Association between tuberculosis, diabetes and 25 hydroxyvitamin D in Tanzania: a longitudinal case control study

Abstract

BackgroundVitamin D level is inversely associated with tuberculosis (TB) and diabetes (DM). Vitamin D could be a mediator in the association between TB and DM. We examined the associations between vitamin D, TB and DM.MethodsConsecutive adults with TB and sex- and age-matched volunteers were included in a case-control study in Dar es Salaam, Tanzania. Glycemia and total vitamin D (25(OH)D) were measured at enrolment and after TB treatment in cases. The association between low 25(OH)D (<75 nmol/l) and TB was evaluated by logistic regression adjusted for age, sex, body mass index, socioeconomic status, sunshine hours, HIV and an interaction between low 25(OH)D and hyperglycemia.ResultsThe prevalence of low 25(OH)D was similar in TB patients and controls (25.8 % versus 31.0 %; p = 0.22). In the subgroup of patients with persistent hyperglycemia (i.e. likely true diabetic patients), the proportion of patients with low 25(OH)D tended to be greater in TB patients (50 % versus 29.7 %; p = 0.20). The effect modification by persistent hyperglycemia persisted in the multivariate analysis (pinteraction = 0.01).ConclusionsLow 25(OH)D may increase TB risk in patients with underlying DM. Trials should examine if this association is causal and whether adjunct vitamin D therapy is beneficial in this population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1960-x) contains supplementary material, which is available to authorized users.

Association between helminth infections and diabetes mellitus in adults from the Lao People’s Democratic Republic: a cross-sectional study

“…The study in China estimated the diabetes prevalence based on a combination of self-reported DM, HbA1c measured in capillary finger-prick blood as well as venous blood fasting glucose and glucose tolerance testing. This suggests that the observed DM prevalence in Lao PDR, may even be higher than reported here as adding glucose to the DM screening tests results in the identification of additional cases [ 14 , 15 ]. The high pre-DM and DM rates with a tendency for earlier onset in Asian populations remain partly unexplained [ 16 ].…”

Associating the blood vitamin A, C, D and E status with tuberculosis: a systematic review and meta-analysis of observational studies

“…A total of 24 studies, 1,21–27,29–33,45–47,52–54,56–60 3295 tuberculosis patients and 18 080 healthy controls were included in the meta-analysis of comparing the blood 25-hydroxyvitamin D concentration of the tuberculosis patients with that of the healthy controls (Fig. 3).…”

“…Among the 47 studies, seven studies reported the vitamin A status, two studies reported the vitamin C status, 33 studies reported the vitamin D status or the number of people with VDD, and five studies reported the vitamin E status in the tuberculosis group versus the control group. The 47 included studies included 32 case-control studies, 1,15,21,[24][25][26]28,[31][32][33][34][45][46][47][48][49][50][51][52][53] seven cross-sectional studies, 21,22,27,29,30,54,55 and eight cohort or nested case-control studies. 16,35,[56][57][58][59][60][61] The study characteristics are shown in Table 1.…”

Changes in Host Response to Mycobacterium tuberculosis Infection Associated With Type 2 Diabetes: Beyond Hyperglycemia

“…Regarding the evidences linking vitamin D deficiency to a higher risk of TB, an study in Tanzania, revealed that vitamin D deficiency is related to an increased risk of TB only in patients with persistent hyperglycemia (OR = 4.0, C.I. 0.86–18.54) (Boillat-Blanco et al, 2016), and another study in China showed that patients with more than 10 years of T2D diagnosis have lower levels of vitamin D (Zhao et al, 2018). In addition to these data, an study in Chinese patients showed that both T2D and pre-T2D people have lower levels of vitamin D in serum (Zhao et al, 2017).…”