The Relation Between Trace Elements and Latent Tuberculosis Infection: a Study Based on National Health and Nutritional Examination Survey 2011-2012

This study aimed to analyze the potential association between trace elements and latent tuberculosis infection (LTBI) based on the data from the National Health and Nutritional Examination Survey (NHANES) during 2011-2012. In this cross-sectional study, tuberculin skin testing (TST) and QuantiFERON®-TB Gold In-Tube (QFT-GIT) were utilized to screen for LTBI. Participants with positive results of TST or/and QFT-GIT were defined as LTBI. Weighted univariate and multivariate logistic regression analyses were used to explore the association between trace elements and LTBI. Subgroup analyses were conducted according to gender, age, birthplace, race, and health insurance holding status. A total of 6064 participants were included in this study, of whom 655 (10.80%) participants were with positive results of LTBI. Weighted multivariable analysis demonstrated that zinc [odds ratio (OR) = 0.89; 95% confidence interval (CI), 0.82-0.97] and selenium (OR = 0.31; 95%CI, 0.13-0.70) in the serum may be associated with a reduced risk of LTBI. In different concentrations of zinc and selenium, serum zinc concentration of 12.56-13.99 μmol/l (vs. < 11.23 μmol/l; OR = 0.37, 95% CI, 0.20-0.67) was related to a reduced risk of LTBI, while no significant difference was observed under different selenium levels (P > 0.05). Subgroup analyses indicated that the role of zinc and selenium in reducing TB risk may be more significant in males, people aged 21-64, people born in the USA, people with health insurance, and non-Hispanic Whites. Maintaining serum zinc and selenium levels may help reduce the risk of LTBI and indirectly help people prevent TB.