Significance of Serum Vitamin D Level in Tuberculosis Patients

Abstract

Introduction: The role of vitamin D in bone homeostasis is well known but nowadays, its role in various essential body processes including prevention of various infective and chronic illnesses like Tuberculosis (TB), by facilitating adaptive and innate immunity in lungs and peripheral blood, is being a matter of debate. Low levels have been associated with respiratory tract infections like TB. Present study aimed to evaluate the level of vitamin D in tubercular patients. Aim: To determine serum vitamin D level in patients with TB and compare it with controls. To compare serum vitamin D level among different types of TB, including Pulmonary TB (PTB), tubercular lymphadenitis and tubercular pleural effusion. Materials and Methods: The present study was a single centre cross-sectional study done during the study period from September 2013 to September 2016 at a tertiary care centre of Uttar Pradesh, India. Total 216 subjects aged between 21 and 60 years were included randomly out of which 113 patients were cases and 103 were controls. Cases of TB were confirmed by sputum Acid Fast Bacilli (AFB) staining, sputum and pleural fluid cytology, Adenosine Deaminase (ADA) of pleural fluid and Fine Needle Aspiration Cytology (FNAC) of lymph nodes. Controls were healthy subjects. Total serum vitamin D levels were measured by Diasorin competitive Radioimmunoassay (RIA) (Autoimmune Diagnostika, GmbH, Strasburg, Germany). Results: The mean serum vitamin D level for patients with TB was 22.4±8.5 ng/mL. Among controls, it was 30.5±8.6 ng/mL (p<0.001). This analysis showed that mean serum vitamin D levels were significantly lower in TB patients as compared with controls and there is no significant difference of serum vitamin D levels in various groups of TB. Also, there was no effect of confounding factors like age, sex and indoor/outdoor activity. Conclusion: The findings of the present study showed that hypovitaminosis-D was highly prevalent among patients with TB as compared to general population in same geographical area and severity of it is not significantly related to different type of TB.

Keywords

• hypovitaminosis d
• pulmonary tuberculosis
• tubercular lymphadenitis
• tubercular pleural effusion