25-Hydroxyvitamin D levels after recovery from tuberculosis: Insights into pathogenesis

Objective: 25-Hydroxyvitamin D [25(OH) D] levels after recovery from tuberculosis (TB) may reflect premorbid levels and therefore provide insight into pathogenesis. We assessed 25(OH) D levels after recovery from TB disease, and compared to levels in persons without TB disease. Methods: Case-control study. Cases were persons who had recovered from culture-confirmed Mycobacterium tuberculosis disease. Controls were persons without TB disease. Total 25(OH) D was measured from stored plasma specimens using liquid chromatography-mass spectrometry. Results: 29 persons with prior TB disease and 36 controls were included. Median 25(OH) D levels were 24.7 ng/mL (IQR, 18.3-34.1) in prior TB disease, and 33.6 ng/mL (IQR, 26.2-42.4) in controls (Mann -Whitney; P = 0.01). Multivariable linear regression analysis showed that black race (adjusted mean difference [beta] = -8.3 ng/mL; 95% CI -14.5, -2.2; P < 0.01), enrollment in winter (beta = -10.4 ng/mL; 95% CI -17.0, -3.8; P < 0.01) and prior TB disease (beta = -5.8 ng/mL; 95% CI -11.4, -0.3; P = 0.05) were associated with lower 25(OH) D levels. Conclusions: Persons who had recovered from TB disease had lower 25(OH) D levels compared to controls without TB disease, after adjusting for important confounders. Larger, longitudinal studies are needed to further characterize the possible role of low 25(OH) D in the pathogenesis of TB disease and TB recurrence after recovery. (C) 2013 Elsevier Ltd. All rights reserved.