Vitamin D status and risk of incident tuberculosis disease: A nested case-control study, systematic review, and individual-participant data meta-analysis
Aibana O, Huang CC, Aboud S, Arnedo-Pena A, Becerra MC, Bellido-Blasco JB, Bhosale R, Calderon R, Chiang S, Contreras C, Davaasambuu G, Fawzi WW, Franke MF, Galea JT, Garcia-Ferrer D, Gil-Fortuño M, Gomila-Sard B, Gupta A, Gupte N, Hussain R, Iborra-Millet J, Iqbal NT, Juan-Cerdán JV, Kinikar A, Lecca L, Mave V, Meseguer-Ferrer N, Montepiedra G, Mugusi FM, Owolabi OA, Parsonnet J, Roach-Poblete F, Romeu-García MA, Spector SA, Sudfeld CR, Tenforde MW, Togun TO, Yataco R, Zhang Z, Murray MB
PLoS medicine · 92 citas
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- Bill and Melinda Gates Foundation
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- Higher Education Commision, Pakistan
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- National Institutes of Health
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- National Institute of Mental Health
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- National Institute on Drug Abuse
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- National Institute of Allergy and Infectious Diseases
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- Fogarty International Center
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- National Institute of Diabetes and Digestive and Kidney Diseases
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- National Institute of Neurological Disorders and Stroke
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- National Institute of Child Health and Human Development
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- Eunice Kennedy Shriver National Institute of Child Health and Human Development
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- Subvenciones
- Fogarty International Center (D43TW0000); National Institute of Allergy and Infectious Diseases (U19 AI 076217); National Institute of Allergy and Infectious Diseases (UM1 AI069536); National Institute of Diabetes and Digestive and Kidney Diseases (HHSN267200800001G); National Institute of Allergy and Infectious Diseases (F32 AI140511); National Institute of Allergy and Infectious Diseases (R01AI080417); National Institute of Allergy and Infectious Diseases (R01 AI 45462); National Institute of Child Health and Human Development (N01-DK-9-001/HHSN267200800001C); National Institute of Allergy and Infectious Diseases (UM1AI106716); Eunice Kennedy Shriver National Institute of Child Health and Human Development (HHSN267200800001C); National Institute of Allergy and Infectious Diseases (U19AI111224); Fogarty International Center (K01TW010829); National Institutes of Health (1f32ai140511-01); National Institute of Allergy and Infectious Diseases (UM1-AI-068636); Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD032257); National Institute of Allergy and Infectious Diseases (TBRU U19AI111224); National Institute of Allergy and Infectious Diseases (U01 AI069497); Higher Education Commision, Pakistan (HEC#20/796/ R&D/06); National Institute of Allergy and Infectious Diseases (R01 AI045462); National Institute of Allergy and Infectious Diseases (U01AI057786); National Institute of Allergy and Infectious Diseases (U01AI068636); National Institute of Child Health and Human Development (R01 HD32257); National Institute of Allergy and Infectious Diseases (UM1AI069465); National Institute of Allergy and Infectious Diseases (UM1AI068632); National Institute of Mental Health (R25 MH 083620); National Institute of Neurological Disorders and Stroke (R01NS077874); Higher Education Commision, Pakistan (HEC#20/796/ R&); National Institutes of Health (U01 AI057786); National Institutes of Health (U19AI076217); National Institute of Allergy and Infectious Diseases (UM1AI068616); National Institute on Drug Abuse (T32DA013911)
Según 19 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2019-09-11 · PLoS Med · vol. 16 · número 9 · pág. e1002907
- Editorial
- Public Library of Science
- Citado
- 135 citas · más que el 96% de estudios similares · 4.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 71 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Vitamin D Research Studies · Tuberculosis Research and Epidemiology · Infectious Diseases and Tuberculosis
- Palabras clave
- vitamin D status, vitamin D deficiency, tuberculosis, 25-hydroxyvitamin D, HIV status, vitamin D supplementation, Lima, Peru
- MeSH
- humans, tuberculosis, vitamin d deficiency, vitamin d, incidence, risk assessment, risk factors, case-control studies, longitudinal studies, prospective studies, adolescent, adult, middle aged, child, child, preschool, infant, infant, newborn, peru, female, male, young adult, biomarkers
40 autores
- Omowunmi Aibana🇺🇸The University of Texas Health Science Center at Houston
- Chuan‐Chin Huang🇺🇸Harvard University
- Said Aboud🇹🇿Muhimbili University of Health and Allied Sciences
- Alberto Arnedo-Pena
- Mercedes C. Becerra🇺🇸Harvard University
- Juan Bautista Bellido-Blasco
- Ramesh A. Bhosale
- Roger I. Calderon
- Silvia S. Chiang🇺🇸Brown University
- Carmen C. Contreras
- Davaasambuu Ganmaa🇺🇸Brigham and Women's Hospital; Harvard University
- Wafaie Wahib Fawzi🇺🇸Harvard University
- Molly Forrest Franke🇺🇸Harvard University
- Jerome Timothy Galea🇺🇸University of South Florida
- Daniel García‐Ferrer🇪🇸Fundación Hospital Provincial de Castellón
- María Gil🇪🇸Fundación Hospital Provincial de Castellón
- Bárbara Gomila-Sard🇪🇸Fundación Hospital Provincial de Castellón
- Amita Jain Gupta🇺🇸Johns Hopkins University; Johns Hopkins Medicine
- Nikhil Gupte🇺🇸Johns Hopkins University
- Rabia Hussain🇵🇰Aga Khan University
- Jesús Iborra-Millet🇪🇸Fundación Hospital Provincial de Castellón
- Najeeha Talat Iqbal🇵🇰Aga Khan University
- José Vicente Juan-Cerdán🇪🇸Fundación Hospital Provincial de Castellón
- Aarti Avinash Kinikar
- Leonid W. Lecca
- Vidya Mave🇺🇸Johns Hopkins University
- Noemí Meseguer‐Ferrer
- Grace Montepiedra
- Ferdinand M Mugusi🇹🇿Muhimbili University of Health and Allied Sciences
- Olumuyiwa Owolabi🇬🇧London School of Hygiene & Tropical Medicine
- Julie Parsonnet🇺🇸Stanford Medicine; Stanford University
- Freddy Roach-Poblete🇨🇱Hospital Regional de Antofagasta
- María Ángeles Romeu-García
- Stephen A. Spector🇺🇸University of California San Diego
- Christopher Robert Sudfeld🇺🇸Harvard University
- Mark W. Tenforde🇺🇸University of Washington
- Toyin Omotayo Togun🇨🇦McGill University
- Rosa M. Yataco
- Zibiao Zhang🇺🇸Brigham and Women's Hospital; Harvard University
- Megan B. Murray🇺🇸 · autor de correspondenciaHarvard University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.
Methods and findings
We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. For each case, we randomly selected four controls from among contacts who did not develop TB disease, matching on gender and year of age. We also conducted a one-stage individual-participant data (IPD) meta-analysis searching PubMed and Embase to identify prospective studies of vitamin D and TB disease until June 8, 2019. We included studies that assessed vitamin D before TB diagnosis. In the primary analysis, we defined vitamin D deficiency as 25-(OH)D 75nmol/L. We estimated the association between baseline vitamin D status and incident TB using conditional logistic regression in the Lima cohort and generalized linear mixed models in the meta-analysis. We further defined severe vitamin D deficiency as 25-(OH)D < 25 nmol/L and performed stratified analyses by HIV status in the IPD meta-analysis. In the Lima cohort, we analyzed 180 cases and 709 matched controls. The adjusted odds ratio (aOR) for TB risk among participants with baseline vitamin D deficiency compared to sufficient vitamin D was 1.63 (95% CI 0.75-3.52; p = 0.22). We included seven published studies in the meta-analysis and analyzed 3,544 participants. In the pooled analysis, the aOR was 1.48 (95% CI 1.04-2.10; p = 0.03). The aOR for severe vitamin D deficiency was 2.05 (95% CI 0.87-4.87; p trend for decreasing 25-(OH)D levels from sufficient vitamin D to severe deficiency = 0.02). Among 1,576 HIV-positive patients, vitamin D deficiency conferred a 2-fold (aOR 2.18, 95% CI 1.22-3.90; p = 0.01) increased risk of TB, and the aOR for severe vitamin D deficiency compared to sufficient vitamin D was 4.28 (95% CI 0.85-21.45; p = 0.08). Our Lima cohort study is limited by the short duration of follow-up, and the IPD meta-analysis is limited by the number of possible confounding covariates available across all studies.
Conclusion
Our findings suggest vitamin D predicts TB disease risk in a dose-dependent manner and that the risk of TB disease is highest among HIV-positive individuals with severe vitamin D deficiency. Randomized control trials are needed to evaluate the possible role of vitamin D supplementation on reducing TB disease risk.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
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