P038

1:Instituto de Investigaciones Científicas y Servicios de Alta Tecnología; 2:Universidad de Granada; 3:CIBER of Epidemiology and Public Health (CIBERESP-Spain); 4:Universidad Latina de Panamá; 5:Universidad de Panamá; 6:University of Bristol; 7:Caja del Seguro Social; 8:Ministerio de Salud; 9:Laboratorio Regional de Tuberculosis de Colón

This cross-sectional study aimed to evaluate the vitamin D receptor [25(OH)D] (VDR) FokI, TaqI, and BsmI polymorphisms frequency and their relationship with vitamin D levels, metabolites, and ratios (VMR) in patients with tuberculosis (PTB) and healthy controls (HC) in Colon, Panama. We analyzed serum of 80 PTB and 50 HC for polymorphisms by polymerase chain reaction-restriction fragment length (PCR-RFLP) and measured vitamin D metabolites by liquid chromatography-tandem mass spectrometry (LC-MS/MS). In VDR polymorphisms, no significant differences in distribution and relative frequencies of BsmI, FokI, and TaqI were observed when comparing PTB and HC. However, we observed significantly low levels of 25(OH)D in PTB with a BsmI BB haplotype (χ2 test, p=0.007). These findings suggest a role of the BsmI VDR in 25(OH)D metabolism and immune response during disease. In the case of 25(OH)D₃, we detected a significant difference (p=0.01) between PTB and HC, indicating that PTB had significantly lower 25(OH)D₃ levels. For 25(OH)D_2, PTB had lower levels than HC with a significant difference (p=0.009), which could be related to an alteration in the metabolism of 25(OH)D₃ and 25(OH)D₂ associated with tuberculosis infection. The 24,25(OH)₂D₃:25(OH)D₃ ratio values revealed that HC had a higher conversion of 25(OH)D₃ to its inactive form 24,25(OH)D₃, reflecting a balanced vitamin D metabolism.  Conversely, 18 PTB had a lower conversion of 25(OH)D₃ to its inactive form, which could reflect a need for vitamin D supplementation. These results emphasize the importance of individual PTB analysis and establishing MRV values in patients with tuberculosis as predictors of metabolic status.