ABSTRACT
Objective: To systematically evaluate the efficacy and safety of vitamin D supplementation in the treatment of pulmonary tuberculosis. Methods: Biomedical Database was searched to collect randomized controlled trials (RCT) related to vitamin D supplementation in tuberculosis patients, and the retrieval time was from establishment to November 2019. Two evaluators independently screened the literature and extracted the data. The negative conversion rate of acid-fast-bacilli of sputum smear, the negative conversion rate of mycobacterium tuberculosis culture and the change of serum vitamin D level were the main outcome indicators, and the body mass index was the secondary outcome indicator. The incidence of hypercalcemia and abnormal urinary calcium were used as adverse event indicators and the RevMan 5.2 software was used for meta-analysis. Results: A total of 8 RCT(S) met the inclusion criteria, including 850 patients with tuberculosis. Meta-analysis showed that compared with the control group, negative conversion rate of acid-fast-bacilli of sputum smear and serum vitamin D level increased after 8 weeks of vitamin D supplementation [RR (95%CI) and mean deviation (MD) (95%CI) were 1.06 (1.00, 1.13) and 8.81 (1.81, 15.81), respectively; negative conversion rate of acid-fast-bacilli of sputum smear was not increased at week 4 and 12 [RR (95%CI) were 1.08 (0.97, 1.20) and 1.01 (0.91, 1.12), respectively]; negative conversion rate of mycobacterium tuberculosis culture in sputum was not increased after 4 and 8 weeks [RR (95%CI) were 1.06 (0.91, 1.22) and 1.02 (0.96, 1.08), respectively]; there was no change in body mass index [MD (95%CI):-0.02 (-0.53, 0.50)]; there was increased risk of abnormal urinary calcium [RR (95%CI): 2.45 (1.75, 3.41)], while no increase in risk of hypercalcemia [RR (95%CI): 1.99 (0.96, 4.13)]. Conclusion: Vitamin D supplementation is safe but not effective in the treatment of pulmonary tuberculosis.