Omowunmi Aibana1,2, Molly F Franke3, Chuan-Chin Huang3, Jerome T Galea3,4, Roger Calderon4, Zibiao Zhang5, Mercedes C Becerra3, Emily R Smith6,7, Carmen Contreras4, Rosa Yataco4, Leonid Lecca3,4, Megan B Murray3. 1. Division of General Internal Medicine, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX. 2. Division of Infectious Diseases, The Miriam Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI. 3. Department of Global Health and Social Medicine, and Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 4. Partners In Health, Socios En Salud Sucursal Peru, Lima, Peru. 5. Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 6. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA. 7. Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA.
Abstract
Background: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression. Objective: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk. Methods: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on age by year and gender. We used univariate and multivariate conditional logistic regression to calculate ORs for incident TB disease by plasma concentrations of α-tocopherol, γ-tocopherol, and δ-tocopherol. Results: Among 6751 HIV-negative HHCs who provided baseline blood samples, 180 developed secondary TB during follow-up. After controlling for possible confounders, we found that baseline α-tocopherol deficiency conferred increased risk of incident TB disease (adjusted OR: 1.59; 95% CI: 1.02, 2.50; P = 0.04). Household contacts in the lowest tertile of δ-tocopherol were also at increased risk of progression to TB disease compared to those in the highest tertile (tertile 1 compared with tertile 3, adjusted OR: 2.29; 95% CI: 1.29, 4.09; P-trend = 0.005). We found no association between baseline concentration of γ-tocopherol and incident TB disease. Conclusions: Vitamin E deficiency was associated with an increased risk of progression to TB disease among HHCs of index TB cases. Assessment of vitamin E status among individuals at high risk for TB disease may play a role in TB control efforts.
Background: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression. Objective: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk. Methods: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on age by year and gender. We used univariate and multivariate conditional logistic regression to calculate ORs for incident TB disease by plasma concentrations of α-tocopherol, γ-tocopherol, and δ-tocopherol. Results: Among 6751 HIV-negative HHCs who provided baseline blood samples, 180 developed secondary TB during follow-up. After controlling for possible confounders, we found that baseline α-tocopherol deficiency conferred increased risk of incident TB disease (adjusted OR: 1.59; 95% CI: 1.02, 2.50; P = 0.04). Household contacts in the lowest tertile of δ-tocopherol were also at increased risk of progression to TB disease compared to those in the highest tertile (tertile 1 compared with tertile 3, adjusted OR: 2.29; 95% CI: 1.29, 4.09; P-trend = 0.005). We found no association between baseline concentration of γ-tocopherol and incident TB disease. Conclusions: Vitamin E deficiency was associated with an increased risk of progression to TB disease among HHCs of index TB cases. Assessment of vitamin E status among individuals at high risk for TB disease may play a role in TB control efforts.
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Authors: Omowunmi Aibana; Chuan-Chin Huang; Said Aboud; Alberto Arnedo-Pena; Mercedes C Becerra; Juan Bautista Bellido-Blasco; Ramesh Bhosale; Roger Calderon; Silvia Chiang; Carmen Contreras; Ganmaa Davaasambuu; Wafaie W Fawzi; Molly F Franke; Jerome T Galea; Daniel Garcia-Ferrer; Maria Gil-Fortuño; Barbará Gomila-Sard; Amita Gupta; Nikhil Gupte; Rabia Hussain; Jesus Iborra-Millet; Najeeha T Iqbal; Jose Vicente Juan-Cerdán; Aarti Kinikar; Leonid Lecca; Vidya Mave; Noemi Meseguer-Ferrer; Grace Montepiedra; Ferdinand M Mugusi; Olumuyiwa A Owolabi; Julie Parsonnet; Freddy Roach-Poblete; Maria Angeles Romeu-García; Stephen A Spector; Christopher R Sudfeld; Mark W Tenforde; Toyin O Togun; Rosa Yataco; Zibiao Zhang; Megan B Murray Journal: PLoS Med Date: 2019-09-11 Impact factor: 11.069