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Sci Rep. 2018 Jan 17;8(1):997. doi: 10.1038/s41598-018-19589-3.

Serum vitamin D levels and risk of prevalent tuberculosis, incident tuberculosis and tuberculin skin test conversion among prisoners.

Author information

1
Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil.
2
School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.
3
Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
4
Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT, USA.
5
Oswaldo Cruz Foundation, Salvador, Brazil.
6
Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
7
Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil. julio.croda@fiocruz.br.
8
School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil. julio.croda@fiocruz.br.
9
Oswaldo Cruz Foundation, Campo Grande, Brazil. julio.croda@fiocruz.br.

Abstract

Poor vitamin D status has been associated with tuberculosis (TB); whether poor status is cause or consequence of disease is uncertain. We conducted a case-control study and two nested case-control studies to determine whether vitamin D levels were associated with active TB, tuberculin skin test (TST) conversion, and risk of progression to the active TB in prisoners in Brazil. In multivariable conditional logistic regression, subnormal vitamin D levels (OR, 3.77; 95% CI, 1.04-13.64) were more likely in prisoners with active TB. In contrast, vitamin D was not found to be a risk factor for either TST conversion (OR, 2.49; 95% CI, 0.64-9.66) or progression to active disease (OR, 0.59; 95% CI, 0.13-2.62). Black race (OR, 11.52; 95% CI, 2.01-63.36), less than 4 years of schooling (OR, 2.70; 95% CI, 0.90-8.16), cigarette smoking (OR, 0.23; 95% CI, 0.06-0.79) were identified as risk factors for TST conversion. Risk of progression to active TB was found to be associated with cigarette smoking (OR, 7.42; 95% CI, 1.23-44.70). Our findings in the prison population show that poor vitamin D status is more common in individuals with active TB, but is not a risk factor for acquisition of latent TB or progression to active TB.

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