title: Vitamin D deficiency and the risk of tuberculosis: a meta-analysis.
abstract: OBJECTIVE
  To conduct meta-analyses of all published studies on various aspects of association between vitamin D and tuberculosis (TB).
  
  
  METHODS
  PubMed and Web of Knowledge were searched for all properly controlled studies on vitamin D and TB. Pooled odds ratio, mean difference or standardized mean difference, and its corresponding 95% confidence interval were calculated with the Cochrane Review Manager 5.3.
  
  
  RESULTS
  A significantly lower vitamin D level was found in TB patients vs controls; vitamin D deficiency (VDD) was associated with an increased risk of TB, although such an association was lacking in the African population and in the human immunodeficiency virus-infected African population. A significantly lower vitamin D level was found in human immunodeficiency virus-TB-coinfected African patients receiving antiretroviral treatment who developed TB-associated immune reconstitution inflammatory syndrome vs those who did not develop TB-associated immune reconstitution inflammatory syndrome. VDD was associated with an increased risk of developing active TB in those subjects with latent TB infection and with an increased risk of tuberculin skin test conversion/TB infection conversion, and the trend toward a lower vitamin D level in active TB patients vs latent TB infection subjects did not reach statistical significance, indicating that VDD was more likely a risk factor than a consequence of TB. This concept was further strengthened by our result that anti-TB treatment did not affect vitamin D level in TB patients receiving the treatment.
  
  
  CONCLUSIONS
  Our analyses revealed an association between vitamin D and TB. VDD is more likely a risk factor for TB than its consequence. More studies are needed to determine whether vitamin D supplementation is beneficial to TB prevention and treatment.
authors.affiliation: Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Shao-Jun
authors.initials: SJ
authors.lastname: Huang
authors.affiliation: Department of Nutrition and Food Hygiene, Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, People's Republic of China.
authors.forename: Xian-Hua
authors.initials: XH
authors.lastname: Wang
authors.affiliation: Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Zhi-Dong
authors.initials: ZD
authors.lastname: Liu
authors.affiliation: Department of Pulmonary Medicine, Beijing Geriatric Hospital, Beijing, People's Republic of China.
authors.forename: Wen-Li
authors.initials: WL
authors.lastname: Cao
authors.affiliation: Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Nutrition and Food Hygiene, Institute of Human Nutrition, Medical College of Qingdao University, Qingdao, People's Republic of China.
authors.forename: Ai-Guo
authors.initials: AG
authors.lastname: Ma
authors.affiliation: Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Shao-Fa
authors.initials: SF
authors.lastname: Xu
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D012307:Risk Factors; D014376:Tuberculosis / Q000097:blood* / Q000188:drug therapy / Q000276:immunology; D014808:Vitamin D Deficiency / Q000097:blood* / Q000276:immunology
chemical_list: D044966:Anti-Retroviral Agents; D000995:Antitubercular Agents
keywords: 25-hydroxyvitamin D; meta-analysis; tuberculosis; vitamin D; vitamin D deficiency