Background

Vitamin D is essential in the host defense against tuberculosis (TB). Suboptimal vitamin D status is common in the hemodialysis population. Hemodialysis patients have an increased risk compared to the general population latent tuberculosis infection (LTBI). However, the association between vitamin D deficiency and LTBI in this population remains unclear.

Materials and methods

We conducted a cross-sectional study between March and May 2017. Interferon-gamma release assay (IGRA) through QuantiFERON-TB Gold In-Tube was used to assess LTBI. Plasma 25-hydroxycholecalciferol (25-OHD) levels were measured by Elecsys Vitamin D Total assay. Suboptimal vitamin D levels included vitamin D insufficiency 20–29 ng/mg and vitamin D deficiency <20 ng/mL. Predictors for LTBI were analyzed.

Results

A total of 287 participants were enrolled. The suboptimal vitamin D level was 31.4% (90/287), which including the vitamin D deficiency was 13.9% (40/287). A total of 49.1% (141/287) people received nutritional vitamin D supplementation. The prevalence of IGRA positivity in this study was 25.1% (72/287). There was no significant difference in vitamin D concentrations or the proportion of vitamin D supplementation among the IGRA-positive and IGRA-negative groups (p = 0.789 and 0.496, respectively). In multivariate analysis, age >65 years old (odds ratio (OR), 1.89; 95% CI, 1.08–3.31; p = 0.026) and TB history (OR, 3.51; 95% CI, 1.38–8.91; p = 0.008) were independent predictors of IGRA positivity.

Conclusion

This is the first study to report that vitamin D deficiency was not associated with IGRA positivity in a hemodialysis population. Aging and TB history were both independent predictors for LTBI.

中文翻译：

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血液透析人群中维生素 D 水平与潜伏性结核病风险的关系

背景

维生素 D 在宿主抵抗结核病 (TB) 的过程中必不可少。次优维生素 D 状态在血液透析人群中很常见。与一般人群潜伏性结核感染 (LTBI) 相比，血液透析患者的风险增加。然而，该人群中维生素 D 缺乏与 LTBI 之间的关联仍不清楚。

材料和方法

我们在 2017 年 3 月至 5 月期间进行了一项横断面研究。通过 QuantiFERON-TB Gold In-Tube 使用干扰素-γ 释放试验 (IGRA) 来评估 LTBI。血浆 25-羟基胆钙化醇 (25-OHD) 水平通过 Elecsys 维生素 D 总含量测定进行测量。次优维生素 D 水平包括维生素 D 不足 20-29 ng/mg 和维生素 D 缺乏 <20 ng/mL。分析了 LTBI 的预测因子。

结果

共有 287 名参与者参加。次优维生素 D 水平为 31.4% (90/287)，其中包括维生素 D 缺乏为 13.9% (40/287)。共有 49.1% (141/287) 的人接受了营养性维生素 D 补充。本研究中 IGRA 阳性的患病率为 25.1% (72/287)。IGRA 阳性组和 IGRA 阴性组的维生素 D 浓度或补充维生素 D 的比例没有显着差异（分别为 p = 0.789 和 0.496）。在多变量分析中，年龄 > 65 岁（优势比 (OR)，1.89；95% CI，1.08–3.31；p = 0.026）和结核病史（OR，3.51；95% CI，1.38–8.91；p = 0.008）是 IGRA 阳性的独立预测因子。

结论

这是第一项报告维生素 D 缺乏与血液透析人群中 IGRA 阳性无关的研究。老龄化和结核病史都是 LTBI 的独立预测因素。