Objective To investigate serum vitamin D levels in tuberculosis (TB) patients with different blood glucose status.Methods Two hundred and forty seven TB patients were recruited from tuberculosis clinics in Jilin province and 80 normal subjects who underwent health check up in Beijing Hospital served as controls.Blood samples were collected,fasting blood glucose (FBG) and serum vitamin D [25 (OH)D] levels were measured.Results FBG results showed that there were 95 patients with normal FBG,69 with pre-diabetes (pre-DM) and 83 with diabetes mellitus (DM).Vitamin D measurement showed that 25(OH) D level in TB patients with normal FBG,pre-DM and DM was 16.1 (10.7,26.2) μg/L,12.9 (9.6,20.1) μg/L and 12.4 (10.4,16.9) μg/L,respectively,(x2 =19.608,P ＜ 0.001) and were much lower than that in the normal controls (20.5 μg/L) (x2 =21.701,P ＜ 0.001).Proportion of TB patients with 25 (OH)D sever deficiency(＜ 10.0 μg/L)in patients with normal FBG,pre-DM and DM was 20.0％ (19/95),31.9％ (22/69),and 24.1％ (20/83) respectively (x2 =6.376,P ＜ 0.05);proportion of 25 (OH) D deficiency (10.0-19.9 ng/ml) in three groups was 41.1％ (39/95),40.6％ (28/69),and 57.8 ％ (48/83),respectively (x2 =15.141,P ＜ 0.05);sufficient 25 (OH) D (≥ 30.0 μg/L) was 14.7％ (14/95),7.2％ (5/69),and 1.2％ (1/83),respectively (x2 =19.118;P ＜0.05).While the proportion of TB patient with 25 (OH) D insufficiency (20.0-29.9 ng/ml) was 24.2％ (23/95),20.3％ (14/69),and 16.9％ (14/48) respectively (x2 =0.933,P =0.627).In TB patients with normal FBG,risk factors for 25 (OH) D deficiency were smoking (OR =5.619,95％ CI:1.293-24.424,P =0.021),cold season (OR =14.402,95％CI:4.070-50.965,P ＜ 0.001) and smear negative TB (OR =6.194,95 ％ CI:1.873-20.481,P =0.003).Living in rural area (OR =3.429,95％ CI:1.040-11.299,P =0.043) was the risk factor for 25 (OH) D deficiency in TB patients with pre-DM and age ≥ 60 years (OR =2.474,95％CI:1.086-5.623,P =0.031) was risk factor for 25 (OH) D deficiency in those with DM.Conclusions Vitamin D level is lower in TB patients than that in normal controls.The diabetic TB patients have the lowest 25 (OH) D level and have highest proportion of vitamin D deficiency and sever deficiency,particularly for elderly patients.

BackgroundPatients after percutaneous coronary intervention （PCI） are prone to experience depression， which has been shown to significantly affect patients' quality of recovery in postoperative period. Resourcefulness plays an important role between stress and depression， yet there is insufficient research evidence on the predictive effect of intellectual resourcefulness levels on depressive symptoms among patients undergoing PCI. ObjectiveTo investigate the cross-lagged effect between level of resourcefulness and depressive symptoms among patients after PCI， so as to provide references for alleviating depressive symptoms in patients after PCI. MethodsA total of 363 patients who had undergone PCI in Tangshan Gongren Hospital from September to December 2019 were selected using random sampling technique. All participants were subjected to complete Chinese Resourcefulness Scale （CRS） and Chinese version of Cardiac Depression Scale （C-CDS） at both baseline and two years after PCI. A structural equation model was constructed to determine the cross-lagged effect between the level of resourcefulness and depressive symptoms in patients. ResultsMale patients scored higher on CRS （t=-19.871， P<0.01） and lower on C-CDS （t=25.557， P<0.01） after two years of PCI compared with female patients after PCI. Correlation analysis indicated that the baseline CRS score was positively correlated with two years after PCI CRS score （r=0.550， P<0.01）， C-CDS score of baseline was positively correlated with two years after PCI C-CDS score （r=0.524， P<0.01）， baseline CRS score was negatively correlated with C-CDS scores at both baseline （r=-0.717， P<0.01） and two years after PCI （r=-0.472， P<0.01）， and two years after PCI， CRS score was negatively correlation with C-CDS score （r=-0.618， P<0.01）. The cross-lagged analysis revealed that baseline CRS score significantly predicted CRS score of two years after PCI （β=0.382， P<0.01） and C-CDS score of two years after PCI （β=-0.200， P<0.01）. Baseline C-CDS score significantly predicted C-CDS score of two years after PCI （β=0.381， P<0.01） and CRS score of two years after PCI （β=-0.235， P<0.01）. There was a reciprocal relationship between baseline CRS score and baseline C-CDS score （β=-0.717， P<0.01）. ConclusionThe established cross-lagged model yields the presence of a reciprocal prediction of level of resourcefulness and depressive symptoms measured in patients at two time points. The higher the baseline level of resourcefulness， the lighter the depressive symptoms experienced by patients two years after PCI surgery.The more severe the baseline depressive symptoms， the lower the patients' level of resourcefulness two years after PCI surgery.［Funded by Project of Hebei Provincial Department of Science and Technology （number， 182777154）］