The effect of micro-nutrients on malnutrition, immunity and therapeutic effect in patients with pulmonary tuberculosis: A systematic review and meta-analysis of randomised controlled trials.

School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China; The Fourth People's Hospital of Nanning, HIV/AIDS Clinical Treatment Center of Guangxi, 530023, China. The Second Nanning People's Hospital, 530031, China. The Fourth People's Hospital of Nanning, HIV/AIDS Clinical Treatment Center of Guangxi, 530023, China. School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China. School of Preclinic Medical, Guangxi Medical University, Nanning, Guangxi, 530021, China. School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China. Electronic address: lixiyi@stu.gxmu.edu.cn. School of Preclinic Medical, Guangxi Medical University, Nanning, Guangxi, 530021, China. Electronic address: wangxinhang@stu.gxmu.edu.cn.

Tuberculosis (Edinburgh, Scotland). 2020;:101994
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Abstract

OBJECTIVE Micro-nutrients are closely related to pulmonary tuberculosis (PTB). Most patients with PTB suffer from micro-nutrients deficiency. We aimed to evaluate the efficacy of micro-nutrients support on clinical therapy and chronic inflammation in patients with PTB. METHODS We searched Pubmed, Springer link, Web of Science, Cochrane, Wan Fang and CNKI databases for randomised controlled trials (RCTs). The patients with anti-TB treatments were divided into two groups, the control group with nutritional advice or placebo, and the experimental group with micro-nutrients support for more than 2 weeks. Two reviewers conducted data extraction and quality assessment of the studies independently, and ReviewManager 5.2 software was used to input and analyse the data. The dichotomous variable was expressed in the risk ratios (RRS) and 95% CI, the continuous data were expressed in the mean difference (MD) and 95% CI, and the heterogeneity of subgroup was evaluated by I (Kerantzas and Jacobs, Jr., 2017) [2] test. RESULTS A total of 13 trials (2847 participants) were included. First, micro-nutrients improved sputum smears or culture negative conversion rates (OR 0.16 0.03-0.77, 2.29; MD -2.36, -4.72~-0.01, z = 1.97). Meanwhile, micro-nutrients support increased lymphocytes and decreased leukocytes, neutrophils, CRP and ESR (MD 0.20, 0.06-0.35, z = 2.78; MD -0.42, -0.65~-0.18, z = 3.48; MD -0.66, -1.12~-0.20, z = 2.82). However it had not impact on body weight, MUAC, haemoglobin, albumin or monocytes (p > 0.05). CONCLUSION Micro-nutrients support can reduce chronic inflammation and improve sputum smears or culture conversions to contribute to anti-TB treatment.

Methodological quality

Publication Type : Meta-Analysis

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