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Letter published on 20 March 2019, see Nutrients 2019, 11(3), 667.

Open AccessArticle
Nutrients 2019, 11(2), 343; https://doi.org/10.3390/nu11020343

Assessment of Vitamin Status in Patients with Nontuberculous Mycobacterial Pulmonary Disease: Potential Role of Vitamin A as a Risk Factor

1
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
2
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
3
Department of Clinical Pharmacology & Therapeutics, Samsung Medical Center, Seoul 06351, Korea
*
Authors to whom correspondence should be addressed.
Received: 12 December 2018 / Revised: 31 January 2019 / Accepted: 1 February 2019 / Published: 5 February 2019
(This article belongs to the Special Issue Vitamin A, Infectious Diseases and the Immune Function)
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Abstract

As microbiological diagnostic techniques improve and the frequency of nontuberculous mycobacterial pulmonary disease (NTM-PD) infection increases worldwide, NTM-PD is becoming increasingly important to clinicians and researchers. Vitamin activity has been associated with the host immune response in tuberculosis; however, such information is very limited in NTM-PD. We performed a case-control study in 150 patients with NTM-PD and 150 healthy controls to investigate serum vitamin status. We measured concentrations of vitamins A, D, and E along with homocysteine and methylmalonic acid (MMA) as indicators of vitamin B12 deficiency, using high-performance liquid chromatography (HPLC) or HPLC-tandem mass spectrometry. The serum concentrations of vitamins A and E were significantly lower in patients with NTM-PD than in healthy controls (1.5 vs. 2.1 µmol/L, p < 0.01 for vitamin A; and 27.3 vs. 33.1 µmol/L, p < 0.01 for vitamin E). In contrast, the serum concentrations of vitamin D and homocysteine were not significantly different between the two groups. Vitamin A deficiency (< 1.05 µmol/L) was significantly more prevalent in patients with NTM-PD than in healthy controls (p < 0.01) and was associated with an 11-fold increase in risk of NTM-PD. Multiple vitamin deficiencies were only observed in patients with NTM-PD (7.3% of all NTM-PD patients). Positive correlations were observed among vitamins (vitamins A and D; r = 0.200, p < 0.05; vitamins D and E, r = 0.238, p < 0.05; vitamins A and E, r = 0.352, p < 0.05). Serum vitamin status, demographic variables, and biochemical indicators were not associated with treatment outcomes. Vitamin A deficiency was strongly associated with patients with NTM-PD. Our study suggests that altered vitamin status is associated with mycobacterial disease. Future well-designed prospective studies with large patient cohorts addressing these issues are needed to clarify the significance of vitamins in NTM-PD. View Full-Text
Keywords: nontuberculous mycobacteria; nutrition; vitamin nontuberculous mycobacteria; nutrition; vitamin
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Oh, J.; Park, H.-D.; Kim, S.-Y.; Koh, W.-J.; Lee, S.-Y. Assessment of Vitamin Status in Patients with Nontuberculous Mycobacterial Pulmonary Disease: Potential Role of Vitamin A as a Risk Factor. Nutrients 2019, 11, 343.

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