2002, Number 1
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Rev Inst Nal Enf Resp Mex 2002; 15 (1)
Hypocholesterolemia: a frequent finding associated to tuberculosis.
Pérez-Guzmán C, Vargas MH, Torres-Cruz A, Villarreal-Velarde H
Language: Spanish
References: 21
Page: 7-11
PDF size: 168.11 Kb.
ABSTRACT
Introduction: Pulmonary tuberculosis is an infectious and contagious disease which apparently develops under conditions of a deficient immunologic response. The immune system requires a wide variety of nutrients to function adequately and some studies suggest that cholesterol might be one of them.
Methods: The clinical records of patients hospitalized at the National Institute of Respiratory Diseases (1989-1994) with diagnosis of pulmonary tuberculosis (group TB), pleural tuberculosis (group TBPL) or miliary tuberculosis (group TBMI), and of patients with pulmonary tuberculosis and diabetes mellitus (group TBDM) were reviewed. Clinical records were randomly selected and information on age, gender and serum cholesterol levels was obtained.
Results: Each one of four groups of tuberculous patients had cholesterol levels significantly lower (p<0.01, ANOVA and Dunnett) than data obtained from three national surveys. Thus, cholesterol levels (mg/dL,X_ ±SD) for each group were: TB, 140.0±44.5 (n=125); TBPL, 142.2±45.9 (n=96); TBMI, 140.9±38.2 (n=58) and TBDM, 156.9±43.5 (n=163). Whereas, in surveys, means varied between 182 and 198 mg/dL.
Conclusions: Our analysis shows that hypocholesterolemia is a common finding in patients with pulmonary tuberculosis. This association may be because tuberculosis, as a chronic infectious pathology, depleted cholesterol or because subjects previously had out hypocholesterolemia and this predisposed them to develop tuberculosis. This latter alternative is very important because it points to the possibility of using cholesterol as a therapeutic tool for the prevention and/or treatment of tuberculosis.
REFERENCES
World Health Organization. Groups at risk: WHO report on the tuberculosis epidemic. Geneve: World Health Organization, 1996.
Dirección General de Epidemiología, SSA. Sistema único de información para la vigilancia epidemiológica SUIVE. México: Secretaría de Salud, 2000.
American Thoracic Society. Treatment of tuberculosis and tuberculosis infection in adults and children. Am J Respir Crit Care Med 1994;149:1359-1374.
Martin TR. The relationship between malnutrition and lung infections. Clin Chest Med 1987;8:359-372.
Schluger NW, Rom WN. The host immune response to tuberculosis. Am J Respir Crit Care Med 1998;157:679-691.
Cooper RA. Abnormalities of cell membrane fluidity in the pathogenesis of disease. N Engl J Med 1977; 297:371-375.
Drabowsky MP, Peel WE, Thomson AER. Plasma membrane cholesterol regulates human lymphocyte cytotoxic function. Eur J Immunol 1980;10:821-827.
Heiniger HJ, Marshall JD. Cholesterol synthesis in polyclonally activated cytotoxic lymphocytes and its requirements for differentiation and proliferation. Proc Natl Acad Sci 1982; 79:3823-3827.
Gatfield J, Pierters J. Essential role for cholesterol in entry of mycobacteria into macrophages. Science 2000;2:1647-1650.
Jacobs D, Blackburn H, Higgins M, Reed D, Iso H, McMillan G, et al. Report of the conference on low blood cholesterol: mortality associations. Circulation 1992; 86:1046-1060.
Taylor GO, Bamgboye AE. Serum cholesterol and diseases in Nigerians. Am J Clin Nutr 1979;32:2540-2545.
Kozarevic D, Mc Gee D, Vojvodic N, Gordon T, Racic Z, Zukel W, et al. Serum cholesterol and mortality. Am J Epidemiol 1981;114:21-28.
Harris T, Feldman JJ, Kleinman JC, Ettinger WH, Makuc DM, Schatzkin AG. The low cholesterol-mortality association in a national cohort. J Clin Epidemiol 1992;45:595-601.
González-Villalpando C, Stren M, Valdéz R, Braxton M, Haffner S. Niveles de lípidos sanguíneos y riesgo aterogénico en población abierta urbana. Rev Invest Clin 1993;45:127-132.
Posadas-Romero C, Sepúlveda J, Tapia-Conyer R, Magos C, Cardoso-Saldaña G, Zamora-Gonzalez J, et al. Valores de colesterol sérico en la población mexicana. Salud Pública Mex 1992;34:157-167.
Dirección General de Epidemiología. Encuesta Nacional de Enfermedades Crónicas 1993. México: Secretaría de Salud, 1993.
Glueck CJ, Kelley N, Gupta A, Fontaine RN, Wang P, Gartside PS. Prospective 10-year evaluation of hypobetalipoproteinemia in a cohort of 772 firefighters and crooss-sectional evaluation of hypocholesterolemia in 1479 men in the National Health and Nutrition Examination Survey I. Metabolism 1997;46:625-633.
Rifkind BM, Segal B. Lipid research clinics program reference values for hyperlipidemia and hypolipidemia. JAMA 1983;250:1869-1872.
Rossouw JE, Gotto AM. Does low cholesterol cause death? Cardiovasc Drugs Ther 1993;7:789-793.
Glueck CJ, Tieger M, Kunkel R, Hamer T, Tracy T, Speirs J. Hypocholesterolemia and affective disorders. Am J Med Sci 1994;308:218-225.
Harris MI. Hypercholesterolemia in diabetes and glucose intolerance in the US population. Diabetes Care 1991;14:366-374.