title: Evaluation of vitamin status in patients with pulmonary tuberculosis.
abstract: Vitamins are known to be associated with immunity and nutrition. Moreover, vitamin deficiency can affect host immunity to various infectious diseases, including tuberculosis. Although patients with tuberculosis often have vitamin D deficiency, little is known about the levels of other vitamins. Here, we aimed to investigate the status of vitamins A, B12, D, and E in patients with tuberculosis. We also aimed to investigate the clinical and laboratory variables related to vitamin status in patients with tuberculosis.
  
  
  
  We performed a case-control study to investigate the serum vitamin concentrations in 152 patients with tuberculosis and 137 control subjects. The concentrations of vitamin A, vitamin D, vitamin E, homocysteine, and methylmalonic acid were measured using high-performance liquid chromatography (HPLC) or HPLC-tandem mass spectrometry. Patient demographic data and other biochemical parameters were also analyzed.
  
  
  
  The serum concentrations of vitamins A, D, and E were significantly lower in patients with tuberculosis than in control subjects (1.4 vs. 2.0 μmol/L, P < 0.001; 10.6 vs. 19.3 ng/mL, P < 0.001; and 22.8 vs. 30.6 μmol/L, P < 0.001, respectively). In contrast, the methylmalonic acid levels were higher in patients with tuberculosis (134.9 vs. 110.8 nmol/L, P < 0.001). The prevalences of vitamin deficiencies were significantly higher in patients with tuberculosis. Moreover, multiple vitamin deficiencies were only observed in patients with tuberculosis (22.4% of all patients with tuberculosis vs. 0% of all control subjects). Positive correlations among vitamin A, D, and E concentrations were observed (vitamins A and D, r = 0.395; vitamins D and E, r = 0.342; and vitamins A and E, r = 0.427, P < 0.001). Body mass index, total cholesterol, low-density lipoprotein, iron, and total iron-binding capacity all showed positive correlations with vitamin A, D, and E concentrations.
  
  
  
  Vitamin deficiencies are common in patients with tuberculosis. Further research investigating the clinical importance of vitamin and nutritional status in patients with tuberculosis is needed.
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jongwon
authors.initials: J
authors.lastname: Oh
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Rihwa
authors.initials: R
authors.lastname: Choi
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyung-Doo
authors.initials: HD
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: Byeong-Ho
authors.initials: BH
authors.lastname: Jeong
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: Hye Yun
authors.initials: HY
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea. Electronic address: wjkoh@skku.edu.
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Pharmacology & Therapeutics, Samsung Medical Center, Seoul, Republic of Korea. Electronic address: sy117.lee@samsung.com.
authors.forename: Soo-Youn
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001361:Avitaminosis / Q000150:complications / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D014397:Tuberculosis, Pulmonary / Q000097:blood*; D014801:Vitamin A / Q000097:blood*; D014805:Vitamin B 12 / Q000097:blood*; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency; D014810:Vitamin E / Q000097:blood*; D055815:Young Adult
chemical_list: D014801:Vitamin A; D014807:Vitamin D; D014810:Vitamin E; D014805:Vitamin B 12
keywords: Nutrition; Tuberculosis; Vitamin