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Comparative Study
. 2016 May:98:86-91.
doi: 10.1016/j.tube.2016.02.007. Epub 2016 Mar 3.

Elevated serum 25-hydroxy (OH) vitamin D levels are associated with risk of TB progression in Gambian adults

Olumuyiwa Owolabi  1 , Schadrac Agbla  2 , Patrick Owiafe  3 , Simon Donkor  2 , Toyin Togun  2 , Abdou K Sillah  2 , Martin O C Ota  4 , Jayne S Sutherland  2
Affiliations
Comparative Study

Elevated serum 25-hydroxy (OH) vitamin D levels are associated with risk of TB progression in Gambian adults

Olumuyiwa Owolabi et al. Tuberculosis (Edinb). 2016 May.

Abstract

Background: Vitamin D is essential in the host defence against tuberculosis (TB) as an immune modulator. The aim of this study was to determine the level of 25-hydroxyvitamin D (25 (OH) D) from adult TB index cases before and after treatment and their exposed household contacts (HHC) in The Gambia.

Methods: Serum from adult index TB cases and their TB-exposed household contacts (HHC) was analysed for 25(OH) D and Vitamin D binding protein (VDBP) concentrations. Tuberculin skin test (TST) status was used as a measure of Mycobacterium tuberculosis (Mtb) infectivity in the HHC. In addition, HHC who later progressed to active TB (incident cases) were assessed alongside non-progressors to determine the influence of 25 (OH) D levels on TB risk.

Results: Eighty-three TB cases, 46 TST+ and 52 TST- HHC were analysed. Generally levels of 25(OH) D were considered insufficient in all subjects. However, median levels of 25(OH) D and VDBP were significantly higher in TB cases compared to both TST+ and TST- HHC at recruitment and were significantly reduced after TB therapy (p < 0.0001 for all). In addition, levels of serum 25(OH) D at recruitment were significantly higher in TB progressors compared to non-progressors (median (IQR): 25.0(20.8-29.2) in progressors and 20.3 (16.3-24.6) ng/ml in non-progressors; p = 0.007).

Conclusion: In The Gambia, an equatorial country, 25(OH) D levels are higher in serum of TB progressors and those with active disease compared to latently infected and uninfected subjects. These results contrast to findings in non-equatorial countries.

Keywords: 25(OH) D; Incident cases; Latent TB infection; Tuberculosis; Vitamin D binding protein.

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Figures

Figure 1
Figure 1
25(OH) D levels in TB cases and household contacts (HHC). A: Serum 25(OH) D levels were measured using ELISA. Box plots (5–95%) are shown for Serum 25(OH) D levels of TB cases at recruitment (R) and 6 months of treatment and TST+ and TST− HHC at recruitment. Line indicates median and dots indicate outliers. B: Serum Vitamin D Binding Protein levels were measured using ELISA. Box plots (5–95%) are shown for TB cases pre and post-treatment compared to TST+ and TST− HHC. Data were analysed using Random effects modelling and Wilcoxon Ranked Sums test (for comparison of TB cases at recruitment and 6 months). A p-value ≤ 0.05 was considered significant.
Figure 2
Figure 2
Median 25(OH) D levels of TB cases and Household contacts (HHC) at recruitment. Median 25(OH) D levels at each month of recruitment for all participants are shown to reflect changes in levels of 25(OH) D levels.
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