Rickets, Vitamin D Deficiency and Tuberculosis in Children of St. Petersburg and its Region.

Q3 Medicine

Open Respiratory Medicine Journal Pub Date : 2026-02-04 eCollection Date: 2026-01-01 DOI:10.2174/0118743064436599260130204102

Yulia Yarovaya, Marina Lozovskaya, Elenа Vasil'eva, Lyudmila Klochkova, Gennadij Stepanov, Ruslan Sagatelyan

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引用次数: 0

Abstract

Introduction: Given the widespread prevalence of vitamin D insufficiency and its clinical manifestations (such as rickets and compromised immune status) in children, this study aimed to assess the likelihood of tuberculosis (TB) diagnosis in children with TB infection and positive ESAT-6/CFP-10 test results, alongside signs of vitamin D deficiency (clinical rickets and/or low serum vitamin D levels).

Method: A total of 98 children aged 1-14 years were examined at the TB department of St. Petersburg Children's Infectious Diseases Hospital No. 3 (2022-2024). Inclusion criteria were a positive ATP test and/or IGRA result. Exclusion criteria included immunodeficiency disorders and hereditary diseases. Diagnostic evaluation for TB and vitamin D status (via serum calcidiol (25(OH)D) measurement was performed.

Result: Rickets-related changes were observed in 70.4±4.6% of cases. Vitamin D insufficiency was detected in 21.4±4.4%, moderate deficiency in 36.7±5.1%, and severe deficiency in 33.7±5.0%. A significantly higher probability of active TB diagnosis was found in children with: • Rickets signs: OR=4.009 (95% CI 1.609-9.987), RR=1.872 (1.148-3.054), φ=0.310. • Vitamin D deficiency: OR=10.411 (3.762-28.809), RR=3.182 (1.648-6.145), φ=0.493. • Either factor: OR=41.167 (10.699-158.404), RR=27.986 (2.720-23.443), φ=0.677 (strong association).

Discussion: The low vitamin D levels in children require not only special attention from TB specialists to patients with tuberculosis infection who test positive in immunological tests for ESAT-6 and CFP-10 antigens and show signs of rickets and/or vitamin D deficiency, but also increased vigilance from pediatricians in the timely diagnosis and treatment of rickets. Rickets often manifests early, has a prolonged course, and can lead to impaired immune status, which is significant for the progression from latent tuberculosis infection to active disease.

Conclusion: Vitamin D deficiency and rickets should prompt heightened TB monitoring in high-risk children, emphasizing early pediatric intervention to prevent immunodeficiency and TB progression.

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圣彼得堡及其地区儿童佝偻病、维生素D缺乏症和结核病。

鉴于儿童普遍存在维生素D不足及其临床表现（如佝偻病和免疫状态低下），本研究旨在评估结核病感染儿童和ESAT-6/CFP-10检测阳性儿童诊断结核病（TB）的可能性，以及维生素D缺乏的迹象（临床佝偻病和/或血清维生素D水平低）。方法：对圣彼得堡第三儿童传染病医院肺结核科（2022-2024）1 ~ 14岁儿童98例进行检查。纳入标准为ATP检测阳性和/或IGRA结果。排除标准包括免疫缺陷疾病和遗传性疾病。对结核病和维生素D状况进行诊断评估（通过血清钙二醇（25(OH)D）测定）。结果：70.4±4.6%的患者出现佝偻病相关改变。维生素D缺乏者为21.4±4.4%，中度缺乏者为36.7±5.1%，重度缺乏者为33.7±5.0%。•佝偻病体征的儿童活动性结核诊断的概率显著较高：OR=4.009 (95% CI 1.609-9.987)， RR=1.872 (1.148-3.054), φ=0.310。•维生素D缺乏：OR=10.411 (3.762-28.809)， RR=3.182 (1.648-6.145), φ=0.493。•任意因素：OR=41.167 (10.699-158.404)， RR=27.986 (2.720-23.443), φ=0.677（强关联）。讨论：儿童维生素D水平低，不仅需要结核病专家对ESAT-6和CFP-10抗原免疫试验阳性的结核病感染患者给予特别关注，而且需要儿科医生提高警惕，及时诊断和治疗佝偻病。佝偻病通常表现较早，病程较长，并可导致免疫状态受损，这对于从潜伏性结核感染发展为活动性疾病具有重要意义。结论：维生素D缺乏和佝偻病应加强对高危儿童的结核病监测，强调早期儿科干预以预防免疫缺陷和结核病进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Respiratory Medicine Journal Medicine-Pulmonary and Respiratory Medicine

CiteScore

1.70

自引率

0.00%

发文量

期刊介绍： The Open Respiratory Medicine Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, letters and guest edited single topic issues in all important areas of experimental and clinical research in respiratory medicine. Topics covered include: -COPD- Occupational disorders, and the role of allergens and pollutants- Asthma- Allergy- Non-invasive ventilation- Therapeutic intervention- Lung cancer- Lung infections respiratory diseases- Therapeutic interventions- Adult and paediatric medicine- Cell biology. The Open Respiratory Medicine Journal, a peer reviewed journal, is an important and reliable source of current information on important recent developments in the field. The emphasis will be on publishing quality articles rapidly and making them freely available worldwide.