86, P < 0.01) Table 2 Correlation between vitamin A level with zinc and biochemical parameters Table 3 shows the effect of background characteristics of patients on vitamin A levels. The vitamin A levels was insignificantly (P > 0.05) higher in the age group of 31-40 years of patients (0.80 �� 0.27 ��mol/l, 95% selleckchem Dorsomorphin CI = 0.71-0.90) as compared to below 20 years (0.79 �� 0.23, 95% CI = 0.69-9.00), above 50 years (0.78 �� 0.27, 95% CI = 0.65-0.91), 20-30 years (0.76 �� 0.20, 95% CI = 0.72-0.79) and 41-50 years (0.74 �� 0.19, 95% CI = 0.66-0.82). The vitamin A levels were significantly (P = 0.001) higher in male (0.82 �� 0.23, 95% CI = 0.77-0.86) patients as compared to females (0.71 �� 0.20, 95% CI = 0.67-0.75). There were no significant differences (P > 0.05) in the levels of vitamin A between married and unmarried patients.

Table 3 Vitamin A levels by background characteristics of the patients Table 4 presents the results of multivariate linear regression analysis determining the effect of serum zinc levels on vitamin A adjusted for age, sex, and BMI of the patients. The adjusted regression coefficient for the serum zinc level remained same as in unadjusted analysis, which was 1.35 (P < 0.0001) indicating that there was no confounding effect of age, sex, and BMI of the patients in the level of vitamin A. Table 4 Effect of serum zinc levels on vitamin A levels adjusted for age, sex, and BMI of the patients DISCUSSION Zinc deficiency affects the host defenses in a variety of ways and it results in decreased phagocytosis and leads to a reduced number of circulating T-cells and reduced tuberculin reactivity, at least in animals.

[21] In vitro cellular killing by macrophages was found to be reduced during zinc deficiency and rapidly restored after zinc supplementation.[22] Zinc has essential role in vitamin A metabolism. Zinc supplementation has a beneficial effect on vitamin A metabolism, which has an important role in TB. An adequate supply of zinc may also limit free radical membrane damage during inflammation.[23] In the present study, a total of 208 TB patients were assessed for their status of zinc level and its association with vitamin A level. The serum zinc and vitamin A levels among the patients were 9.60 (��0.86) ��mol/l Cilengitide and 0.77 (��0.22) ��mol/l respectively. However, Hb, WBC, ESR and serum albumin were 10.02 (��1.33) g/dl, 10076.01 (��1822.67) cell/mm3, 14.50 (��2.95) mm/h and 3.40 (��0.32) g/dl respectively. A study from Rwanda reported vitamin A deficiency among adults with TB. Concentration of vitamin A was found lower in TB patients than controls;[24] however, in an Indian study, the low vitamin A levels observed in TB patients returned to normal at the end of anti-tuberculosis treatment without vitamin A supplementation.