A double burden of tuberculosis and diabetes mellitus and the possible role of vitamin D deficiency

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2021-02, Vol.40 (2), p.350-357
• Main Authors: Wang, Qiuzhen, Ma, Aiguo, Schouten, Evert G., Kok, Frans J.
• Format: Article
• Language: English
• Subjects: Diabetes mellitus; Double burden; Epidemic; Immunity; Tuberculosis; Vitamin D deficiency
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2020.08.040

Tuberculosis remains a major global health challenge, particularly in low-to-middle income countries such as China. At the same time, the country is facing a rapidly increasing diabetes incidence over the last 10 years. Diabetes aggravates the tuberculosis epidemic which poses a serious challenge in public health. In recent years, the high prevalence of vitamin D deficiency represents a global health problem, which is also associated with the risk of diabetes, and tuberculosis. Therefore, this review aims to provide an overall and updated understanding of the epidemiology of co-occurrence of tuberculosis and diabetes in China, and to elucidate the possible role of vitamin D deficiency. In conclusion, significant aggravation of the tuberculosis epidemic due to diabetes may exist in China for a relatively long period of time to come. Further, the double burden and its implications to public health in this country may be significantly influenced by the high prevalence of vitamin D deficiency. Bidirectional screening for tuberculosis and diabetes is recommended, and extra vitamin D may benefit especially in a situation of a heavy tuberculosis burden combined with prevalent vitamin D deficiency. Longitudinal studies to verify the role of vitamin D deficiency in the double burden, and trials on the effect of vitamin D supplementation are needed in the future.