Ucan Bekir, Sahin Mustafa, Sayki Arslan Muyesser, Colak Bozkurt Nujen, Kizilgul Muhammed, Güngünes Askin, Cakal Erman, Ozbek Mustafa
1 Department of Endocrinology and Metabolism, Diskapi Teaching and Research Hospital, Ankara, Turkey.
2 Department of Endocrinology and Metabolism, Ankara University, School of Medicine, Ankara, Turkey.
Int J Vitam Nutr Res. 2016 Feb;86(1-2):9-17. doi: 10.1024/0300-9831/a000269. Epub 2017 Jul 12.
The relationship between Hashimoto's thyroiditis and vitamin D has been demonstrated in several studies. The aim of the present study was to evaluate vitamin D concentrations in patients with Hashimoto's thyroiditis, the effect of vitamin D therapy on the course of disease, and to determine changes in thyroid autoantibody status and cardiovascular risk after vitamin D therapy. We included 75 patients with Hashimoto's thyroiditis and 43 healthy individuals. Vitamin D deficiency is defined as a 25-hydroxy vitamin D (25(OH)D3) concentration less than 20ng/mL. Vitamin D deficient patients were given 50.000 units of 25(OH)D3 weekly for eight weeks in accordance with the Endocrine Society guidelines. All evaluations were repeated after 2 months of treatment. Patients with Hashimoto's thyroiditis had significantly lower vitamin D concentrations compared with the controls (9.37±0.69 ng/mL vs 11.95±1.01 ng/mL, p < 0.05, respectively). Thyroid autoantibodies were significantly decreased by vitamin D replacement treatment in patients with euthyroid Hashimoto's thyroiditis. Also, HDL cholesterol concentrations improved in the euthyroid Hashimoto group after treatment. The mean free thyroxine (fT4) concentrations were 0.89±0.02 ng/dL in patients with Hashimoto's thyroiditis and 1.07±0.03 ng/dL in the healthy control group (p < 0.001). The mean thyroid volumes were 7.71±0.44 mL in patients with Hashimoto's thyroiditis and 5.46±0.63 mL in the healthy control group (p < 0.01). Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
多项研究已证实桥本甲状腺炎与维生素D之间的关系。本研究的目的是评估桥本甲状腺炎患者的维生素D浓度、维生素D治疗对疾病进程的影响，并确定维生素D治疗后甲状腺自身抗体状态和心血管风险的变化。我们纳入了75例桥本甲状腺炎患者和43名健康个体。维生素D缺乏定义为25-羟基维生素D（25(OH)D3）浓度低于20ng/mL。根据内分泌学会指南，维生素D缺乏的患者每周给予50000单位的25(OH)D3，共八周。治疗2个月后重复所有评估。与对照组相比，桥本甲状腺炎患者的维生素D浓度显著降低（分别为9.37±0.69 ng/mL和11.95±1.01 ng/mL，p<0.05）。甲状腺功能正常的桥本甲状腺炎患者通过维生素D替代治疗后，甲状腺自身抗体显著降低。此外，甲状腺功能正常的桥本甲状腺炎组治疗后高密度脂蛋白胆固醇浓度有所改善。桥本甲状腺炎患者的平均游离甲状腺素（fT4）浓度为0.89±0.02 ng/dL，健康对照组为1.07±0.03 ng/dL（p<0.001）。桥本甲状腺炎患者的平均甲状腺体积为7.71±0.44 mL，健康对照组为5.46±0.63 mL（p<0.01）。维生素D缺乏在桥本甲状腺炎中很常见，用维生素D治疗这种疾病的患者可能会减缓甲状腺功能减退的发展进程，还可降低这些患者的心血管风险。对这些患者进行维生素D检测和补充可能至关重要。
