Hypocholesterolemia: A frequent finding associated to tuberculosis

Introduction: Pulmonary tuberculosis is an infectious and contagious disease which apparently develops under conditions of a deficient immunologic response. The immune system requires a wide variety of nutrients to function adequately and some studies suggest that cholesterol might be one of them. Methods: The clinical records of patients hospitalized at the National Institute of Respiratory Diseases (1989-1994) with diagnosis of pulmonary tuberculosis (group TB), pleural tuberculosis (group TBPL) or miliary tuberculosis (group TBMI), and of patients with pulmonary tuberculosis and diabetes mellitus (group TBDM) were reviewed. Clinical records were randomly selected and information on age, gender and serum cholesterol levels was obtained. Results: Each one of four groups of tuberculous patients had cholesterol levels significantly lower (p<0.01, ANOVA and Dunnett) than data obtained from three national surveys. Thus, cholesterol levels (mg/dL,X̄±SD) for each group were: TB, 140.0±44.5 (n=125); TBPL, 142.2±45.9 (n=96); TBMI, 140.9±38.2 (n=58) and TBDM, 156.9±43.5 (n=163). Whereas, in surveys, means varied between 182 and 198 mg/dL. Conclusions: Our analysis shows that hypocholesterolemia is a common finding in patients with pulmonary tuberculosis. This association may be because tuberculosis, as a chronic infectious pathology, depleted cholesterol or because subjects previously had out hypocholesterolemia and this predisposed them to develop tuberculosis. This latter alternative is very important because it points to the possibility of using cholesterol as a therapeutic tool for the prevention and/or treatment of tuberculosis.