Effects of sunlight and diet on vitamin D status of pulmonary tuberculosis patients in Tbilisi, Georgia.
OBJECTIVE
Vitamin D deficiency is common in tuberculosis (TB) and this may modulate immune responses. This study investigated vitamin D status in patients with TB and examined the sources of vitamin D in Tbilisi, Georgia.


METHODS
We measured plasma 25-hydroxyvitamin D (25[OH]D) and dietary vitamin D intake in patients with pulmonary TB (n = 85) in Tbilisi, Georgia. To determine the impact of season on vitamin D status, we tested the in vitro conversion of 7-dehydrocholesterol (7-DHC) to previtamin D(3) after sunlight exposure.


RESULTS
In subjects with TB, mean plasma 25(OH)D concentrations were 14.4 ± 7.0 ng/mL, and vitamin D insufficiency (25[OH]D <30 ng/mL) occurred in 97% of subjects. The dietary sources of vitamin D were mainly fish, eggs, and butter. The daily intake was well below recommended daily intakes in subjects with TB (172 ± 196 IU). The conversion of 7-DHC to previtamin D(3) was undetectable from October to March and highest in June and July from 11:00 to 14:00 h.


CONCLUSIONS
An insufficient vitamin D dietary intake and a limited production of vitamin D from sunlight for most of the year may explain the high prevalence of vitamin D insufficiency in patients with TB in Tbilisi.
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Nirali S
NS
Desai
Nestani
N
Tukvadze
Jennifer K
JK
Frediani
Maia
M
Kipiani
Ekaterine
E
Sanikidze
Memorie M
MM
Nichols
Gautam
G
Hebbar
Russell R
RR
Kempker
Veriko
V
Mirtskhulava
Iagor
I
Kalandadze
Shabnam
S
Seydafkan
Nilay
N
Sutaria
Tai C
TC
Chen
Henry M
HM
Blumberg
Thomas R
TR
Ziegler
Vin
V
Tangpricha
D000328:Adult; D002762:Cholecalciferol / Q000097:blood; D003684:Dehydrocholesterols / Q000097:blood; D004032:Diet; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D009751:Nutritional Requirements; D009752:Nutritional Status; D015995:Prevalence; D013472:Sunlight; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000150:complications*; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood*; D055815:Young Adult
D003684:Dehydrocholesterols; D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D; C016705:7-dehydrocholesterol