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

Autor: Boillat-Blanco N; Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania. noemie.boillat@chuv.ch.; Swiss Tropical and Public Health Institute, Basel, Switzerland. noemie.boillat@chuv.ch.; Department of Sciences, University of Basel, Basel, Switzerland. noemie.boillat@chuv.ch.; Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland. noemie.boillat@chuv.ch., Bovet P; Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland., Ramaiya KL; Shree Hindu Mandal Hospital and Muhimbili University of Health Sciences, Dar es Salaam, United Republic of Tanzania., Mganga M; Kinondoni Municipal Council, National Tuberculosis Program, Dar es Salaam, United Republic of Tanzania., Minja LT; Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania., Saleh L; Institute of Clinical Chemistry, University of Zurich, University Hospital of Zurich, Zurich, Switzerland., Imboden M; Swiss Tropical and Public Health Institute, Basel, Switzerland.; Department of Sciences, University of Basel, Basel, Switzerland., Schindler C; Swiss Tropical and Public Health Institute, Basel, Switzerland.; Department of Sciences, University of Basel, Basel, Switzerland., Gagneux S; Swiss Tropical and Public Health Institute, Basel, Switzerland.; Department of Sciences, University of Basel, Basel, Switzerland., Daubenberger C; Swiss Tropical and Public Health Institute, Basel, Switzerland.; Department of Sciences, University of Basel, Basel, Switzerland., Reither K; Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania.; Swiss Tropical and Public Health Institute, Basel, Switzerland.; Department of Sciences, University of Basel, Basel, Switzerland., Probst-Hensch N; Swiss Tropical and Public Health Institute, Basel, Switzerland.; Department of Sciences, University of Basel, Basel, Switzerland.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2016 Nov 03; Vol. 16 (1), pp. 626. Date of Electronic Publication: 2016 Nov 03.
DOI: 10.1186/s12879-016-1960-x
Abstrakt: Background: Vitamin 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.
Methods: Consecutive 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.
Results: The 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 (p interaction  = 0.01).
Conclusions: Low 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.
Databáze: MEDLINE
Externí odkaz: