian, Hong ; Li, Tongxia ; Jiang, Guofeng ; Du, Baoli ; Kou, Tingyan ; Song, Jiaqi ; Kok, Frans J. ; Schouten, Evert G. / Severe hypovitaminosis D in active tuberculosis patients and its predictors. In: Clinical Nutrition. 2018 ; Vol. 37, No. 3. pp. 1034-1040.
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abstract = "Background & aims: Tuberculosis (TB) patients have a significant vitamin D deficiency (VDD) endemic, which may be closely related to the onset and progress of the disease. The comorbidity of diabetes (DM) and TB has posed an increasing challenge in recent years. However, the influence of DM on TB and the possible mechanism are still uncertain. We carried out this study to identify the nutritional status of vitamin D (VD) in TB patients in a northern city in China (latitude 36° N) and investigate the possible predictors of severe vitamin D deficiency (SVDD). Methods: A cross-sectional study including 461 active TB patients (192 with and 269 without DM) were randomly selected from Qingdao Chest Hospital from June 2015 to August 2016. We measured serum 25 hydroxyvitamin D [25(OH)D], and investigated the association between sociodemographic, dietary intake, DM, body mass index (BMI), severity of initial TB signs and symptoms (TB score) and VD status. Multivariate logistic regression analysis was used to define the possible predictors of SVDD. Results: The median serum 25(OH)D concentration was 8.50 ng/mL. Of the 461 TB patients included, 383 (83.1{\%}) had VDD [25(OH)D < 20 ng/mL], and 217 (47.1{\%}) had SVDD [25(OH)D < 8 ng/mL]. The variables associated with serum 25(OH)D concentrations were DM, outdoor activity level, TB score and BMI (p < 0.05). Patients with severe TB score had nearly 5 fold higher risk of having SVDD compared with those in mild subgroup [OR (95{\%} CI) = 4.919 (2.644-9.150), p < 0.001]. Low outdoor activity level also increased the odds of SVDD, while DM and high fish consumption showed protect effects. Conclusions: Severe hypovitaminosis D is prevalent in active TB patients, and the main predictors of SVDD were severe TB score, low outdoor activity, inadequate fish consumption. Lowered serum 25(OH)D may be associated with increased risk of TB in DM.",
keywords = "Diabetes, Fish consumption, Outdoor activity, Serum 25(OH)D, Severe vitamin D deficiency, Tuberculosis",
author = "Qiuzhen Wang and Yufeng Liu and Yan Ma and Lei Han and Mei Dou and Yue Zou and Limei Sun and Hong Tian and Tongxia Li and Guofeng Jiang and Baoli Du and Tingyan Kou and Jiaqi Song and Kok, {Frans J.} and Schouten, {Evert G.}",
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Wang, Q, Liu, Y, Ma, Y, Han, L, Dou, M, Zou, Y, Sun, L, Tian, H, Li, T, Jiang, G, Du, B, Kou, T, Song, J, Kok, FJ & Schouten, EG 2018, 'Severe hypovitaminosis D in active tuberculosis patients and its predictors', Clinical Nutrition, vol. 37, no. 3, pp. 1034-1040. https://doi.org/10.1016/j.clnu.2017.04.018

Severe hypovitaminosis D in active tuberculosis patients and its predictors. / Wang, Qiuzhen; Liu, Yufeng; Ma, Yan; Han, Lei; Dou, Mei; Zou, Yue; Sun, Limei; Tian, Hong; Li, Tongxia; Jiang, Guofeng; Du, Baoli; Kou, Tingyan; Song, Jiaqi; Kok, Frans J.; Schouten, Evert G.

In: Clinical Nutrition, Vol. 37, No. 3, 06.2018, p. 1034-1040.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Severe hypovitaminosis D in active tuberculosis patients and its predictors

AU - Wang, Qiuzhen

AU - Liu, Yufeng

AU - Ma, Yan

AU - Han, Lei

AU - Dou, Mei

AU - Zou, Yue

AU - Sun, Limei

AU - Tian, Hong

AU - Li, Tongxia

AU - Jiang, Guofeng

AU - Du, Baoli

AU - Kou, Tingyan

AU - Song, Jiaqi

AU - Kok, Frans J.

AU - Schouten, Evert G.

PY - 2018/6

Y1 - 2018/6

N2 - Background & aims: Tuberculosis (TB) patients have a significant vitamin D deficiency (VDD) endemic, which may be closely related to the onset and progress of the disease. The comorbidity of diabetes (DM) and TB has posed an increasing challenge in recent years. However, the influence of DM on TB and the possible mechanism are still uncertain. We carried out this study to identify the nutritional status of vitamin D (VD) in TB patients in a northern city in China (latitude 36° N) and investigate the possible predictors of severe vitamin D deficiency (SVDD). Methods: A cross-sectional study including 461 active TB patients (192 with and 269 without DM) were randomly selected from Qingdao Chest Hospital from June 2015 to August 2016. We measured serum 25 hydroxyvitamin D [25(OH)D], and investigated the association between sociodemographic, dietary intake, DM, body mass index (BMI), severity of initial TB signs and symptoms (TB score) and VD status. Multivariate logistic regression analysis was used to define the possible predictors of SVDD. Results: The median serum 25(OH)D concentration was 8.50 ng/mL. Of the 461 TB patients included, 383 (83.1%) had VDD [25(OH)D < 20 ng/mL], and 217 (47.1%) had SVDD [25(OH)D < 8 ng/mL]. The variables associated with serum 25(OH)D concentrations were DM, outdoor activity level, TB score and BMI (p < 0.05). Patients with severe TB score had nearly 5 fold higher risk of having SVDD compared with those in mild subgroup [OR (95% CI) = 4.919 (2.644-9.150), p < 0.001]. Low outdoor activity level also increased the odds of SVDD, while DM and high fish consumption showed protect effects. Conclusions: Severe hypovitaminosis D is prevalent in active TB patients, and the main predictors of SVDD were severe TB score, low outdoor activity, inadequate fish consumption. Lowered serum 25(OH)D may be associated with increased risk of TB in DM.

AB - Background & aims: Tuberculosis (TB) patients have a significant vitamin D deficiency (VDD) endemic, which may be closely related to the onset and progress of the disease. The comorbidity of diabetes (DM) and TB has posed an increasing challenge in recent years. However, the influence of DM on TB and the possible mechanism are still uncertain. We carried out this study to identify the nutritional status of vitamin D (VD) in TB patients in a northern city in China (latitude 36° N) and investigate the possible predictors of severe vitamin D deficiency (SVDD). Methods: A cross-sectional study including 461 active TB patients (192 with and 269 without DM) were randomly selected from Qingdao Chest Hospital from June 2015 to August 2016. We measured serum 25 hydroxyvitamin D [25(OH)D], and investigated the association between sociodemographic, dietary intake, DM, body mass index (BMI), severity of initial TB signs and symptoms (TB score) and VD status. Multivariate logistic regression analysis was used to define the possible predictors of SVDD. Results: The median serum 25(OH)D concentration was 8.50 ng/mL. Of the 461 TB patients included, 383 (83.1%) had VDD [25(OH)D < 20 ng/mL], and 217 (47.1%) had SVDD [25(OH)D < 8 ng/mL]. The variables associated with serum 25(OH)D concentrations were DM, outdoor activity level, TB score and BMI (p < 0.05). Patients with severe TB score had nearly 5 fold higher risk of having SVDD compared with those in mild subgroup [OR (95% CI) = 4.919 (2.644-9.150), p < 0.001]. Low outdoor activity level also increased the odds of SVDD, while DM and high fish consumption showed protect effects. Conclusions: Severe hypovitaminosis D is prevalent in active TB patients, and the main predictors of SVDD were severe TB score, low outdoor activity, inadequate fish consumption. Lowered serum 25(OH)D may be associated with increased risk of TB in DM.

KW - Diabetes

KW - Fish consumption

KW - Outdoor activity

KW - Serum 25(OH)D

KW - Severe vitamin D deficiency

KW - Tuberculosis

U2 - 10.1016/j.clnu.2017.04.018

DO - 10.1016/j.clnu.2017.04.018

M3 - Article

VL - 37

SP - 1034

EP - 1040

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 3

ER -