Evaluation and Comparison of Body Mass Index and Albumin Level in Patients with Active Tuberculosis and Latent Tuberculosis Infection

Document Type: Original Article


1 Master of Immunology, Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Bachelors of Biology, Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Pulmonologist, Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Immunologist, Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Microbiologist, Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Introduction: Limited data are available on the relationship between nutritional status and tuberculosis. The aim of this study was to evaluate and compare the body mass index (BMI) and serum albumin level in patients with active tuberculosis (ATB) and latent tuberculosis (LTB).
Materials and Methods: A cross-sectional study was conducted on 17 patients newly diagnosed with pulmonary TB  who were referred in Iran, during September 2011 to March 2012 and 17 latent tuberculosis infection individuals. Standard method was performed to collect an early morning fasting blood sample for albumin (by the bromocresolgreen method). Also (BMI) was calculated as body weight divided by height squared (kg/m2).
Results: One-sample Kolmogorov-Smirnov test was used to check normal distribution data The mean ± Standard deviation(SD) for albumin in the patients and controls were 3.62±0/56 and 4.68±0.25, respectively. BMI in the patients and controls were 19.46±2.79 and  25.4±3.46, respectively. The serum albumin level was significantly lower in the patient group, compared to the control group (P<0.001).BMI was significantly lower in the patient group, compared to the control group (P<0.001).
Conclusion: Our findings demonstrated that BMI and serum Albumin were significantly lower in the active tuberculosis patients than latent tuberculosis groups.


1. Pai-Dhungat J.V. Parikh F, Centenary of discovery of Tubercle bacillus. J Assoc Physicians India, 2003:51:  668.

2. Deveci F, Ilhan N. Plasma malondialdehyde and serum trace element concentrations in patients with active pulmonary tuberculosis. Biol Trace Elem Res, 2003: 95:  29-38.

3. Sapozhnikova NV, Skvortsova LA, Pavlova MV, Vishnevskiĭ BI, Otten TF, Vasil'eva SN, et al.Pulmonary tuberculosis caused by Mycobacterium tuberculosis of different genotypes. Probl Tuberk Bolezn Legk, 2003:  13-5.

4. Karyadi E, Schultink W, Nelwan RH, Gross R, Amin Z, Dolmans WM, et al. Poor micronutrient status of active pulmonary tuberculosis patients in Indonesia. J Nutr, 2000 130:  2953-8.

5. Cantin AM, Paquette B, Richter M, Larivée P. Albumin-mediated regulation of cellular glutathione and nuclear factor kappa B activation. Am J Respir Crit Care Med, 2000. 162(4 Pt 1): 1539-46.

6. Mendez DL, Jensen RA, McElroy LA, Pena JM, Esquerra RM. The effect of non-enzymatic glycation on the unfolding of human serum albumin. Arch Biochem Biophys 2005; 444: 92-9.

7. Arroyo, V. Review article: albumin in the treatment of liver diseases--new features of a classical treatment. Aliment Pharmacol Ther  2002. 16 Suppl 5: 1-5.

8. Middleton AM, Chadwick MV, Nicholson AG, Wilson R, Thornton DJ, Kirkham S. Interaction between mycobacteria and mucus on a human respiratory tissue organ culture model with an air interface. Exp Lung Res, 2004. 30:  17-29.

9. Ramakrishnan K, Shenbagarathai R, Kavitha K, Uma A, Balasubramaniam R, Thirumalaikolundusubramanian P. Serum zinc and albumin levels in pulmonary tuberculosis patients with and without HIV. Jpn J Infect Dis 2008. 61: 202-4.

10. Onwubalili, J.K. Malnutrition among tuberculosis patients in Harrow, England. Eur J Clin Nutr 1988. 42:  363-6.

11. Saha, K, K.N. Rao, Undernutrition in lepromatous leprosy. V. Severe nutritional deficit in lepromatous patients co-infected with pulmonary tuberculosis. Eur J Clin Nutr 1989;43:  117-28.

12. Tsukaguchi K, Yoneda T, Yoshikawa M, Narita N, Enoki Y, Miyazaki R. Interaction between interleukin-1 and tumor necrosis factor productions by peripheral blood monocytes and nutritional disturbance in active pulmonary tuberculosis. Kekkaku 199166:  477-84.

13. Beisel, W.R. Infection-induced depression of serum retinol--a component of the acute phase response or a consequence? Am J Clin Nutr 1998. 68: 993-4.

14. Xing Z, Gauldie J, Cox G, Baumann H, Jordana M, Lei XF. IL-6 is an antiinflammatory cytokine required for controlling local or systemic acute inflammatory responses. J Clin Invest. 1998 ;101:311-20

15. Gabay C, Kushner I, Acute-phase proteins and other systemic responses to inflammation. N Engl J Med, 1999. 340:  448-54.

16. Fleck, A., Clinical and nutritional aspects of changes in acute-phase proteins during inflammation. Proc Nutr Soc 1989 48:  347-54.

17. Lynn M, Wilson AR, Solotorovsky M, Role of bovine serum albumin in the nutrition of Mycobacterium tuberculosis. Appl Environ Microbiol 1979. 38: 806-10.

18. Swaminathan S, Padmapriyadarsini C, Sukumar B, Iliayas S, Kumar SR, Triveni C, et al., Nutritional status of persons with HIV infection, persons with HIV infection and tuberculosis, and HIV-negative individuals from southern India. Clin Infect Dis. 2008 ;46:946-9

19. van Lettow M, Fawzi WW, Semba RD, Triple trouble: the role of malnutrition in tuberculosis and human immunodeficiency virus co-infection. Nutr Rev. 2003 ;61:81-90.

20. Van Lettow M, Kumwenda JJ, Harries AD, Whalen CC, Taha TE, et al. Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis in Malawi. Int J Tuberc Lung Dis. 2004;8:211-7

21. Kaiser JD, Campa AM, Ondercin JP, Leoung GS, Pless RF, Baum MK. Micronutrient supplementation increases CD4 count in HIV-infected individuals on highly active antiretroviral therapy: a prospective, double-blinded, placebo-controlled trial. J Acquir Immune Defic Syndr. 2006 ;42:523-8.

22. McGrath N, Bellinger D, Robins J, Msamanga GI, Tronick E, Fawzi WW. Effect of maternal multivitamin supplementation on the mental and psychomotor development of children who are born to HIV-1-infected mothers in Tanzania. Pediatrics, 2006. 117(2): p. e216-25.

23. Karyadi E, West CE, Schultink W, Nelwan RH, Gross R, Amin Z, et al.A double-blind, placebo-controlled study of vitamin A and zinc supplementation in persons with tuberculosis in Indonesia: effects on clinical response and nutritional status. Am J Clin Nutr, 2002. 75:720-727.