Vitamin and HbA1C Status in Tuberculosis Patients with Diabetes and its Association

Author(s):  
Dr. Charanpreet Singh

Diabetes mellitus (DM)-tuberculosis is associated with poor glycemic control in DM patients. 2. DM is the most common risk factor associated with tuberculosis (TB); TB is also the third cause of death due to non-communicable disease (NCD). Materials and Methods: Present study was conducted in Dept. of TB and Chest Vedanta Institute of Medical sciences, Vedanta Hospital. A total of 100 patients of Type 2 DM were enrolled in the study of which 60 were male and 40 were female. Written consent was obtained from each patient to participate in the study. The study will be conducted in the patients admitted in the Department of TB and Chest in collaboration with Dept. of Biochemistry, Intensive Coronary Care Unit at Vedanta Hospital. All patients of DM with TB infection are diagnosed by clinician and admitted in our hospital for treatment. Informed consent was taken from all patients, who participated in our study and the study was approved by the college ethics committee. Blood pressure, height, body weight, and waist and hip circumferences of each patient were measured as an anthropometric and dietary measurement. Body mass index (BMI) and ratios of waist to hip circumference was calculated. Blood pressure of each patient was measured after giving rest for at least 5 min. Results: HbA1C levels were higher in the selected group of DM + TB patients mean value being 8.1 ± 0.56 %. There was a significant difference in Vit. B12 levels between cases (218.15 ± 35.65) and controls (355.02 ± 23.39), where serum level was low in cases compared to control group. About 13(18.88%) patients had Vit. B12 level less than 150pg/ml and 28(40.58%) were lying in the intermediate level between 150pg/ml to 350pg/ml. Serum vit.B12 levels ranged from 118pg/ml to 315pg/ml. 25(OH) D3 levels were 17.09 ± 2.15 ng/ml in study group where as in control group the levels were found to be 22.88±4.01.The BMI was higher in those suffering from DM+TB (28.13± 3.24) in comparison to normal subjects (24.89 ± 3.95). Conclusion: Our study has showed high prevalence of TB-DM co-burden of disease in our hospital settings and TB+DM TB-DM were significantly associated with age. Also it is concluded that vitamin D is a link between PTB and DM. Vitamin D levels are lower in patients with TB with DM. This study recommends the importance of performing diabetes screening among pulmonary TB patients and further similar studies needs to be done to determine the feasibility of TB-DM co-management.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4717-4717
Author(s):  
Georgia Kaiafa ◽  
Vasiliki Tsavdaridou ◽  
Athanasios Papadopoulos ◽  
Christos Savopoulos ◽  
Apostolos Hatzitolios ◽  
...  

Abstract Background: Blood cells are deficient in membrane-bound glycosyl-phosphatidylinositol (GPI)-anchored proteins in paroxysmal nocturnal hemoglobinuria (PNH) because of an acquired disorder of the pluripotent stem cell. CD55 and CD59 antigens are the most common GPI-anchored proteins that are used for the diagnosis of the presence of PNH clone. The association of MDS with PNH is rather controversial. There are few published individual cases of PNH arrived from a previous MDS or MDS following PNH. Aim: Recent studies have demonstrated the existence of PNH clone in some MDS patients. These studies were performed mostly on erythrocytes and to the best of our knowledge they are only 4. Granulocytes appear to be more sensitive markers of PNH clone existence than erythrocytes and therefore we investigate the expression of PNH clone on granulocytes of patients with MDS. Material-Methods: A total number of 95 patients 25–80 yrs old with MDS {A:19 with refractory anaemia (RA), B:9 with refractory anaemia with ring sideroblasts (RARS), C:17 with refractory anaemia with excess blasts (RAEB), D: 12 with refractory anaemia with excess blasts in transformation (RAEB-t) and E: 19 with chronic myelomonocytic leukemia (CMLL)} and 19 healthy donors were included in our study. The presence of GPI-anchored proteins (CD55, CD59)-deficient granulocytes was examined by flow cytometry. For the detection of the PNH clone the commercial kit by Beckman Coulter (cellquant CD55/CD59) was used. Statistical analysis was made by ANOVA, while Robust test was performed because there was no homogeneity of variances by ANOVA. Results: Table 1 shows the percentages of CD55 and CD59 deficient granulocytes in the 5 groups of pts with MDS comparing with the control group. a) Although the mean values of CD55 deficient granulocytes in the groups RAEB, RAEB-t and CMLL were higher enough than those of the normal subjects, there were no statistically significant differences (p>0.10) in the comparison of the mean values of CD55 deficient granulocytes between each group of patients with the control group. b) On the contrary there was a very statistically significant difference in the comparison of the mean value of CD59 deficient granulocytes between the three last groups (C, D and E) of pts with the control group (p< 0.086, p< 0.001 and p<0.001 respectively). The percentages of CD55 and CD59 deficient granulocytes in the 5 groups of patients with MDS and in the control group CD55 CD55 CD59 CD59 Groups N Mean Value Std deviation Mean Value Std deviation A (RA) 19 2.89 2.79 2.91 2.85 B (RARS) 9 1.05 1.14 3.89 3.63 C (RAEB) 17 4.78 4.76 11.75 6.06 D (RAEB-t) 12 4.23 2.85 23.76 8.53 E (CMLL) 19 6.01 4.97 38.26 16.18 Control 19 3.67 2.89 3.67 2.89 Total 95 4.00 3.87 14.44 16.39 Conclusions: There are relatively large CD59 negative subpopulations (mean values 11.75–38.26%) of granulocytes in the last three groups (RAEB, RAEB-t, CMLL) of MDS patients. On the contrary the two low risk forms (RA, RARS) revealed no such populations. Non-expression of CD59 antigen on granulocytes is a more sensitive marker than that of CD55 antigen for the presence of a possible PNH clone in MDS patients.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e20000-e20000
Author(s):  
Nurdan Tacyildiz ◽  
Gulsah oktay Tanyildiz ◽  
Deniz Tekin ◽  
Can Ates ◽  
Handan Dincaslan ◽  
...  

e20000 Background: There is increasing interest in the possible association between cancer incidence and vitamin D through its role as a regulator of cell growth and differentiation. Although there are several studies related cancer risk and prognosis of cancer, related vit D levels in adult patients there are only few recent studies in pediatric patients. Methods: Between 2010 and 2011, D Vit levels of 45 patients (25 boys, 20 girls; age range: 6 months-17 years, median: 11 years) have been compared to D Vit levels of 22 healthy children with similar age group. Patient groups were leukemias, lymphomas, bone tumors, retinoblastoma (RB), and other tumors. Kruskal-Wallis and Spearman nonparametric correlations test of SPSS has been used for statistics. Results: Although there was no statistically significant difference for vit D levels between control group (range: 7.2-22.8; median: 14.75 ng/ml) and patients (range: 5.5-40.2; median: 16.0 ng/ml),difference between patients groups were significant (Table). Patients with RB have statistically lower level of Vit D than leukemia (p:0.016) and lymphoma groups ( p: 0.047). “Other tumors group” has lower vit D levels than leukemia group (p: 0.024). Since RB and other tumors group have younger age than other patients, Spearsman’s nonparametric correlation has been performed to exclude age effect on the results and no statistically significant correlation between D vit levels and age (p: 0.779) was found, although there was an inverse correlation between age and vit D levels in patient group (p: 0.03). Conclusions: According to our preliminary results, most of the patients and healthy children have low level of Vit D. Especially patients with RB have statistically significant lower level of Vit D than other malignancies which can be subject to future studies for confirmation of our results. In addition, etiologic studies related RB may have a new area. [Table: see text]


2021 ◽  
pp. 201010582110414
Author(s):  
Amin R. Soliman ◽  
Tarek Samy Abdelaziz ◽  
Ahmed Fathy

Background Coronavirus disease-19 (COVID-19) is an ongoing pandemic causing considerable fatalities worldwide. Vitamin D modulates the immune response through effects on various cells, such as: macrophages, B and T lymphocytes, neutrophils, and dendritic cells. Aim To explore whether supplementation of vitamin D, in the form of a single intramuscular cholecalciferol injection, to patients with diabetes, COVID-19, and low vitamin D levels could improve the prognosis of those patients. Methods This was a placebo-controlled randomized prospective study. The study has two arms as follows: the intervention arm (40 vitamin D deficient diabetes elderly patients that acquired SARS-CoV-2), compared to the control arm (16 elderly diabetes patients, with deficient vitamin D with SARS-CoV-2). Patients in the intervention arm were given vitamin D as a single intramuscular injection (200,000 IU); patients in the control arm were given placebo. The primary outcome was mortality within 6 weeks of the diagnosis of COVID-19. Clinical, laboratory, treatment, and outcome data were recorded after 6 weeks of follow-up. Results No significant difference in 6 weeks mortality was observed between patients who received vitamin D and patients who received placebo (17.5% vs 18.8%, p = 0.838). Age, presence of hypertension, and chronic obstructive pulmonary disease were independent predictors of mortality at 6 weeks. Conclusion Vitamin D supplementation did not reduce the severity or mortality of COVID-19 at 6 weeks. Further large scale studies are required to explore the effect of vitamin D therapy on survival in patients with diabetes mellitus who acquire COVID-19.


Aim – To compare vitamin D levels between Tb infected and non-infected subjects in 16-25 years of age. Methods – Tb patients (16-25 years) from low income group were identified from the DOT centres in Pitampura, subjects were interviewed through questionnaire method, analysis of vitamin D content of identified patients and non infected subjects were done and finally assessment of relationship between vitamin D and non infected subjects. Results- The population included 30 patients infected with Tb and 30 subjects who are non-infected, which have been tested for vitamin D. When results were compared with healthy control group it was found that vitamin D was relatively low i.e. p- <0.001.There is a high prevalence of VDD in this population. Conclusion- vitamin D deficiency is positively and significantly co related with Tb. In the present study, general population itself established to be extremely deficient in Vitamin D. Hence; this is very difficult to delineate relation within VITAMIN D and TB. In future, a multicentre study with a large size of sample needs to be carried out to elicit a relation within vitamin D status and TB.


2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Yasir Iqbal Malik ◽  
Aqsa Malik ◽  
Rabbia Shabbir ◽  
Atteaya Zaman ◽  
Sohail Zia ◽  
...  

Purpose: To determine the levels of Vitamin D in children with myopia and to compare them with age matched controls. Study Design:  Case control study. Place and Duration of Study:  The study was conducted in Naseer Memorial Hospital, Dadhyal Azad Kashmir from March 2016 to March 2017. Material and Methods:  Two hundred patients were selected using convenient sampling technique and were divided two groups (group I Myopic and group II control). Myopia was labeled if after subjective refraction a Spherical Equivalent (SE) of −0.50 diopters (D) or more was found. Vitamin D levels were measured by radioimmunoassay technique with Diasorin SR® kit following the user’s manual. Vitamin D levels less than 20 ng/ml were considered Vitamin D deficient following the standards of American academy of pediatrics. The collected data was entered in the statistical package for social sciences (SPSS) version 21 for analysis. Independent t–test was used to determine the significant difference of means between controls and patients. P-values less than 0.05 were considered significant. Results:  Mean age of controls and myopes were 10.65 ± 3.9 and 10.20 ± 2.5 years respectively. Vitamin D levels in myopic children were found to be 14.95 ± 3.75 ng/ml and there was no significant difference in mean values of Vitamin D levels in myopic and control group. Conclusion:  We found no difference in Vitamin D levels of myopic and non myopic children and concluded that Vitamin D has no role in development or progression of myopia.


Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1297
Author(s):  
Yusuf Karadeniz ◽  
Fatma Özpamuk-Karadeniz ◽  
Süleyman Ahbab ◽  
Esra Ataoğlu ◽  
Günay Can

Background and objectives: Hypertension is a global health problem and a major risk factor for cardiovascular diseases. Vitamin D deficiency is closely related to high blood pressure and the development of hypertension. This study investigated the relationship between the vitamin D and blood pressure status in healthy adults, and their 8-year follow-up was added. Materials and Methods: A total of 491 healthy middle-aged participants without any chronic illness, ages 21 to 67 at baseline, were divided into two groups as non-optimal blood pressure (NOBP) and optimal blood pressure (OBP). NOBP group was divided into two subgroups: normal (NBP) and high normal blood pressure (HNBP). Serum 25-hydroxy vitamin D levels were measured with the immunoassay method. 8-year follow-up of the participants was added. Results: The average vitamin D level was detected 32.53 ± 31.50 nmol/L in the OBP group and 24.41 ± 14.40 nmol/L in the NOBP group, and a statistically significant difference was found (p < 0.001). In the subgroup analysis, the mean vitamin D level was detected as 24.69 ± 13.74 and 24.28 ± 14.74 nmol/L in NBP and HNBP, respectively. Together with parathyroid hormone, other metabolic parameters were found to be significantly higher in the NOBP. During a median follow-up of 8 years, higher hypertension development rates were seen in NOBP group (p < 0.001). Conclusions: The low levels of vitamin D were significantly associated with NBP and HNBP. The low levels of vitamin D were also associated with the development of hypertension in an 8-year follow-up.


Author(s):  
Beyza Genç Çetin ◽  
Taşkın Şentük ◽  
Neriman Aydın

Introduction: Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune connective tissue disease characterized by a variable course and prognosis. We aimed to determine IL-10, IL-17 and IL-23 cytokines and vitamin D levels in SLE patients, which we think play role in the pathogenesis of the disease. Material and Method: Forty SLE patients and 20 healthy controls were included in our study. Levels of IL-10, IL-17 and IL-23 were measured by sandwich ELISA method. Quantitative data are expressed as mean ± standard deviation and median range (maximum-minimum) values. The data were analyzed at 95% confidence interval, and cases where the p value was less than 0.05 were considered statistically significant. Results: IL-10 and IL-17 levels of the control and patient groups were compared and no statistically significant difference was found (p=0.333, p=0.99). IL-23 levels of the patient group were found to be higher than the control group and were found to be statistically significant (p<0.001). No statistically significant relationship was found between disease duration or SLEDAI score and IL-23 levels (p=0.476). 25 (OH) vitamin D levels of the patient group were found to be lower than the control group and were statistically significant (p=0.003). No significant relationship was found between IL-10 and IL-17 levels and vitamin D. Significant relationship was found between IL-23 and vitamin D levels (p=0.019). Discussion: In our study, there was no significant difference between the groups in terms of IL-10 or IL-17, while IL-23 levels were found to be significantly higher in SLE patients. Vitamin D levels were found to be lower in the patient group with SLE compared to the control group, and a negative correlation was found between the disease duration and IL-23. Specific blocking of the IL-23 immune pathway can be an effective and safe treatment option in the treatment of SLE.


2021 ◽  
Vol 25 (6) ◽  
pp. 81-86
Author(s):  
A. P. Lichacheva ◽  
N. V. Agranovich ◽  
A. T. Klassova ◽  
A. S. Anopchenko ◽  
E. L. Solovyova

BACKGROUND. Vitamin D has been known since 1928. The wide range of its metabolic effects paradoxically contrasts with the high prevalence of insufficiency and deficiency in the population of different regions of the world. A number of publications have demonstrated information about the relationship between vitamin D and insulin production by beta cells of the pancreas, as well as the excretory function of the kidneys.THE AIM: to assess the level of vitamin D in patients with diabetes mellitus in combination with chronic kidney disease (CKD).PATIENTS AND METHODS. A questionnaire and a study of the level of 25-hydroxyvitamin D, creatinine, urea, and glucose in the blood were conducted in 117 patients aged 18 to 84 years who gave voluntary consent. All patients were divided into three study groups: group 1 - patients with long-term DM, group 2 - patients with newly diagnosed DM, and 3 - control group. The glomerular filtration rate (GFR) is calculated by the formula CKD-EPI.RESULTS. As a result of the study, it was found that patients with DM, regardless of the duration of its course, were more likely to suffer from vitamin D deficiency, compared with the control group, where D-deficiency and D-deficiency occurred with the same frequency. In addition, patients with DM were more likely to have stage 2-3A CKD, in contrast to the control group, where preserved kidney function prevailed. We also identified and confirmed the direct dependence of GFR on the level of vitamin D in the blood of patients with DM.CONCLUSION. In the patients studied by us, a clear association was found between a lower vitamin D index in the blood serum and the presence of a history of diabetes. They also showed a tendency to decrease the excretory function of the kidneys and the formation of CKD. Consequently, a full-fledged diagnosis of vitamin D-deficient conditions and timely initiated therapy can prevent or at least slow down the progression of CKD in these patients, which will certainly improve their quality of life and reduce the costs of health services for renal replacement therapy and rehabilitation of this group of patients.


2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Asmaa Alhusseiny Ahmed Alsharkawy ◽  
Ahmed R. Rezk

Abstract Background Community-acquired pneumonia is a major cause of death among children. Inadequate nutrition disrupts the immune system and increases the susceptibility to infections. We aimed to evaluate the association between vitamin D, serum zinc, and iron, and pneumonia. A case-control study was conducted at the outpatient clinic and emergency room of Children’s Hospital. Thirty-one patients with community-acquired pneumonia and 36 healthy children (control group) underwent serum sampling for vitamin D, zinc, and iron. Results Most patients had mild form (n = 17, 54.8%). All patients survived and were discharged. The serum iron level showed a non-significant difference between pneumonia and control groups (p ˃ 0.05). TIBC, vitamin D, and serum zinc were significantly lower in the patient group than the control group (P value = 0.04, < 0.001, and 0.03, respectively). Vitamin D deficiency was highly associated with the severity of pneumonia (P value = 0.008). Conclusion Adequate serum zinc and vitamin D levels may be protective against infection with community-acquired pneumonia in children aged from 2 months to 5 years old, but not iron.


2019 ◽  
Vol 13 ◽  
Author(s):  
Ceyda Anar ◽  
Melike Yüksel Yavuz ◽  
Filiz Güldaval ◽  
Dilek Kalenci

Background: The aim of this paper was to evaluate the availability of FRAX for assessing osteoporosis risk, and to demonstrate the importance of vitamin D levels in COPD patients. Methods: Fourty-six males who fulfilled the COPD diagnostic criteria defined by GOLD were included. Age, race, BMI, physical activity frequency, smoking and dietary habits, age at COPD diagnosis, disease duration, fractures history, and medications use were determined. Levels of 25(OH)D were detected. BMD was measured by DXA at lumbar spine, femoral neck, and entire femur, and classified according to ISCD. FRAX score was calculated. Control group was composed of 40 non-smoker individuals without previous history of pulmonary diseases. Results: 25(OH)D levels were significantly different between patients and controls. In the COPD group, a statistically significant difference in vitamin D levels was detected among the A, B, C, and D grades, while no such significant differences in FRAX scores were detected. 25(OH)D levels were significantly low in COPD patients with disease exacerbations and hospitalizations in the previous one year. No correlation was detected between vitamin D levels and the FRAX score. A positive correlation was observed between vitamin D levels and T-score. FRAX scores were higher and vitamin D levels were lower in osteoporotic COPD patients than in non-osteoporotic COPD patients. Conclusion: Using FRAX for assessing osteoporosis in COPD can reduce fracture risk and allow adequate treatment. Since vitamin D levels are related to exacerbations and hospitalizations, vitamin D supplementation may be needed in COPD patients, especially in those with high FRAX scores.


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