Association of Serum Cholesterol Levels With Degree of Radiological Extent and Sputum Positivity In Pulmonary Tuberculosis – A One Year Crosssectional Study

Abstract

Background & Objectives : Alterations in serum lipids, especially cholesterol, are known to occur in bacterial infections like tuberculosis. However, relationship between serum cholesterol and extent of tuberculosis and smear positivity has not been studied in detail. The objective is to study the association of Total cholesterol, HDL and LDL with degree of sputum positivity and degree of radiological extent in pulmonary tuberculosis. Methods: Fifty patients of sputum positive pulmonary tuberculosis were included in the study. Levels of total cholesterol, HDL and LDL were determined in this group and were compared with degree of sputum positivity (stage I, II and III) and degree of radiological extent (stage I, II and III). Results: The levels of all the lipids were found to be significantly lower in the advanced Tuberculosis group (stage III) group as compared with stages II and I. In comparison with DSP , total cholesterol values were 155.7±14.97 (DSP I), 133.3±9.09 (DSP II) and 119.7±16.68 (DSP III). HDL values were 41.9±6.25 (DSPI), 32.9±4.87 (DSP II) and 29.5±5.63 (DSP III). LDL values were 101.28.77 (DSPI), 85.2±10.77 (DSP II) and 79±11.41 (DSP III). The difference between the groups was statistically significant (p<0.001). In comparison with DRED, the values of total cholesterol were 158.1±10.31 mg/dl(DRED I), 133.9±10.53 mg/dl(DRED II) and 124±16.81mg/dl (DRED III). HDL values were 42.5±4.51mg/dl (DRED I), 33.9±6.23mg/dl (DRED II) and 30.3±6.51mg/dl (DRED III). LDL values being 102.3±6.41mg/dl (DRED I), 86.3±11.34mg/dl (DRED II) and 81.1±12mg/dl DRED III). The difference between the groups was statistically significant. (p=<0.001). iii Conclusion and Interpretation: Our study suggests that serum total cholesterol, HDL and LDL are lower in patients with advanced disease. Low cholesterol level impedes macrophage function and accelerates the disease process. This observation has important therapeutic implication in tuberculosis control programmes.