Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India.
OBJECTIVES:Our study goal was to evaluate a set of nutritional indicators among adults with confirmed or suspected active tuberculosis disease in southern India, given the limited literature on this topic. Study objectives were to assess the: I) double burden of malnutrition at individual and popula...
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doaj-2dd075e726a54e5fbb357217300127422021-03-03T21:48:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01155e023330610.1371/journal.pone.0233306Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India.Elaine A YuJulia L FinkelsteinPatsy M BrannonWesley BonamDavid G RussellMarshall J GlesbySaurabh MehtaOBJECTIVES:Our study goal was to evaluate a set of nutritional indicators among adults with confirmed or suspected active tuberculosis disease in southern India, given the limited literature on this topic. Study objectives were to assess the: I) double burden of malnutrition at individual and population levels; II) relative performance of anthropometric indicators (body mass index, waist circumference) in diabetes screening; and III) associations between vitamin D and metabolic abnormalities. DESIGN:Cross-sectional study. SETTING:Hospital in rural southern India. PARTICIPANTS:Among adult patients (n = 834), we measured anthropometry, body composition, and biomarkers (vitamin D, glycated hemoglobin, hemoglobin) of nutritional status. Subsets of participants provided blood and sputum samples. RESULTS:Among participants, 91.7% had ≥ 1 malnutrition indicator; 34.6% had both undernutrition and overnutrition indicators. Despite the fact that >80% of participants would be considered low-risk in diabetes screening based on low body mass index and waist circumference, approximately one-third had elevated glycated hemoglobin (≥ 5.7%). The lowest quintile of serum 25-hydroxyvitamin D was associated with an increased risk of glycated hemoglobin ≥ 5.7% (adjusted risk ratio 1.61 [95% CI 1.02, 2.56]) compared to the other quintiles, adjusting for age and trunk fat. CONCLUSIONS:Malnutrition and diabetes were prevalent in this patient population; since both can predict poor prognosis of active tuberculosis disease, including treatment outcomes and drug resistance, this emphasizes the importance of dual screening and management of under- and overnutrition-related indicators among patients with suspected or active tuberculosis disease. Further studies are needed to determine clinical implications of vitamin D as a potential modifiable risk factor in metabolic abnormalities, and whether population-specific body mass index and waist circumference cut-offs improve diabetes screening.https://doi.org/10.1371/journal.pone.0233306 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elaine A Yu Julia L Finkelstein Patsy M Brannon Wesley Bonam David G Russell Marshall J Glesby Saurabh Mehta |
spellingShingle |
Elaine A Yu Julia L Finkelstein Patsy M Brannon Wesley Bonam David G Russell Marshall J Glesby Saurabh Mehta Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India. PLoS ONE |
author_facet |
Elaine A Yu Julia L Finkelstein Patsy M Brannon Wesley Bonam David G Russell Marshall J Glesby Saurabh Mehta |
author_sort |
Elaine A Yu |
title |
Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India. |
title_short |
Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India. |
title_full |
Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India. |
title_fullStr |
Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India. |
title_full_unstemmed |
Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India. |
title_sort |
nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural india. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2020-01-01 |
description |
OBJECTIVES:Our study goal was to evaluate a set of nutritional indicators among adults with confirmed or suspected active tuberculosis disease in southern India, given the limited literature on this topic. Study objectives were to assess the: I) double burden of malnutrition at individual and population levels; II) relative performance of anthropometric indicators (body mass index, waist circumference) in diabetes screening; and III) associations between vitamin D and metabolic abnormalities. DESIGN:Cross-sectional study. SETTING:Hospital in rural southern India. PARTICIPANTS:Among adult patients (n = 834), we measured anthropometry, body composition, and biomarkers (vitamin D, glycated hemoglobin, hemoglobin) of nutritional status. Subsets of participants provided blood and sputum samples. RESULTS:Among participants, 91.7% had ≥ 1 malnutrition indicator; 34.6% had both undernutrition and overnutrition indicators. Despite the fact that >80% of participants would be considered low-risk in diabetes screening based on low body mass index and waist circumference, approximately one-third had elevated glycated hemoglobin (≥ 5.7%). The lowest quintile of serum 25-hydroxyvitamin D was associated with an increased risk of glycated hemoglobin ≥ 5.7% (adjusted risk ratio 1.61 [95% CI 1.02, 2.56]) compared to the other quintiles, adjusting for age and trunk fat. CONCLUSIONS:Malnutrition and diabetes were prevalent in this patient population; since both can predict poor prognosis of active tuberculosis disease, including treatment outcomes and drug resistance, this emphasizes the importance of dual screening and management of under- and overnutrition-related indicators among patients with suspected or active tuberculosis disease. Further studies are needed to determine clinical implications of vitamin D as a potential modifiable risk factor in metabolic abnormalities, and whether population-specific body mass index and waist circumference cut-offs improve diabetes screening. |
url |
https://doi.org/10.1371/journal.pone.0233306 |
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