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Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy
Macronutrient and micronutrient deficiencies are associated with tuberculosis (TB) incidence. However, evidence is limited on the impact of micronutrient (vitamins and minerals) supplementation among underweight individuals. We conducted a secondary data analysis of a randomised controlled trial of...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343057/ https://www.ncbi.nlm.nih.gov/pubmed/37440476 http://dx.doi.org/10.1371/journal.pgph.0002007 |
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author | Schwalb, Alvaro Bergstrom, Malin Woodd, Susannah Rehman, Andrea M. PrayGod, George Kasonka, Lackson Koethe, John R. Filteau, Suzanne Houben, Rein M. G. J. |
author_facet | Schwalb, Alvaro Bergstrom, Malin Woodd, Susannah Rehman, Andrea M. PrayGod, George Kasonka, Lackson Koethe, John R. Filteau, Suzanne Houben, Rein M. G. J. |
author_sort | Schwalb, Alvaro |
collection | PubMed |
description | Macronutrient and micronutrient deficiencies are associated with tuberculosis (TB) incidence. However, evidence is limited on the impact of micronutrient (vitamins and minerals) supplementation among underweight individuals. We conducted a secondary data analysis of a randomised controlled trial of lipid nutritional supplements with and without high-dose vitamin and mineral supplementation (LNS-VM vs LNS) for underweight (Body Mass Index [BMI] <18.5 kg/m(2)) adults with human immunodeficiency virus (HIV) initiating antiretroviral therapy (ART) in Tanzania and Zambia (2011–2013). Incident TB disease diagnoses were extracted from trial records. We used multivariable Cox regression to estimate hazard ratios (HR) for the impact of receiving LNS-VM on TB incidence, and the dose-response relationship between baseline BMI and TB incidence. Overall, 263 (17%) of 1506 participants developed TB disease. After adjusting for age, sex, CD4 count, haemoglobin, and C-reactive protein, receiving LNS-VM was not associated with TB incidence (aHR [95%CI] = 0.93 [0.72–1.20]; p = 0.57) compared to LNS alone. There was strong evidence for an association between lower BMI and incident TB (aHR [95%CI]: 16–16.9kg/m(2) = 1.15 [0.82–1.62] and <16kg/m(2) = 1.70 [1.26–2.30] compared to 17–18.5kg/m(2); linear trend p<0.01). There was strong evidence that the rate of developing TB was lower after initiating ART (p<0.01). In conclusion, the addition of micronutrient supplementation to LNS was not associated with lower TB incidence in this underweight ART-naive population. |
format | Online Article Text |
id | pubmed-10343057 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-103430572023-07-14 Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy Schwalb, Alvaro Bergstrom, Malin Woodd, Susannah Rehman, Andrea M. PrayGod, George Kasonka, Lackson Koethe, John R. Filteau, Suzanne Houben, Rein M. G. J. PLOS Glob Public Health Research Article Macronutrient and micronutrient deficiencies are associated with tuberculosis (TB) incidence. However, evidence is limited on the impact of micronutrient (vitamins and minerals) supplementation among underweight individuals. We conducted a secondary data analysis of a randomised controlled trial of lipid nutritional supplements with and without high-dose vitamin and mineral supplementation (LNS-VM vs LNS) for underweight (Body Mass Index [BMI] <18.5 kg/m(2)) adults with human immunodeficiency virus (HIV) initiating antiretroviral therapy (ART) in Tanzania and Zambia (2011–2013). Incident TB disease diagnoses were extracted from trial records. We used multivariable Cox regression to estimate hazard ratios (HR) for the impact of receiving LNS-VM on TB incidence, and the dose-response relationship between baseline BMI and TB incidence. Overall, 263 (17%) of 1506 participants developed TB disease. After adjusting for age, sex, CD4 count, haemoglobin, and C-reactive protein, receiving LNS-VM was not associated with TB incidence (aHR [95%CI] = 0.93 [0.72–1.20]; p = 0.57) compared to LNS alone. There was strong evidence for an association between lower BMI and incident TB (aHR [95%CI]: 16–16.9kg/m(2) = 1.15 [0.82–1.62] and <16kg/m(2) = 1.70 [1.26–2.30] compared to 17–18.5kg/m(2); linear trend p<0.01). There was strong evidence that the rate of developing TB was lower after initiating ART (p<0.01). In conclusion, the addition of micronutrient supplementation to LNS was not associated with lower TB incidence in this underweight ART-naive population. Public Library of Science 2023-07-13 /pmc/articles/PMC10343057/ /pubmed/37440476 http://dx.doi.org/10.1371/journal.pgph.0002007 Text en © 2023 Schwalb et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Schwalb, Alvaro Bergstrom, Malin Woodd, Susannah Rehman, Andrea M. PrayGod, George Kasonka, Lackson Koethe, John R. Filteau, Suzanne Houben, Rein M. G. J. Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy |
title | Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy |
title_full | Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy |
title_fullStr | Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy |
title_full_unstemmed | Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy |
title_short | Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy |
title_sort | impact of micro- and macronutrient status on the incidence of tuberculosis: an examination of an african cohort initiating antiretroviral therapy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343057/ https://www.ncbi.nlm.nih.gov/pubmed/37440476 http://dx.doi.org/10.1371/journal.pgph.0002007 |
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