Document Detail


A cholesterol-rich diet accelerates bacteriologic sterilization in pulmonary tuberculosis.
MedLine Citation:
PMID:  15706008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypocholesterolemia is common among tuberculous patients and is associated with mortality in miliary cases. Some in vitro studies have shown that cholesterol is necessary for the good functioning of macrophages and lymphocytes. STUDY OBJECTIVES: To determine whether a cholesterol-rich diet could accelerate sputum sterilization in patients with pulmonary tuberculosis. DESIGN: An 8-week follow-up, randomized, controlled trial carried out from March 2001 to January 2002. SETTING: A third-level hospital for respiratory diseases in Mexico City. PATIENTS AND INTERVENTIONS: Adult patients with newly diagnosed pulmonary tuberculosis were hospitalized for 8 weeks and randomly assigned to receive a cholesterol-rich diet (800 mg/d cholesterol [experimental group]) or a normal diet (250 mg/d cholesterol [control group]). All patients received the same four-drug antitubercular regimen (ie, isoniazid, rifampin, pyrazinamide, and ethambutol). MEASUREMENTS AND RESULTS: Every week, a quantitative sputum culture and laboratory tests were done and respiratory symptoms were recorded. Patients in the experimental group (10 patients) and the control group (11 subjects) were HIV-negative and harbored Mycobacterium tuberculosis that was fully sensitive to antitubercular drugs. Sterilization of the sputum culture was achieved faster in the experimental group, as demonstrated either by the percentage of negative culture findings in week 2 (80%; control group, 9%; p = 0.0019) or by the Gehan-Breslow test for Kaplan-Meier curves (p = 0.0037). Likewise, the bacillary population decreased faster (p = 0.0002) in the experimental group. Respiratory symptoms improved in both groups, but sputum production decreased faster in the experimental group (p < 0.05). Laboratory test results did not differ between the groups. CONCLUSIONS: A cholesterol-rich diet accelerated the sterilization rate of sputum cultures in pulmonary tuberculosis patients, suggesting that cholesterol should be used as a complementary measure in antitubercular treatment.
Authors:
Carlos Pérez-Guzmán; Mario H Vargas; Francisco Quiñonez; Norma Bazavilvazo; Adriana Aguilar
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Chest     Volume:  127     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-02-11     Completed Date:  2005-03-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  643-51     Citation Subset:  AIM; IM    
Affiliation:
Instituto Nacional de Enfermedades Respiratorias, Tlalpan 4502, CP 14080, México City, Mexico.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antitubercular Agents / therapeutic use*
Bacteriological Techniques
Cholesterol / blood,  deficiency*
Colony Count, Microbial
Combined Modality Therapy
Drug Administration Schedule
Drug Therapy, Combination
Female
Follow-Up Studies
Food-Drug Interactions*
Humans
Male
Mexico
Middle Aged
Mycobacterium tuberculosis / drug effects*
Sputum / microbiology
Treatment Outcome
Tuberculosis, Pulmonary / blood,  diet therapy*,  microbiology
Chemical
Reg. No./Substance:
0/Antitubercular Agents; 57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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