Original Article
Effect of first-line antituberculous treatment on vitamin D level in patients with pulmonary tuberculosis
Deliang Lv, Weiguo Tan, Jian Xu, Hui Yang, Junluan Mo, Yumei Zhu, Xiongshun Liang, Xiaoling Che, Qingfang Wu, Weiye Yu
Published 2019-04-30
Cite as Chin J Clin Nutr, 2019, 27(2): 90-95. DOI: 10.3760/cma.j.issn.1674-635X.2019.02.005
Abstract
ObjectiveTo explore the effect of first-line anti-tuberculosis treatment on vitamin D level in patients with pulmonary tuberculosis, and to master the changes of vitamin D level in the course of treatment, so as to provide a scientific basis for tuberculosis and nutrition health education in Shenzhen.
MethodsA total of 100 patients diagnosed as smear-positive pulmonary tuberculosis and receiving initial treatment in 2016 were enrolled and all the patients were treated with the standardized short-course chemotherapy regimens. The blood samples were extracted before treatment and at the ends of intensive and continuation phase. The 25-hydroxyvitamin D[25-(OH)D] concentrations were determined by chemiluminescence (CLIA)at each time point. The change of 25-(OH)D concentrations during anti-tuberculosis treatment was analyzed and the differences of vitamin D levels between different time points were identified.
Results79(79.0%), 94(94.0%) and 96(96.0%)patients were found vitamin D deficiency before treatment and at the end of the intensive and continuation phases respectively, which showed an upward trend(χ2=15.543, P<0.001)and the 25-(OH)D concentrations were (15.74±6.54)ng/ml, (12.56±5.15)ng/ml, (11.51±4.28)ng/ml, respectively. During the whole course of treatment, the 25-(OH)D concentration decreased by 26.9% or (4.23±6.75)ng/ml(t=6.257, P<0.001), wherein it decreased (3.18±5.24)ng/ml in intensive phase (t=6.069, P<0.001) and (1.05±4.86)ng/ml in continuation phase (t=2.154, P=0.034). The former had a greater decreased value (t=2.836, P=0.006). There were 77 (77.0%) and 55 (55.0%) patients with 25-(OH)D concentration reduction in intensive and continuation phases respectively(χ2=9.680, P=0.003), of which 41 patients (41.0%) continued to decline.
ConclusionOnce anti-tuberculosis treatment is conducted, the vitamin D level will decrease rapidly in the intensive phase and continue decreasing throughout the course of treatment, which leads to a general lack of vitamin D in patients with primary pulmonary tuberculosis. First-line anti-tuberculosis drugs may be the main cause for vitamin D level reduction. Therefore, it is necessary for clinicians to strengthen vitamin D health education for each patient throughout the treatment period, especially for those at high risk of vitamin D deficiency who should be recommended adjuvant vitamin D supplementation therapy.
Key words:
Pulmonary tuberculosis; Vitamin D deficiency; 25-hydroxyvitamin D; Anti-tuberculosis drug
Contributor Information
Deliang Lv
Department of Health Management, Shenzhen Center for chronic disease control, Shenzhen 518020, China
Weiguo Tan
Jian Xu
Hui Yang
Junluan Mo
Yumei Zhu
Xiongshun Liang
Xiaoling Che
Qingfang Wu
Weiye Yu
