Correlation Analysis Of Vitamin D And LL-37 With Active Pulmonary Tuberculosis

objective1.To understand the baseline levels of peripheral blood vitamin D and LL-37 in patients with active pulmonary tuberculosis.2.To compare the different contents of vitamin D and LL-37 in patients with different types of active pulmonary tuberculosis.3.To investigate the correlation of vitamin D and LL-37 in peripheral blood and T lymphocyte and CRP in patients with active pulmonary tuberculosis.4.To discuss the clinical significance of vitamin D and LL-37 on active pulmonary tuberculosis.Methods1.The pulmonary tuberculosis patients?group A,n=59?were selected from inpatients of Chengdu Public Health Clinical Medical Center between January 2017 and June 2017,who were confirmed by positive mycobacterium tuberculosis culture.The healthy control subjects?group B,n=40?were healthy physical examination staffs in the same period.The two group people have long lived in Sichuan.Group A was then divided into six subgroups:Pulmonary tuberculosis group?PTB?without diabetes mellitus?group A1,n=34?and pulmonary tuberculosis group with diabetes mellitus?group A2,n=25?,pulmonary tuberculosis group without pulmonary infection?group A3,n=15?and pulmonary tuberculosis group with pulmonary infection?group A4,n=44?,grug-resistant pulmonary tuberculosis group?group A5,n=17?and non-drug-resistant pulmonary tuberculosis group?group A6,n=42?.2.The serum and plasma samples of subjects were collected.Serum25-hydroxyvitaminD3?25?OH?D3?wasmeasuredbyenzyme-linked immunosorbent assay?ELISA?.Plasma antimicrobial peptide LL-37 was examined by solid-phase enzyme-linked immunosorbent assay.Blood samples were collected for detection of C-reactive Protein?CRP?and T lymphocytes,Sputum Mycobacterium tuberculosis culture and drug sensitivity test and the chest CT.All statistical analyzes were used by SPSS 17.0 software.The baseline datas were presented as mean±standard deviation?x±s?in the statistical data.The t-test for independent samples was used to analyze the statistical differences between the measurement data.One-way analysis of variance was used for comparison between groups,LSD test was used for any pairwise comparison,Pearson correlation analysis was used for correlation analysis,P<0.05 was considered as statistically significant.Results:1.The different levels of serum 25 hydroxyvitamin D3 in all study subjects.1)The levels of serum 25 hydroxyvitamin D3 in group A?26.97±10.83nmol/L?was significantly lower than group B?53.77±11.79nmol/L??P<0.001?.2)The levels of serum 25 hydroxyvitamin D3 in group A1?25.01±10.792 nmol/L?was slightly lower than group A2?29.64±10.52 nmol/L?,but there was no significant difference between the group A1 and group A2?P=0.105?.3)The levels of serum 25 hydroxyvitamin D3 in group A3?33.77±7.72nmol/L?was significantly higher than group A4?24.66±10.95 nmol/L??P=0.006?.4)The levels of serum 25 hydroxyvitamin D3 in group A5?26.08±8.79nmol/L?was slightly lower than group A6?27.37±11.62nmol/L?,but there was no significant difference between the group A3 and group A4 of serum 25 hydroxyvitamin D3?P=0.683?.2.The levels of plasma LL-37 in all paticipants.1)The levels of serum plasma LL-37 in group A?31.28±10.31 ng/mL?was significantly higher than group B?23.41±3.18 ng/mL??P<0.001?.2)The levels of serum plasma LL-37 in group A1?31.89±10.62 ng/mL?was slightly higher than group A2?30.46±10.03 ng/mL?,but there was no significant difference between the group A1 and group A2 of plasma LL-37.?P=0.602?.3)The levels of serum plasma LL-37 in group A3?27.57±11.41 ng/mL?was lower than group A4?32.55±9.73 ng/mL?,but there was no significant difference between the group A3and group A4 of plasma LL-37?P=0.107?.4)The levels of serum plasma LL-37 in group A5?28.34±9.94 ng/mL?was lower than the group A6?32.48±10.34 ng/mL?,but there was no significant difference between the group A5 and group A6 of plasma LL-37?P=0.165?.3.Correlation analysis1)The correlation analysis showed the negative correlation among CRP and serum 25-hydroxyvitamin D3 in pulmonary tuberculosis group without pulmonary infection?r=-0.486,P=0.001?.2)CD₄⁺T lymphocyte count was positively correlated with serum25-hydroxyvitamin D3 in pulmonary tuberculosis group?r=0.637,P=0.000?.3)There was a positive correlation between CD₈⁺T lymphocyte count and serum 25-hydroxyvitamin D3 in pulmonary tuberculosis group?r=0.579,P=0.000?.4)There was no significant correlation between CRP and plasma LL-37level in pulmonary tuberculosis group without pulmonary infection?r=-0.182,P=0.236?.5)There was no significant correlation between CD₄⁺T lymphocyte count and plasma LL-37 level in pulmonary tuberculosis group?r=0.029,P=0.828?.6)There was no significant correlation between CD₈⁺T lymphocyte count and plasma LL-37 level in pulmonary tuberculosis group?r=0.072,P=0.589?.7)There was no significant correlation between serum 25-hydroxyvitamin D3 and plasma LL-37 in pulmonary tuberculosis group?r=0.061,P=0.644?.Conclusions1.The levels of serum 25 hydroxyvitamin D3 in pulmonary tuberculosis group was significantly lower than the healthy control group,which suggested that patients with active pulmonary tuberculosis were widely with vitamin D deficiency,and vitamin D supplementation may be beneficial for the treatment of active pulmonary tuberculosis.2.There was no significant difference in the levels of vitamin D and LL-37 in active pulmonary tuberculosis patients with diabetes mellitus compared with active pulmonary tuberculosis without diabetes mellitus.Although there was no significant difference in the levels of vitamin D and LL-37betweendrug-resistantpulmonarytuberculosispatientsand non-drug-resistant pulmonary tuberculosis patients,but the levels of vitamin D and LL-37 in patients with drug-resistant pulmonary tuberculosis might be lower.3.The counts of CD₄⁺and CD₈⁺T lymphocytes in patients with active pulmonary tuberculosis were positively correlated with the level of vitamin D and had no significant correlation with the level of LL-37.CRP was negatively correlated with the level of vitamin D in patients with pulmonary infection,but there was no significant correlation with the level of LL-37.4.Vitamin D,LL-37 may be used as biomarkers for patients with active pulmonary tuberculosis.