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维生素 D 缺乏症严重程度与桥本甲状腺炎的相关性。

The association between severity of vitamin D deficiency and Hashimoto's thyroiditis.

机构信息

Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

出版信息

Endocr Pract. 2013 May-Jun;19(3):479-84. doi: 10.4158/EP12376.OR.

Abstract

OBJECTIVE

The relation between vitamin D and autoimmune disorders has long been investigated regarding the important roles of this hormone in immune regulation. We evaluated 25-hydroxyvitamin D (25OHD) status in subjects with Hashimoto's thyroiditis (HT) and healthy controls.

METHODS

Group-1 included 180 euthyroid patients (123 females/57 males) with HT who were on a stable dose of L-thyroxine (LT). A total of 180 sex-, age-, and body mass index (BMI)-matched euthyroid subjects with newly diagnosed HT were considered as Group-2, and 180 healthy volunteers were enrolled as controls (Group-3). All 540 subjects underwent thyroid ultrasound and were evaluated for serum 25OHD, anti-thyroid peroxidase (anti-TPO), and anti-thyroglobulin (anti-TG) levels.

RESULTS

Group-1 had the lowest 25OHD levels (11.4 ± 5.2 ng/mL) compared to newly diagnosed HT subjects (Group-2) (13.1 ± 5.9 ng/mL, P = .002) and to control subjects (15.4 ± 6.8 ng/mL, P<.001). Serum 25OHD levels directly correlated with thyroid volume (r = 0.145, P<.001) and inversely correlated with anti-TPO (r = -0.361, P<.001) and anti-TG levels (r = -0.335, P<.001). We determined that 48.3% of Group-1, 35% of Group-2, and 20.5% of controls had severe 25OHD deficiency (<10 ng/mL). Female chronic HT patients had the lowest serum 25OHD levels (10.3 ± 4.58 ng/mL), and male control subjects had the highest (19.3 ± 5.9 ng/mL, P<.001).

CONCLUSIONS

We demonstrated that serum 25OHD levels of HT patients were significantly lower than controls, and 25OHD deficiency severity correlated with duration of HT, thyroid volume, and antibody levels. These findings may suggest a potential role of 25OHD in development of HT and/or its progression to hypothyroidism.

摘要

目的

维生素 D 与自身免疫性疾病之间的关系一直受到关注,因为这种激素在免疫调节中起着重要作用。我们评估了桥本甲状腺炎 (HT) 患者和健康对照者的 25-羟维生素 D (25OHD) 水平。

方法

第 1 组包括 180 名甲状腺功能正常的患者 (123 名女性/57 名男性),他们正在服用稳定剂量的左甲状腺素 (LT)。总共 180 名新诊断为 HT 的甲状腺功能正常的年龄、性别和体重指数 (BMI) 匹配的患者被视为第 2 组,180 名健康志愿者被纳入对照组 (第 3 组)。所有 540 名受试者均接受甲状腺超声检查,并评估血清 25OHD、抗甲状腺过氧化物酶 (anti-TPO) 和抗甲状腺球蛋白 (anti-TG) 水平。

结果

第 1 组的 25OHD 水平最低 (11.4 ± 5.2ng/mL),明显低于新诊断的 HT 患者 (第 2 组) (13.1 ± 5.9ng/mL,P =.002) 和对照组 (第 3 组) (15.4 ± 6.8ng/mL,P<.001)。血清 25OHD 水平与甲状腺体积呈正相关 (r = 0.145,P<.001),与 anti-TPO(r = -0.361,P<.001) 和 anti-TG 水平呈负相关 (r = -0.335,P<.001)。我们发现,第 1 组中 48.3%、第 2 组中 35%和对照组中 20.5%的患者存在严重的 25OHD 缺乏症 (<10ng/mL)。慢性 HT 女性患者的血清 25OHD 水平最低 (10.3 ± 4.58ng/mL),而男性对照组的血清 25OHD 水平最高 (19.3 ± 5.9ng/mL,P<.001)。

结论

我们发现 HT 患者的血清 25OHD 水平明显低于对照组,25OHD 缺乏症的严重程度与 HT 的持续时间、甲状腺体积和抗体水平相关。这些发现可能提示 25OHD 在 HT 的发生和/或向甲状腺功能减退症的发展中具有潜在作用。

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