Study On Correlation Between Genetic Polymorphism Of Vitamin D Receptor And Efficacy Of Supplementary Vitamin D In Initial Treatment Against Pulmonary Tuberculosis

Objective: Patients with pulmonary tuberculosis treated initially were studied in this paper. Patients in treatment group received standard anti-tuberculosis therapeutic regimen, with supplementary vitamin D as an adjunctive therapy. In control group, patients only received standard anti-tuberculosis therapeutic regimen. The study observed whether vitamin D could improve the patients with tuberculosis or not, and identify the differences of genetic polymorphism of vitamin D receptor between the two groups, and whether genetic polymorphism of vitamin D receptor was correlated with recovery from tuberculosis.Methods: A comparative design was adopted. Inpatients with pulmonary tuberculosis admitted from Jan. 2014 to Sept. 2014 in our hospital were selected as subjects. Vitamin D receptor genes were genotyped based on Fok I loci, and were divided into FF, Ff and ff. Each patient was randomly divided into vitamin D treatment group and blank control group. Patients in treatment received standard enhanced anti-tuberculosis therapy composed of isoniazid, rifampicin, pyrazinamide and ethambutol for 8 weeks, and supplementary vitamin D 800 U daily was also administered. Patients in control group only received the standard enhanced therapy for 8 weeks. By detecting vitamin D concentration, body weight and body mass index, recovery rate of absorption in chest radiography, seroconversion time of phlegm smear, blood sedimentation rate, and different immunological parameters(including IL-1, IL-10, INF-γ and TNF-α) before and after treatment, treatment group and control group were compared for whether the efficacy was different, and if yes, what were the different parameters. Treatment group and control group were further divided into subgroups FF, Ff and ff, to compare whether the above parameters were different in the same subgroups between the two groups(e.g., subgroup FF between treatment group and control group), and between the three subgroups in each group.Results: Before treatment, no statistical difference was observed in vitamin D concentration, body weight, body mass index, seroconversion time of phlegm bacteria, blood sedimentation rate, different immunological parameters between treatment group and control group, in the same subgroups between the two groups, and between the three subgroups in control group; in treatment group, vitamin D concentration in subgroup FF was obviously superior to those in subgroups Ff and ff(Z=7.246,P=0.027), no other statistical difference was observed. After treatment, compared to control group, vitamin D concentration, body weight and body mass index were higher in treatment group, in treatment group, blood sedimentation rate, IL-1, INF-γ and TNF-α decreased more quickly, IL-10 increased more rapidly, and some parameters showed statistical differences 2 weeks after treatment; treatment group was superior to control in seroconversion time of phlegm bacteria and recovery rate of absorption in chest radiography, but without significance. In comparison of Ff subgroups and ff subgroups between treatment group and control group, vitamin D concentration, body weight, body mass index, blood sedimentation rate, various immunological parameters, seroconversion time of phlegm bacteria and recovery rate of absorption in chest radiography were similar. In comparison of FF subgroups between treatment group and control group, treatment group was superior to control group in recovery rate of absorption in chest radiography, with statistical significance(X2=5.563, P=0.018), while the remaining parameters were similar to other subgroups. In comparison of three subgroups in treatment group, FF subgroup had the highest body weight increase and body mass index increase, followed by Ff subgroup and ff subgroup, with statistical difference, the three subgroups had no statistical difference in blood sedimentation rate, vitamin D concentration and recovery rate of absorption in chest radiography.Conclusion: The treatment group and control group had low seroconversion rates of phlegm bacteria, which were not compared in subgroups. Vitamin D treatment group and control group all had low occurrence of adverse drug reactions which showed no statistical difference, and were not compared in subgroups.