Vitamin D deficiency in patients with tuberculosis and its correlation with glycemic status

Abstract

Background: Comorbidity of diabetes and tuberculosis has serious health implications. Presence of diabetes at least three times increases the risk of tuberculosis which may be mediated by an abnormal innate immune response due to hyperglycaemia or low vitamin D levels.Aim of the study- Present study was carried out to investigate whether lower serum 25(OH) D might be associated with higher prevalence of pulmonary or extra pulmonary tuberculosis which might provide an evidence for a role of vitamin D in the comorbidity of these two diseases and does it have any correlation with glycemic status.Methods: In a hospital based cross sectional study, 264 patients with newly diagnosed tuberculosis were enrolled and according to glycemic status they were divided into three groups. They were assessed for vitamin D deficiency in addition to routine laboratory and biochemical parameters.Results: The patients with diabetes had significantly lower vitamin D levels. The prevalence of severe vitamin D deficiency was highest in patients who had diabetes with tuberculosis. There was negative correlation between vitamin D levels and Hba1C and extensiveness of pulmonary tuberculosisConclusions: Serum vitamin D levels were significantly lower in tuberculosis patients with pre-diabetes and type 2 diabetes compared with those, who had normal glycemic status. We suggest that there is a need to pay more attention to vitamin D status in this country and if there is coexisting diabetes or impaired glucose intolerance, emphasis on vitamin D supplementation can be of utmost importance.

Impact of diabetes mellitus on tuberculosis treatment outcomes: a cohort study in Bengaluru, India

“…These issues are paralleled in global studies, including Wang et al, who explore the potential role of metformin in improving TB treatment outcomes in TB-DM comorbidity, Wang et al, and Karoli et al, who examine the significance of vitamin D deficiency in managing TB-DM comorbidity. 16,17 Our findings of poorer outcomes and increased ADRs in TB-DM patients reflect the dual burden of these diseases, as underscored by Aweis et al and Babu et al 18,19 The study underscores the urgent need for integrated TB and DM management approaches, advocating for tailored treatment regimens, comprehensive patient education, and the utilization of advanced technologies like artificial intelligence. The study also highlights the importance of strengthening follow-up strategies and enhancing healthcare provider training to improve patient care and the outcomes for those affected by the TB-DM comorbidity.…”

Hypovitaminosis D among newly diagnosed pulmonary TB patients and their household contacts in Uganda

“…Cathelicidin antimicrobial peptide is a defense molecule that is involved in both innate and adaptive immunity and modulates infections through Toll-like receptor responses 10 . Through its expression, cathelicidin aids in restraining the growth of intracellular Mycobacterium tuberculosis 11 , 12 . Several studies have provided evidence that vitamin D deficiency is a risk factor for active TB disease 13 – 16 .…”

“…Although the free and bioavailable vitamin D levels penetrate the cell and are involved in biological activities, they have not yet been used to define vitamin D status. Total 25-hydroxyvitamin D , also known as 25(OH)D, is accepted as the best indicator for vitamin D status, as defined by the Institute of Medicine (IOM) and the Endocrine Society, and this has been adopted by several studies 11 , 12 , 23 – 29 . However, inconsistent findings on vitamin D status have been reported from various regions 30 , 31 .…”