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Published on: September 14, 2011
Vitamin D and tuberculosis: a multicenter study in children
Elisabetta Venturini1, Ludovica Facchini2, Nuria Martinez-Alier3
1Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, viale Pieraccini 24, I-50139, Florence, Italy. elisabetta-venturini@virgilio.it.
Insights
Children with tuberculosis (TB) have significantly lower vitamin D levels. This study found a higher risk of vitamin D deficiency in children with latent and active TB, suggesting a link between vitamin D and TB infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Tuberculosis (TB) remains a significant global health concern, particularly in pediatric populations.
- Vitamin D deficiency (hypovitaminosis D) is prevalent worldwide and has been implicated in various immune functions.
- The relationship between vitamin D status and TB infection in children requires further elucidation.
Purpose of the Study:
- To investigate and compare vitamin D levels in children diagnosed with latent or active tuberculosis (TB) against a control group of healthy children.
- To determine the prevalence of vitamin D deficiency, insufficiency, and sufficiency in pediatric TB patients and controls.
- To assess the association between vitamin D status and the presence of TB infection in children.
Main Methods:
- A multicenter observational study involving 996 children across three tertiary pediatric centers in Italy and the UK.
- Serum vitamin D levels were measured, with deficiency defined as <25 nmol/L, insufficiency between 25-50 nmol/L, and sufficiency >50 nmol/L.
- Multivariate analysis was employed to compare vitamin D levels and assess the risk of hypovitaminosis D between TB-affected children and controls.
Main Results:
- The study included 44 children with active TB (4.4%), 138 with latent TB (13.9%), and 814 controls (81.7%).
- A high prevalence of hypovitaminosis D was observed across the entire study population.
- Children with latent TB showed a 1.61-fold increased risk of hypovitaminosis D (P=0.018), while those with active TB had a 4.587-fold increased risk (P<0.0001) compared to controls.
Conclusions:
- Hypovitaminosis D is significantly associated with both latent and active tuberculosis infection in children.
- These findings highlight the potential importance of vitamin D status in pediatric TB.
- Further research is warranted to explore the role of vitamin D in the prevention and treatment strategies for childhood tuberculosis.
Background:
The aim of this study is to evaluate vitamin D levels in children with latent and active TB compared to healthy controls of the same age and ethnical background.
Methods:
A multicenter observational study has been conducted in three tertiary care paediatric centres: Anna Meyer Children's University Hospital, Florence, Italy; Evelina London Children's Hospital, London, United Kingdom and Great Ormond Street Hospital, London, United Kingdom. Vitamin D was considered deficient if the serum level was <25 nmol/L, insufficient between 25 and 50 nmol/L and sufficient for a level >50 nmol/L.
Results:
The study population included 996 children screened for TB, which have been tested for vitamin D. Forty-four children (4.4%) had active TB, 138 (13.9%) latent TB and 814 (81.7%) were controls. Our study confirmed a high prevalence of hypovitaminosis D in the study population. A multivariate analysis confirmed an increased risk of hypovitaminosis D in children with latent and active TB compared to controls [(P = 0.018; RR = 1.61; 95% CI: 1.086-2.388), (P < 0.0001; RR = 4.587; 95% CI:1.190-9.608)].
Conclusions:
Hypovitaminosis D was significantly associated with TB infection in our study. Further studies are needed to evaluate a possible role of vitamin D in the treatment and prevention of tuberculosis in children.
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