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维生素D对左甲状腺素治疗的桥本甲状腺炎且维生素D状态正常的女性甲状腺自身免疫的影响。

The Effect of Vitamin D on Thyroid Autoimmunity in Levothyroxine-Treated Women with Hashimoto's Thyroiditis and Normal Vitamin D Status.

作者信息

Krysiak Robert, Szkróbka Witold, Okopień Bogusław

机构信息

Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.

出版信息

Exp Clin Endocrinol Diabetes. 2017 Apr;125(4):229-233. doi: 10.1055/s-0042-123038. Epub 2017 Jan 10.

Abstract

Low vitamin D status is associated with autoimmune thyroid disease. Oral vitamin D supplementation was found to reduce titers of thyroid antibodies in levothyroxine-treated women with postpartum thyroiditis and low vitamin D status. The study included 34 women with Hashimoto's thyroiditis and normal vitamin D status (serum 25-hydroxyvitamin D levels above 30 ng/mL) who had been treated for at least 6 months with levothyroxine. On the basis of patient preference, women were divided into 2 groups, receiving (n=18) or not receiving (n=16) oral vitamin D preparations (2000 IU daily). Serum levels of thyrotropin, free thyroxine, free triiodothyronine and 25-hydroxyvitamin D, as well as titers of thyroid peroxidase and thyroglobulin antibodies were measured at the beginning of the study and 6 months later. There were no significant differences in baseline values between both study groups. 25-hydroxyvitamin D levels inversely correlated with titers of thyroid antibodies. No changes in hypothalamic-pituitary-thyroid axis activity and thyroid antibody titers were observed in vitamin-naïve patients. Vitamin D increased serum levels of 25-hydroxyvitamin D, as well as reduced titers of thyroid antibodies. This effect was more pronounced for thyroid peroxidase than for thyroglobulin antibodies and correlated with their baseline titers. Vitamin D preparations may reduce thyroid autoimmunity in levothyroxine-treated women with Hashimoto's thyroiditis and normal vitamin D status.

摘要

维生素D水平低下与自身免疫性甲状腺疾病有关。研究发现,口服补充维生素D可降低产后甲状腺炎且维生素D水平低下的左甲状腺素治疗女性的甲状腺抗体滴度。该研究纳入了34名患有桥本甲状腺炎且维生素D水平正常(血清25-羟维生素D水平高于30 ng/mL)、接受左甲状腺素治疗至少6个月的女性。根据患者意愿,将女性分为2组,分别接受(n = 18)或不接受(n = 16)口服维生素D制剂(每日2000 IU)。在研究开始时和6个月后测量血清促甲状腺激素、游离甲状腺素、游离三碘甲状腺原氨酸和25-羟维生素D水平,以及甲状腺过氧化物酶和甲状腺球蛋白抗体滴度。两个研究组的基线值无显著差异。25-羟维生素D水平与甲状腺抗体滴度呈负相关。在未使用维生素的患者中,未观察到下丘脑-垂体-甲状腺轴活性和甲状腺抗体滴度的变化。维生素D可提高血清25-羟维生素D水平,并降低甲状腺抗体滴度。这种作用对甲状腺过氧化物酶比对甲状腺球蛋白抗体更明显,且与它们的基线滴度相关。维生素D制剂可能会降低接受左甲状腺素治疗、患有桥本甲状腺炎且维生素D水平正常的女性的甲状腺自身免疫性。

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