The Level of Vitamin D in Patients with Susceptible Pulmonary Tuberculosis and Evaluation of its Influence on the Clinical Course of the Disease

Abstract

Vitamin D insufficiency or deficiency is defined as a very common condition in the general population. On the one hand, vitamin D deficiency is associated with several adverse health conditions, on the other hand, vitamin D supplements are inexpensive and safe to use, which makes it an attractive therapeutic option for both doctors and patients, especially for groups risk among the population. Several researchers claim that vitamin D metabolites play an important role in the coordinated work of the body’s immune system by inducing the migration of phagocytes, modulating the Th1—Th2 cell balance, and differentiating T-regulatory cells. Objective — to determine the level of vitamin D in patients with susceptible pulmonary tuberculosis and to evaluate its influence on the clinical course of the disease. Materials and methods. The randomized case-control study included 45 patients with newly diagnosed pulmonary tuberculosis of the lungs with preserved sensitivity and 30 practically healthy individuals (PHI) of the control group. The level of vitamin D in blood serum was examined using the VD (Vitamin D) ELISA Kit (Optics Valley Biomedical Industrial Park, Wuhan, China (430075)), for the quantitative detection of vitamin D in blood serum, number: EU2541, parameter: 1.563—100 ng/ml. Results and discussion. According to the results of our study, it was established that the average level of 25(OH)D concentration in the blood serum of patients with pulmonary tuberculosis was (18.46 ± 4.23) ng/ml, in the control group it was (28.834 ± 5.79) ng/ml and was statistically significant (p = 0.001). Our multivariate studies with binary logistic regression showed a strong direct relationship between the presence of a specific tubercular process and vitamin D deficiency (< 20 ng/ml) (OR 2.817, 95 % CI 1.287—4.894, p < 0.005. Conclusions. Vitamin D deficiency was noted in 94 % of patients with pulmonary tuberculosis with severe intoxication syndrome (7—10 points). In tuberculosis with moderate intoxication syndrome (4—6 points), 69.7 % of patients had a vitamin D deficiency, which practically did not differ from indicators in patients with mild intoxication syndrome (1—3 points) — 67.2 % of people.