Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis
Abstract Background Vitamin D is involved in the host immune response toward Mycobacterium tuberculosis. However, the efficacy of vitamin D supplementation on sputum conversion, clinical response to treatment, adverse events, and mortality in patients with pulmonary tuberculosis (PTB) remains contro...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-018-0677-6 |
| _version_ | 1828235134776639488 |
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| author | Hong-xia Wu Xiao-feng Xiong Min Zhu Jia Wei Kai-quan Zhuo De-yun Cheng |
| author_facet | Hong-xia Wu Xiao-feng Xiong Min Zhu Jia Wei Kai-quan Zhuo De-yun Cheng |
| author_sort | Hong-xia Wu |
| collection | DOAJ |
| description | Abstract Background Vitamin D is involved in the host immune response toward Mycobacterium tuberculosis. However, the efficacy of vitamin D supplementation on sputum conversion, clinical response to treatment, adverse events, and mortality in patients with pulmonary tuberculosis (PTB) remains controversial. We aimed to clarify the efficacy and safety of vitamin D supplementation in PTB treatment. Methods We searched Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science for double-blind, randomized controlled trials of vitamin D supplementation in patients with PTB that reported sputum conversion, clinical response to treatment, adverse events, or mortality, published from database inception to November 26, 2017. This study was registered with PROSPERO, number CRD42018081236. Results A total of 1787 patients with active PTB receiving vitamin D supplementation along with standard anti-tuberculosis regimen were included in the eight trials with different doses of vitamin D ranging from 1000 IU/day to 600,000 IU/month at different intervals. Primary analysis revealed that vitamin D supplementation increased the proportion of sputum smear and culture conversions (OR 1.21, 95%CI 1.05~ 1.39, z = 2.69, P = 0.007; OR 1.22, 95%CI 1.04~ 1.43, z = 2.41, P = 0.02), but did not improve the time to sputum smear and culture conversions (HR 1.07, 95%CI 0.83~ 1.37, z = 0.50, P = 0.62; HR 0.97, 95%CI 0.76~ 1.23, z = 0.29, P = 0.77). In the secondary analysis, vitamin D improved serum 25(OH)D, plasma calcium concentration, lymphocyte count, and chest radiograph (MD 103.36, 95%CI 84.20~ 122.53, z = 10.57, P < 0.00001; SMD 0.26, 95%CI 0.15~ 0.37, z = 4.61, P < 0.00001; MD 0.09, 95%CI 0.03~ 0.14, z = 2.94, P = 0.003); MD -0.33, 95% CI -0.57~ − 0.08 z = 2.57, P = 0.01), but had no impact on adverse events, mortality and other indicators(TB score, BMI, mean mid-upper arm circumference, weight gain, CRP, ESR, and other blood cells) (P > 0.05). Conclusions Vitamin D supplementation can be considered as a combination therapy in patients with PTB. |
| first_indexed | 2024-04-12T20:08:48Z |
| format | Article |
| id | doaj.art-1bddce2b5938497a984523c56454a0bf |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-12T20:08:48Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-1bddce2b5938497a984523c56454a0bf2022-12-22T03:18:19ZengBMCBMC Pulmonary Medicine1471-24662018-06-0118111210.1186/s12890-018-0677-6Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysisHong-xia Wu0Xiao-feng Xiong1Min Zhu2Jia Wei3Kai-quan Zhuo4De-yun Cheng5Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Respiratory Medicine, Chengdu Second People’s HospitalDepartment of Neurosurgery, Suining Municipal Hospital of TCMDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityAbstract Background Vitamin D is involved in the host immune response toward Mycobacterium tuberculosis. However, the efficacy of vitamin D supplementation on sputum conversion, clinical response to treatment, adverse events, and mortality in patients with pulmonary tuberculosis (PTB) remains controversial. We aimed to clarify the efficacy and safety of vitamin D supplementation in PTB treatment. Methods We searched Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science for double-blind, randomized controlled trials of vitamin D supplementation in patients with PTB that reported sputum conversion, clinical response to treatment, adverse events, or mortality, published from database inception to November 26, 2017. This study was registered with PROSPERO, number CRD42018081236. Results A total of 1787 patients with active PTB receiving vitamin D supplementation along with standard anti-tuberculosis regimen were included in the eight trials with different doses of vitamin D ranging from 1000 IU/day to 600,000 IU/month at different intervals. Primary analysis revealed that vitamin D supplementation increased the proportion of sputum smear and culture conversions (OR 1.21, 95%CI 1.05~ 1.39, z = 2.69, P = 0.007; OR 1.22, 95%CI 1.04~ 1.43, z = 2.41, P = 0.02), but did not improve the time to sputum smear and culture conversions (HR 1.07, 95%CI 0.83~ 1.37, z = 0.50, P = 0.62; HR 0.97, 95%CI 0.76~ 1.23, z = 0.29, P = 0.77). In the secondary analysis, vitamin D improved serum 25(OH)D, plasma calcium concentration, lymphocyte count, and chest radiograph (MD 103.36, 95%CI 84.20~ 122.53, z = 10.57, P < 0.00001; SMD 0.26, 95%CI 0.15~ 0.37, z = 4.61, P < 0.00001; MD 0.09, 95%CI 0.03~ 0.14, z = 2.94, P = 0.003); MD -0.33, 95% CI -0.57~ − 0.08 z = 2.57, P = 0.01), but had no impact on adverse events, mortality and other indicators(TB score, BMI, mean mid-upper arm circumference, weight gain, CRP, ESR, and other blood cells) (P > 0.05). Conclusions Vitamin D supplementation can be considered as a combination therapy in patients with PTB.http://link.springer.com/article/10.1186/s12890-018-0677-6Vitamin DTuberculosisMeta-analysisTherapy |
| spellingShingle | Hong-xia Wu Xiao-feng Xiong Min Zhu Jia Wei Kai-quan Zhuo De-yun Cheng Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis BMC Pulmonary Medicine Vitamin D Tuberculosis Meta-analysis Therapy |
| title | Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis |
| title_full | Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis |
| title_fullStr | Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis |
| title_full_unstemmed | Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis |
| title_short | Effects of vitamin D supplementation on the outcomes of patients with pulmonary tuberculosis: a systematic review and meta-analysis |
| title_sort | effects of vitamin d supplementation on the outcomes of patients with pulmonary tuberculosis a systematic review and meta analysis |
| topic | Vitamin D Tuberculosis Meta-analysis Therapy |
| url | http://link.springer.com/article/10.1186/s12890-018-0677-6 |
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