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Volume 16, Issue 4 (2024)
Iran J War Public Health 2024, 16(4): 381-387 |
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Received: 2024/11/1 | Accepted: 2024/12/5 | Published: 2024/12/15
Received: 2024/11/1 | Accepted: 2024/12/5 | Published: 2024/12/15
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Simanjuntak J, Fitriana E. Association between Microalbuminuria and Vitamin D Levels in Elderly Individuals with Tuberculosis, Diabetes Mellitus, and HIV Comorbidities. Iran J War Public Health 2024; 16 (4) :381-387
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J.P. Simanjuntak *1, E. Fitriana1
1- Medical Laboratory Technology Department, Health Polytechnic of Jambi, Jambi, Indonesia
Abstract (243 Views)
Aims: This study aimed to explore the association between immune status and the occurrence of nephropathy in patients with tuberculosis and comorbidities.
Instrument & Methods: This cross-sectional study was conducted in health centers in Jambi City, Indonesia, from April to August 2024. Sixty tuberculosis patients were selected based on the reports from several selected health centers that recorded the highest number of tuberculosis patients in the region. An ANOVA test was used to assess differences in the mean values across the three groups for each laboratory test. The Fisher Exact test was applied to examine differences in proportions based on the occurrence of nephropathy and immune status.
Findings: Mild microalbuminuria was also noted in the tuberculosis (49.0±15.1mg/g) and TB-HIV (35.0±9.2mg/g) groups, but most patients in TB (16.4±6.8mg/g), and TB-HIV (23.5±3.9mg/g) groups had normal UACR values (p=0.00016). A significant proportion of the TB-HIV group exhibited vitamin D deficiency (13.3±4.0ng/mL), reflecting the compromised immunity associated with this viral infection. Similarly, a high deficiency prevalence was observed in the TB-DM group (12.8±3.9ng/mL). Vitamin D insufficiency (23.9±2.9ng/mL) rather than deficiency (15.9±2.4ng/mL) was observed in the TB group (p=0.05427).
Conclusion: Microalbuminuria, as a marker of nephropathy, is prevalent in TB-DM and TB-HIV patients, suggesting compromised immune status in these groups.
Instrument & Methods: This cross-sectional study was conducted in health centers in Jambi City, Indonesia, from April to August 2024. Sixty tuberculosis patients were selected based on the reports from several selected health centers that recorded the highest number of tuberculosis patients in the region. An ANOVA test was used to assess differences in the mean values across the three groups for each laboratory test. The Fisher Exact test was applied to examine differences in proportions based on the occurrence of nephropathy and immune status.
Findings: Mild microalbuminuria was also noted in the tuberculosis (49.0±15.1mg/g) and TB-HIV (35.0±9.2mg/g) groups, but most patients in TB (16.4±6.8mg/g), and TB-HIV (23.5±3.9mg/g) groups had normal UACR values (p=0.00016). A significant proportion of the TB-HIV group exhibited vitamin D deficiency (13.3±4.0ng/mL), reflecting the compromised immunity associated with this viral infection. Similarly, a high deficiency prevalence was observed in the TB-DM group (12.8±3.9ng/mL). Vitamin D insufficiency (23.9±2.9ng/mL) rather than deficiency (15.9±2.4ng/mL) was observed in the TB group (p=0.05427).
Conclusion: Microalbuminuria, as a marker of nephropathy, is prevalent in TB-DM and TB-HIV patients, suggesting compromised immune status in these groups.
Keywords:
References
1. WHO. Tuberculosis [Internet]. Geneva: World Health Organization; 2023 [cited 2023, Mar, 23rd]. Available from: https://www.who.int/indonesia/news/campaign/tb-day-2022/fact-sheets. [Link]
2. Kemenkes RI. Indonesia Health Profile. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023. [Indonesian] [Link]
3. Putra IGNE, Rahmaniati M, Eryando T, Sipahutar T. Modeling the prevalence of tuberculosis in Java, Indonesia: An ecological study using geographically weighted regression. J Popul Soc Stud. 2022;30:741-63. [Link] [DOI:10.25133/JPSSv302022.041]
4. Conradie F, Diacon AH, Ngubane N, Howell P, Everitt D, Crook AM, et al. Treatment of highly drug-resistant pulmonary tuberculosis. N Engl J Med. 2020;382(10):893-902. [Link] [DOI:10.1056/NEJMoa1901814]
5. Peloquin CA, Davies GR. The treatment of tuberculosis. Clin Pharmacol Ther. 2021;110(6):1455-66. [Link] [DOI:10.1002/cpt.2261]
6. Koo HK, Min J, Kim HW, Lee J, Kim JS, Park JS, et al. Prediction of treatment failure and compliance in patients with tuberculosis. BMC Infect Dis. 2020;20:622. [Link] [DOI:10.1186/s12879-020-05350-7]
7. Abrar MN, Syafa'Ah I, Mudjanarko SW, Permatasari A. Impact of comorbidity in pulmonary tuberculosis patients with acute respiratory failure: Literature review. Int J Sci Adv. 2024;5(6):1286-93. [Link] [DOI:10.51542/ijscia.v5i6.35]
8. Anasulfalah H, Tamtomo DG, Murti B. Effect of diabetes mellitus comorbidity on mortality risk in tuberculosis patients who received tuberculosis treatment: A meta-analysis. J Epidemiol Public Health. 2022;7(4):441-53. [Link] [DOI:10.26911/jepublichealth.2022.07.04.03]
9. Singh A, Prasad R, Balasubramanian V, Gupta N. Drug-resistant tuberculosis and HIV infection: Current perspectives. HIV AIDS. 2020;12:9-31. [Link] [DOI:10.2147/HIV.S193059]
10. Hamada Y, Getahun H, Tadesse BT, Ford N. HIV-associated tuberculosis. Int J STD AIDS. 2021;32(9):780-90. [Link] [DOI:10.1177/0956462421992257]
11. Ayelign B, Workneh M, Molla MD, Dessie G. Role of vitamin-D supplementation in TB/HIV co-infected patients. Infect Drug Resist. 2020;13:111-8. [Link] [DOI:10.2147/IDR.S228336]
12. Sudfeld CR, Mugusi F, Muhihi A, Aboud S, Nagu TJ, Ulenga N, et al. Efficacy of vitamin D3 supplementation for the prevention of pulmonary tuberculosis and mortality in HIV: A randomised, double-blind, placebo-controlled trial. Lancet HIV. 2020;7(7):e463-71. [Link] [DOI:10.1016/S2352-3018(20)30108-9]
13. Cerrone M, Bracchi M, Wasserman S, Pozniak A, Meintjes G, Cohen K, et al. Safety implications of combined antiretroviral and anti-tuberculosis drugs. Expert Opin Drug Saf. 2020;19(1):23-41. [Link] [DOI:10.1080/14740338.2020.1694901]
14. Pooranagangadevi N, Padmapriyadarsini C. Treatment of tuberculosis and the drug interactions associated with HIV-TB co-infection treatment. Front Trop Dis. 2022;3:834013. [Link] [DOI:10.3389/fitd.2022.834013]
15. Krishna S, Jacob JJ. Diabetes mellitus and tuberculosis. In: Endotext. South Dartmouth (MA): MDText.com, Inc; 2021. [Link]
16. Huang D, Wang Y, Wang Y, Liang Z. The impact of diabetes mellitus on drug resistance in patients with newly diagnosed tuberculosis: A systematic review and meta-analysis. Ann Palliat Med. 2020;9(2):152-62. [Link] [DOI:10.21037/apm.2020.02.16]
17. Bisson GP, Bastos M, Campbell JR, Bang D, Brust JC, Isaakidis P, et al. Mortality in adults with multidrug-resistant tuberculosis and HIV by antiretroviral therapy and tuberculosis drug use: An individual patient data meta-analysis. Lancet. 2020;396(10248):402-11. [Link] [DOI:10.1016/S0140-6736(20)31316-7]
18. Cummings C. Cross-sectional design. In: The SAGE Encyclopedia of Communication Research Methods. Thousand Oaks: SAGE Publications; 2017. [Link]
19. Assebe LF, Negussie EK, Jbaily A, Tolla MTT, Johansson KA. Financial burden of HIV and TB among patients in Ethiopia: A cross-sectional survey. BMJ Open. 2020;10(6):e036892. [Link] [DOI:10.1136/bmjopen-2020-036892]
20. Long Q, Jiang W, Dong D, Chen J, Xiang L, Li Q, et al. A new financing model for tuberculosis (TB) care in China: Challenges of policy development and lessons learned from the implementation. Int J Environ Res Public Health. 2020;17(4):1400. [Link] [DOI:10.3390/ijerph17041400]
21. Long Q, Jiang WX, Zhang H, Cheng J, Tang SL, Wang WB. Multi-source financing for tuberculosis treatment in China: Key issues and challenges. Infect Dis Poverty. 2021;10(2):17. [Link] [DOI:10.1186/s40249-021-00809-4]
22. Canetti D, Riccardi N, Martini M, Villa S, Di Biagio A, Codecasa L, et al. HIV and tuberculosis: The paradox of dual illnesses and the challenges of their fighting in the history. Tuberculosis. 2020;122:101921. [Link] [DOI:10.1016/j.tube.2020.101921]
23. Mave V, Gaikwad S, Barthwal M, Chandanwale A, Lokhande R, Kadam D, et al. Diabetes mellitus and tuberculosis treatment outcomes in Pune, India. Open Forum Infect Dis. 2021;8(4):ofab097. [Link] [DOI:10.1093/ofid/ofab097]
24. Gautam S, Shrestha N, Mahato S, Nguyen TPA, Mishra SR, Berg-Beckhoff G. Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: A systematic review and meta-analysis. Sci Rep. 2021;11(1):2113. [Link] [DOI:10.1038/s41598-021-81057-2]
25. Tulu B, Amsalu E, Zenebe Y, Abebe M, Fetene Y, Agegn M, et al. Diabetes mellitus and HIV infection among active tuberculosis patients in Northwest Ethiopia: Health facility-based cross-sectional study. Trop Med Health. 2021;49(1):68. [Link] [DOI:10.1186/s41182-021-00358-4]
26. Nyirenda JLZ, Wagner D, Ngwira B, Lange B. Bidirectional screening and treatment outcomes of diabetes mellitus (DM) and Tuberculosis (TB) patients in hospitals with measures to integrate care of DM and TB and those without integration measures in Malawi. BMC Infect Dis. 2022;22(1):28. [Link] [DOI:10.1186/s12879-021-07017-3]
27. Dabhi PA, Thangakunam B, Gupta R, James P, Thomas N, Naik D, et al. Screening for prevalence of current TB disease and latent TB infection in type 2 diabetes mellitus patients attending a diabetic clinic in an Indian tertiary care hospital. PLoS One. 2020;15(6):e0233385. [Link] [DOI:10.1371/journal.pone.0233385]
28. Rizwan M, Cheng K, Gang Y, Hou Y, Wang C. Immunomodulatory effects of vitamin D and Zinc on viral infection. Biol Trace Elem Res. 2025;203(1):1-17. [Link] [DOI:10.1007/s12011-024-04139-y]
29. Vaccaro J. Role of vitamin D, folate, and cobalamin deficiency in mycobacterium avium paratuberculosis infection and inflammation [dissertation]. Orlando, FL: University of Central Florida; 2023. [Link]
30. Periyasamy KM, Ranganathan UD, Tripathy SP, Bethunaickan R. Vitamin D-A host directed autophagy mediated therapy for tuberculosis. Mol Immunol. 2020;127:238-44. [Link] [DOI:10.1016/j.molimm.2020.08.007]
31. Singh M, Vaughn C, Sasaninia K, Yeh C, Mehta D, Khieran I, et al. Understanding the relationship between glutathione, TGF-β, and vitamin D in combating Mycobacterium tuberculosis infections. J Clin Med. 2020;9(9):2757. [Link] [DOI:10.3390/jcm9092757]
32. Blanc FX, Badje AD, Bonnet M, Gabillard D, Messou E, Muzoora C, et al. Systematic or test-guided treatment for tuberculosis in HIV-infected adults. N Engl J Med. 2020;382(25):2397-410. [Link] [DOI:10.1056/NEJMoa1910708]
33. Szymczak-Pajor I, Miazek K, Selmi A, Balcerczyk A, Śliwińska A. The action of vitamin D in adipose tissue: Is there the link between vitamin D deficiency and adipose tissue-related metabolic disorders?. Int J Mol Sci. 2022;23(2):956. [Link] [DOI:10.3390/ijms23020956]
34. Contreras-Bolívar V, García-Fontana B, García-Fontana C, Muñoz-Torres M. Mechanisms involved in the relationship between vitamin D and insulin resistance: Impact on clinical practice. Nutrients. 2021;13(10):3491. [Link] [DOI:10.3390/nu13103491]
35. Szymczak-Pajor I, Drzewoski J, Śliwińska A. The molecular mechanisms by which vitamin D prevents insulin resistance and associated disorders. Int J Mol Sci. 2020;21(18):6644. [Link] [DOI:10.3390/ijms21186644]
36. Ehrampoush E, Razzaz JM, Ghaemi A, Shahraki HR, Babaei AE, Osati S, et al. The association of vitamin D levels and insulin resistance. Clin Nutr ESPEN. 2021;42:325-32. [Link] [DOI:10.1016/j.clnesp.2021.01.012]
37. Huang HY, Lin TW, Hong ZX, Lim LM. Vitamin D and diabetic kidney disease. Int J Mol Sci. 2023;24(4):3751. [Link] [DOI:10.3390/ijms24043751]