Nutrition and clinical manifestations of pulmonary tuberculosis: A cross-sectional study in Shandong province, China.

The aim is to investigate the association between nutritional status and clinical picture of pulmonary tuberculosis (PTB).A total of 613 pulmonary tuberculosis patients in Weifang city, Shandong province, China were included. Clinical and nutritional history, anthropometry, nutritionally relevant indicators including serum total protein and albumin, hemoglobin and lymphocyte count were measured. Adjustments were made for confounders in multivariable logistic models where tuberculosis activity (clinical symptoms and signs, sputum-smear tests or chest computerized tomography (CT)) was the dependent variable.Hypoalbuminemia (OR=2.61; 95% CI, 1.69-4.03), anemia (OR=1.62; 95% CI, 1.04-2.51) and lymphocytopenia (OR=1.92; 95% CI, 1.21-3.05) were associated with a higher TB score (a clinical severity measure for pulmonary tuberculosis based on typical signs and symptoms); hypoalbuminemia (OR=1.75; 95% CI, 1.08-2.84) and anemia (OR=1.87; 95% CI, 1.14-3.08) were associated with a positive sputum smear; anemia (OR=3.58; 95% CI, 1.85-6.94) was associated with cavitation in CT.Hypoalbuminemia, anemia and lymphocytopenia were positively associated with the severity of clinical manifestation of PTB. Nutritional status may be a marker for the severity of the clinical manifestations of PTB.