Barchetta I, Baroni M G, Leonetti F, De Bernardinis M, Bertoccini L, Fontana M, Mazzei E, Fraioli A, Cavallo M G
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Viale del Policlinico, 155, 00161, Rome, Italy.
Clin Exp Med. 2015 Aug;15(3):389-96. doi: 10.1007/s10238-014-0290-9. Epub 2014 Jun 13.
A circannual periodicity in thyrotropin (TSH) secretion has been reported but the causes of these phenomenon are still undefined. Vitamin D exerts a direct influence on pituitary axes including the hypothalamus-pituitary-thyroid axis. Aims of the present study were to investigate the presence of a seasonal variability of TSH secretion and to study the association between vitamin D status and TSH levels in a population of euthyroid adults. For this purpose, we recruited 294 euthyroid adults (M/F 133/161, 48.5 ± 12.4 years). Study participants underwent clinical examination and routine biochemistry assessment. Vitamin D deficiency was diagnosed for serum 25(OH) vitamin D <25 nmol/l. Significantly higher TSH levels were found in subjects who underwent blood sampling during the Autumn-Winter compared with individuals evaluated in Spring-Summer (2.3 ± 1.3 vs. 1.8 ± 1.1 μIU/ml, p = 0.03). Vitamin D deficiency was strongly associated with higher TSH levels (p = 0.01) after adjusting for sex, age, and sample's season. Although vitamin D deficiency was also associated with metabolic syndrome and its components, the association between TSH levels and vitamin D status persisted also considering these confounders. These data reveal the occurrence of seasonal variability of serum TSH concentration in euthyroid subjects and provide evidence for the first time that an association exists between vitamin D status and serum TSH levels.
已有报道称促甲状腺激素(TSH)分泌存在年周期节律,但这些现象的原因仍不明确。维生素D对包括下丘脑 - 垂体 - 甲状腺轴在内的垂体轴有直接影响。本研究的目的是调查甲状腺功能正常的成年人中TSH分泌的季节性变化情况,并研究维生素D状态与TSH水平之间的关联。为此,我们招募了294名甲状腺功能正常的成年人(男/女133/161,年龄48.5±12.4岁)。研究参与者接受了临床检查和常规生化评估。血清25(OH)维生素D<25 nmol/l被诊断为维生素D缺乏。与在春夏季接受评估的个体相比,在秋冬季节进行血液采样的受试者TSH水平显著更高(2.3±1.3 vs. 1.8±1.1 μIU/ml,p = 0.03)。在对性别、年龄和采样季节进行校正后,维生素D缺乏与较高的TSH水平密切相关(p = 0.01)。尽管维生素D缺乏也与代谢综合征及其组分相关,但考虑到这些混杂因素后,TSH水平与维生素D状态之间的关联仍然存在。这些数据揭示了甲状腺功能正常的受试者血清TSH浓度存在季节性变化,并首次提供了维生素D状态与血清TSH水平之间存在关联的证据。