Changes in Nutritional Status in Pulmonary Tuberculosis: Longitudinal Changes in BMI According to Acid-Fast Bacilli Smear Positivity

Abstract

Malnutrition is closely associated with pulmonary tuberculosis (PTB). However, changes before and after treatment remain unclear. We aimed to investigate the longitudinal changes in nutritional status from treatment to follow-up of TB in 215 PTB cases in South Korea. First, we evaluated the trend in body mass index (BMI) from the time of diagnosis to a 2-year follow-up. Second, we compared the BMIs of our cases with 5694 controls who participated in a Korean national survey after treatment. During the treatment period, the BMI of the smear-positive group (n = 72) significantly increased compared with that of the smear-negative group (n = 143) (+1.9 kg/m2 vs. +0.4 kg/m2, p = 0.001). Almost all the changes occurred in the early phase, with unremarkable differences in the rest of the treatment period and up to the 2-year follow-up period. When compared with controls, the smear-positive PTB group also had a lower BMI than the smear-negative PTB group, which, however, was lower than that of the general population, though all the participants regained their BMIs during treatment. These results clarify the nutritional aspects of PTB and enable better strategies to support patients with PTB.

Study on serum zinc and copper levels in pulmonary tuberculosis patients before starting Directly Observed Treatment, Short-course

“…Some study showed that there was significant variation in BMI of PTB patients -mostly decreased BMI below normal. 14 In the present study there is highly significant decrease of serum zinc concentration in case group compared with control group that showed similarity with Sharda and Bhandari., Karyadiet et al, and Koyanagi et al,. 8,15,16 Redistribution of zinc in the liver plays an important role and Metallothionein that bind with zinc and draw away from circulating pool done by IL-1 that explain MTB use zinc for growth and reproduction.…”

Long-Term Mortality of Tuberculosis Survivors in Korea: A Population-based Longitudinal Study

“…Low BMI has a substantial impact on TB development [ 24 , 40 ], and weight loss during TB treatment is associated with increased mortality [ 41 ]. In addition, TB survivors are known to have lower BMI than those without TB [ 42 ]. However, the long-term effect of low BMI on mortality in TB survivors is not well known, and our study provided informative data showing the persistent long-term effect of low BMI on mortality in TB survivors.…”

Nutritional and Microbiological Characteristics of Snakehead Fish Flour (Channa Striata) and Its Modification as Weight Enhancing Supplements for Children with Tuberculosis

“…Chiang et al showed that weight gain optimizes TB treatment in children with tuberculosis [15]. In line with that study, a study using data in the TB clinic of Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea, showed that nutritional status significantly correlated with the optimization of treatment for pulmonary tuberculosis (PTB) patients [16]. In addition, oral nutritional supplement consumption such as food, protein/energy supplements, or micronutrients can increase their body weight [5] [17] [18].…”

“…Fulfillment of nutritional adequacy and development of the adaptive immune system in children are determined by exclusive breastfeeding from birth to 6 months of age [11] [12][13] [14]. Conversely, children with tuberculosis are at risk of experiencing malnutrition due to decreased appetite and intake, nutrient malabsorption, and increased metabolic [7][15] [16]. Chiang et al showed that weight gain optimizes TB treatment in children with tuberculosis [15].…”