Unfavourable treatment outcomes in tuberculosis patients with different vitamin D status and blood glucose levels in a program setting in China
Tropical Medicine and International Health https://doi.org/10.1111/tmi.13355
Yan Lin Yunlong Bai Tiejuan Zhang Wanli Kang Demei Kang Qiang Miao Yunlong Wang Hongshan Shao Xiangwen Li Grania Brigden … See all authors
Note: Diabetis is associated with low vitamin D
Patients having both Diabetes and TB treated by vitamin D – June 2012
Overview Tuberculosis and Vitamin D has the following summary
Many studies have found that Vitamin D both PREVENTS and TREATS TB
- As with many other diseases, we expect that there will be at least a 4X range of vitamin D due to:
- 4X range in the response in the vitamin D blood level for the same IU dose - for healthy, non-obese, people
- Poor Vitamin D Receptor activation results in far less vitamin D getting to cells
- However, a VDR restriction is not noticed by Vitamin D blood tests
- UV appears to be as powerful or perhaps more powerful than vitamin D in TREATING TB
- Tuberculosis -100 percent cure rate with 10,000 IU of vitamin D daily – RCT 2006
- TB 10X less likely to catch if have sufficient vitamin D – Dec 2011
- Trials using small vitamin D doses neither prevent nor treat TB 2023 2022 2020
- No tuberculosis if more than 80 ng of vitamin D (cattle) - Jan 2022
- Humans need a lot of Vitamin D as well
Items in both categories TB and Radomized Controlled Trials are listed here:
- Spinal TB surgery now includes Vitamin D as the standard of care (5,000 IU daily) – Sept 2024
- TB treatment helped by the addition of Vitamin D (100,000 IU bi-weekly) – RCT April 2024
- Tuberculosis not prevented by a tiny amount of vitamin D (equiv to 1,400 IU daily) – RCT May 2023
- Tuberculosis treatment helped a bit by a bit of Vitamin D - RCT Feb 2022
- TB not prevented by a small amount of Vitamin D (2,000 IU daily average, Mongolia) – RCT July 2020
- TB not treated by vitamin D given for only 2 months – RCT Sept 2017
- Tuberculosis recovery speeded up by single 450,000 IU dose of vitamin D – RCT Jan 2017
- Tuberculosis treatment greatly helped by injection of 200,000 IU of vitamin D – RCT April 2016
- Tuberculosis -100 percent cure rate with 10,000 IU of vitamin D daily – RCT 2006
- Tuberculosis not treated by lots of vitamin D for 16 weeks – RCT Sept 2015
- Every TB patient benefited from 2 doses of 600,000 IU of vitamin D – RCT Jan 2013
- TB treatment helped with Vitamin D – RCT Sept 2012
- Probability of getting TB reduced 60 percent with just 800 IU of vitamin D – RCT Aug 2012
- Overview Tuberculosis and Vitamin D
- Evaluating the vitamin D evidence - Heaney Dec 2010
Items in both categories TB and Meta-analysis are listed here:
- Latent Tuberculosis 44 percent less likely if Vitamin D more than 30 ng - 14th meta-analysis Jan 2022
- Those with TB were 3.2 X more likely to have low vitamin D – 13th meta-analysis Sept 2021
- Tuberculosis still associated with low vitamin D – 12th meta-analysis June 2021
- Tuberculosis 3X more likely if less than 12 ng of Vitamin D - meta-analysis Sept 2019
- Tuberculosis increased risk if poor Vitamin D receptor varies by race – meta-analysis Feb 2019
- Tuberculosis (multi-drug resistant) was 13.4 X more likely to be quickly cleared with Vitamin D - Meta-analysis Feb 2019
- Catching Tuberculosis from family member 2 X more likely if low vitamin D – meta-analysis Dec 2018
- Tuberculosis in children 1.7 X more likely if low vitamin D – meta-analysis Aug 2018
- Low vitamin D is a risk factor for tuberculosis – meta-analysis Dec 2016
- Tuberculosis 1.3 times more likely if poor Vitamin D Receptor – meta-analysis Oct 2016
- Tuberculosis 4.5X more likely if vitamin D less than 10 nanogram – meta-analysis May 2015
- Tuberculosis, genes and vitamin D – Meta-Analysis Dec 2013
- TB associated with low vitamin D in a review and meta-analysis – 2008
- TB and vitamin D updated review and meta-analysis – plays a role Jan 2010
Objective
Tuberculosis (TB) treatment success rates are high in China, but there are still a considerable number of cases who have unfavourable treatment outcomes (UTO). We aimed to determine the pro‐portion of TB patients with UTO and to assess whether baseline characteristics that included glycaemic status [normal fasting blood glucose (FBG), transient hyperglycaemia and diabetes mellitus (DM)] and vitamin D status were associated with UTO.
Method
Prospective cohort study conducted between November 2015 and July 2016 at six clinics within routine TB services in Jilin province, where persons with TB were consecutively recruited. Data analysis was performed using the chi square test and multivariate logistic regression.
Results
Of 306 recruited TB patients, 96 (31.4%) had smear positive pulmonary TB, 187 (61.1%) had smear‐negative pulmonary TB and 23 (7.5%) had extra pulmonary TB (EPTB). Of these, 95 (31.1%) had normal blood glucose, 83 (27.1%) had transient hyperglycaemia and 128 (41.8%) had DM. 227 (74.2%) patients had vitamin D deficiency/severe deficiency. There were 125 (40.8%) patients with UTO of whom the majority were lost to follow‐up (57.6%) or not evaluated (28.8%). UTO was significantly associated with smear negative pulmonary TB (P=0.009), EPTB (P<0.001), and DM (P=0.007).
Conclusion
The proportion of TB patients with UTO increased with smear‐negative pulmonary TB, EPTB and DM. TB Programmes need to pay more attention to these issues and ensure intensive patient support to those at risk and early detection of DM.
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