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Vitamin D deficiency and the risk of tuberculosis: a meta-analysis

Authors Huang SJ, Wang XH, Liu ZD, Cao WL, Han Y, Ma AG, Xu SF

Received 25 December 2014

Accepted for publication 30 June 2016

Published 28 December 2016 Volume 2017:11 Pages 91—102

DOI https://doi.org/10.2147/DDDT.S79870

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Wei Duan

Shao-Jun Huang,1 Xian-Hua Wang,2 Zhi-Dong Liu,1 Wen-Li Cao,3 Yi Han,1 Ai-Guo Ma,2 Shao-Fa Xu1

1Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Nutrition and Food Hygiene, Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, People’s Republic of China; 3Department of Pulmonary Medicine, Beijing Geriatric Hospital, Beijing, People’s Republic of China

Background and aim: To conduct meta-analyses of all published studies on various aspects of association between vitamin D and tuberculosis (TB).
Methods: PubMed and Web of Knowledge were searched for all properly controlled studies on vitamin D and TB. Pooled odds ratio, mean difference or standardized mean difference, and its corresponding 95% confidence interval were calculated with the Cochrane Review Manager 5.3.
Results: A significantly lower vitamin D level was found in TB patients vs controls; vitamin D deficiency (VDD) was associated with an increased risk of TB, although such an association was lacking in the African population and in the human immunodeficiency virus-infected African population. A significantly lower vitamin D level was found in human immunodeficiency virus-TB-coinfected African patients receiving antiretroviral treatment who developed TB-associated immune reconstitution inflammatory syndrome vs those who did not develop TB-associated immune reconstitution inflammatory syndrome. VDD was associated with an increased risk of developing active TB in those subjects with latent TB infection and with an increased risk of tuberculin skin test conversion/TB infection conversion, and the trend toward a lower vitamin D level in active TB patients vs latent TB infection subjects did not reach statistical significance, indicating that VDD was more likely a risk factor than a consequence of TB. This concept was further strengthened by our result that anti-TB treatment did not affect vitamin D level in TB patients receiving the treatment.
Conclusion: Our analyses revealed an association between vitamin D and TB. VDD is more likely a risk factor for TB than its consequence. More studies are needed to determine whether vitamin D supplementation is beneficial to TB prevention and treatment.

Keywords: vitamin D, vitamin D deficiency, tuberculosis, 25-hydroxyvitamin D, meta-analysis

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