Volume 30, Issue 139 (March & April 2022)                   J Adv Med Biomed Res 2022, 30(139): 109-115 | Back to browse issues page

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Oveissi M, Nikoonajad A, Allami A. Status of Vitamin D, Calcium and Parathyroid Hormone Levels & Hepatorenal Function in Untreated Pulmonary Tuberculosis: A Matched Case-Control Study. J Adv Med Biomed Res 2022; 30 (139) :109-115
URL: http://journal.zums.ac.ir/article-1-6364-en.html
Status of Vitamin D, Calcium and Parathyroid Hormone Levels & Hepatorenal Function in Untreated Pulmonary Tuberculosis: A Matched Case-Control Study
Maryam Oveissi1 , Alireza Nikoonajad1 , Abbas Allami *2
1- Dept. of Infectious Diseases, Clinical Research Development Unit, BuAliSina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
2- Dept. of Infectious Diseases, Clinical Research Development Unit, BuAliSina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran , allami9@yahoo.com
Abstract:   (94086 Views)

Background and Objective: Tuberculosis (TB) remains an ongoing major public health problem in the world. In recent years, experimental evidenc suggests a link between TB and Vitamin (Vit) D. This study was conducted to determine serum Vit D, calcium (Ca), phosphorus (P), and parathormone (PTH) levels in untreated pulmonary TB (PTB) patients.
Materials and Methods: In this case control study, 50 outdoor PTB patients were selected with 50 gender- matched controls from April 2019 to March 2020. Controls were drawn randomly from general population. Body mass index (BMI) ,serum Vit D, PTH, Ca, P, Albumin (Alb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin, blood urea nitrogen (BUN) and creatinine (Cr) levels were measured in the two study groups. The results were analyzed on SPSS version 25.
Results: Median [IQR] Vit D levels were 17.4 [14.0- 24.0] ng/ml in cases,and 23.0 [18.0- 27.0] ng/ml in controls (P=0.002). Median [IQR] serum corrected Ca value for the TB patients (8.91 [8.60- 9.15] mg/dL) was significantly lower than that of the healthy controls (9.60 [9.15- 9.89] mg/dL, P< 0.001). Median [IQR] PTH was 48 in TB patients [45- 52 pg/ml ]and 38 in controls [28- 42 pg/ml] (P<0.0001).
Conclusion: BMI and uncorrected and corrected serum Ca, P, Vit D, Alb, and both two aminotransferases levels were significantly lower and serum PTH was significantly higher in patients with TB as compared to controls.

Keywords: Tuberculosis, Vitamin D, serum Calcium, Parathormone, Aminotransferase
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✅ BMI and uncorrected and corrected serum Ca, P, Vit D, Alb, and both two aminotransferases levels were significantly lower and serum PTH were significantly higher in patients with TB as compared to controls.


Type of Study: Original Article | Subject: Clinical medicine
Received: 2021/01/10 | Accepted: 2021/04/5 | Published: 2022/01/31
References
1. Allami A, Mohammadi N, Afaghi A, Lashgari A. BCG scar formation and test results in two generations. Shiraz E Med J. 2011;12(1):22-9.
2. Allami A, Jafarpour Khameneh H, Haji Ali F. Prevalence of latent tuberculosis in students of Qazvin University of Medical Sciences (2014). J Inflamm Disease. 2015;19(3):49-54. [DOI:10.1093/infdis/jiu160] [PMID]
3. Garrido-Cardenas J, de Lamo-Sevilla C, Cabezas-Fernández M, Manzano-Agugliaro F, Martínez-Lirola M. Global tuberculosis research and its future prospects. Tuberculosis. 2020;121:101917. [DOI:10.1016/j.tube.2020.101917] [PMID]
4. Tavakoli A. Incidence and prevalence of tuberculosis in Iran and neighboring countries. Zahedan J Res Med Sci. 2017;19(7):e9238. [DOI:10.5812/zjrms.9238]
5. Wilkinson RJ, Lange C. Vitamin D and tuberculosis: new light on a potent biologic therapy? Am J Respir Crit Care Med 2009;179:740-2. [DOI:10.1164/rccm.200902-0186ED] [PMID]
6. Ganmaa D, Uyanga B, Zhou X, et al. Vitamin D supplements for prevention of tuberculosis infection and disease. N Engl J Med. 2020;383(4):359-68. [DOI:10.1056/NEJMoa1915176] [PMID] [PMCID]
7. Jolliffe DA, Ganmaa D, Wejse C, et al. Adjunctive vitamin D in tuberculosis treatment: meta-analysis of individual participant data. Eur Respir J. 2019;53(3):1802003. [DOI:10.1183/13993003.02003-2018] [PMID]
8. Liu PT, Stenger S, Tang DH, Modlin RL. Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol. 2007;179(4):2060-3. [DOI:10.4049/jimmunol.179.4.2060] [PMID]
9. Ziaee A, Javadi A, Javadi M, Zohal M, Afaghi A. Nutritional status assessment of minodar residence in Qazvin City, Iran: Vitamin D deficiency in sunshine country, a public health issue. Glob J Health Sci. 2013;5(1):174-9. [DOI:10.5539/gjhs.v5n1p174]
10. Lian IA, Åsberg A. Should total calcium be adjusted for albumin? A retrospective observational study of laboratory data from central Norway. BMJ open. 2018;8(4):e017703. [DOI:10.1136/bmjopen-2017-017703] [PMID] [PMCID]
11. Iftikhar R, Kamran SM, Qadir A, Haider E, Bin Usman H. Vitamin D deficiency in patients with tuberculosis. J Coll Physicians Surg Pak. 2013;23(10):780-3.
12. Tabrizi R, Moosazadeh M, Akbari M, et al. High prevalence of vitamin D deficiency among Iranian population: a systematic review and meta-analysis. Iran J Med Sci. 2018;43(2):125-39.
13. SH J, MH K. Epidemiology of vitamin D deficiency among 10-18 years old population of Minoodar district, Qazvin (2010). J Inflamm Dis. 2015;18(6):24-32. https://doi.org/10.1086/651457 [DOI:10.1007/s10753-009-9170-y] [PMID]
14. Vatandost S, Jahani M, Afshari A, Amiri MR, Heidarimoghadam R, Mohammadi Y. Prevalence of vitamin D deficiency in Iran: a systematic review and meta-analysis. Nutr Health. 2018;24(4):269-78. [DOI:10.1177/0260106018802968] [PMID]
15. Lydia W, Nasution MS, Pase MA. The Differences of TNF-α Levels and BMI in Diabetic Patients With Pulmonary Tuberculosis After Intensive Phase of Tuberculosis Treatment. J Endocrinol Trop Med Infect Dis. 2020;2(2):87-95. [DOI:10.32734/jetromi.v2i2.3873]
16. Chan T, Poon P, Pang J, et al. A study of calcium and vitamin D metabolism in Chinese patients with pulmonary tuberculosis. J Trop Med Hyg. 1994;97(1):26-30.
17. Grange JM, Davies P, Brown RC, Woodhead JS, Kardjito T. A study of vitamin D levels in Indonesian patients with untreated pulmonary tuberculosis. Tubercle. 1985;66(3):187-91. [DOI:10.1016/0041-3879(85)90035-2]
18. Chan T. Differences in vitamin D status and calcium intake: possible explanations for the regional variations in the prevalence of hypercalcemia in tuberculosis. Calcif Tissue Int. 1997;60(1):91-3. [DOI:10.1007/s002239900192] [PMID]
19. Nnoaham KE, Clarke A. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol. 2008;37(1):113-9. [DOI:10.1093/ije/dym247] [PMID]
20. Martineau AR, Wilkinson KA, Newton SM, et al. IFN-γ-and TNF-independent vitamin D-inducible human suppression of mycobacteria: the role of cathelicidin LL-37. J Immunol. 2007;178(11):7190-8. [DOI:10.4049/jimmunol.178.11.7190] [PMID]
21. Liu PT, Stenger S, Li H, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science. 2006;311(5768):1770-3. [DOI:10.1126/science.1123933] [PMID]
22. Lips P. Vitamin D physiology. Prog Biophys Mol Biol. 2006;92(1):4-8. [DOI:10.1016/j.pbiomolbio.2006.02.016] [PMID]
23. Holick MF. The parathyroid hormone D-lema. J Clin Endocrinol Metab. 2003;88(8):3499-500. [DOI:10.1210/jc.2003-031025] [PMID]
24. Matos E, Moreira Lemos A. Association between serum albumin levels and in-hospital deaths due to tuberculosis. Int J Tuberc Lung Dis. 2006;10(12):1360-6.
25. Ho-Pham LT, Nguyen ND, Nguyen TT, et al. Association between vitamin D insufficiency and tuberculosis in a Vietnamese population. BMC Infect Dis. 2010;10(1):306. [DOI:10.1186/1471-2334-10-306] [PMID] [PMCID]
26. Davies P, Church H, Brown R, Woodhead J. Raised serum calcium in tuberculosis patients in Africa. European journal of respiratory diseases Eur J Respir Dis. 1987;71(5):341-4.
27. Keleştimur F, Güven M, Ŏzesmi M, Paşaoglu H. Does tuberculosis really cause hypercalcemia? J Endocrinol Invest. 1996;19(10):678-81. [DOI:10.1007/BF03349038] [PMID]
28. Wauthier L, Theunssens X, Durez P, Fillée C, Maisin D, Gruson D. A rare case of tuberculosis-induced hypercalcemia. Biochemia Medica. 2020;30(3):471-4. [DOI:10.11613/BM.2020.030801] [PMID] [PMCID]
29. John SM, Sagar S, Aparna JK, Joy S, Mishra AK. Risk factors for hypercalcemia in patients with tuberculosis. Int J Mycobacteriol. 2020;9(1):7.
30. Abdullah AS, Adel AM, Hussein RM, et al. Hypercalcemia and acute pancreatitis in a male patient with acute promyelocytic leukemia and pulmonary tuberculosis. Acta Biomed. 2018;89(Suppl 3):23-37.
31. Kardjito T, Ediyanto S, Grange J. Serum phosphorus levels in pulmonary tuberculosis. Postgrad Med J. 1984;60(704):394-6. [DOI:10.1136/pgmj.60.704.394] [PMID] [PMCID]
32. Deniz O, Tozkoparan E, Yonem A, et al. Low parathormone levels and hypercalcaemia in patients with pulmonary tuberculosis: relation to radiological extent of disease and tuberculin skin test. Int J Tuberc Lung Dis. 2005;9(3):317-21.
33. Quist J, Hill AR. Serum lactate dehydrogenase (LDH) in Pneumocystis carinii pneumonia, tuberculosis, and bacterial pneumonia. Chest. 1995;108(2):415-8. [DOI:10.1378/chest.108.2.415] [PMID]
34. Sharma OP. Hypercalcemia in granulomatous disorders: a clinical review. Curr Opin Pulm Med. 2000;6(5):442-7. [DOI:10.1097/00063198-200009000-00010] [PMID]
35. Fukagawa M, Kurokawa K. Calcium homeostasis and imbalance. Nephron. 2002;92(Suppl. 1):41-5. [DOI:10.1159/000065376] [PMID]
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