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维生素 D 缺乏影响碘充足地区的甲状腺自身免疫和功能障碍:韩国国家健康和营养检查调查。

Vitamin D deficiency affects thyroid autoimmunity and dysfunction in iodine-replete area: Korea national health and nutrition examination survey.

机构信息

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.

Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 03181, Korea.

出版信息

Endocrine. 2017 Nov;58(2):332-339. doi: 10.1007/s12020-017-1425-z. Epub 2017 Sep 21.

Abstract

PURPOSE

We evaluated the effects of vitamin D levels and iodine intake on thyroid autoimmunity and dysfunction in the Korean population.

METHODS

In this nationwide population-based study, data were obtained from the Korea National Health and Nutrition Examination Survey VI-1 and 2 (2013 and 2014), which was the first nationwide survey that measured both serum 25-hydroxy vitamin D [25(OH)D] levels and urinary iodine concentrations (UICs) in Korea. A total of 4181 participants who underwent laboratory tests for thyroid function, serum 25(OH)D levels, and UICs were included.

RESULTS

Anti-thyroid peroxidase antibody (TPOAb) positivity was more prevalent in the vitamin D deficient group (9.1%) than the vitamin D insufficient and sufficient groups (5.3% each; P = 0.016). The rate of TPOAb positivity was significantly higher in the iodine deficient group (P = 0.032). Thyroid dysfunction was significantly more prevalent in the iodine excessive group than in the other groups in total (P = 0.016) and TPOAb negative participants (P = 0.007). In the vitamin D deficient group, excessive iodine intake was significantly associated with high prevalence of thyroid dysfunction in total and TPOAb negative participants (P = 0.021 and P = 0.033, respectively). In the vitamin D insufficient and sufficient groups, association between thyroid dysfunction and iodine intake disappeared in total and TPOAb negative participants.

CONCLUSIONS

This nationwide survey revealed a significant association between vitamin D deficiency and high prevalence of thyroid autoimmunity and dysfunction in participants with excessive iodine intake. Our findings might be helpful for elucidating the potential benefit of vitamin D supplements in TPOAb negative patients with excessive iodine intake.

摘要

目的

我们评估了维生素 D 水平和碘摄入量对韩国人群甲状腺自身免疫和功能障碍的影响。

方法

在这项全国性的基于人群的研究中,数据来自韩国国家健康和营养检查调查 VI-1 和 2(2013 年和 2014 年),这是首次在韩国进行的同时测量血清 25-羟维生素 D [25(OH)D]水平和尿碘浓度 (UIC) 的全国性调查。共纳入了 4181 名接受甲状腺功能、血清 25(OH)D 水平和 UIC 实验室检测的参与者。

结果

抗甲状腺过氧化物酶抗体(TPOAb)阳性在维生素 D 缺乏组(9.1%)中比维生素 D 不足和充足组(各 5.3%;P=0.016)更常见。碘缺乏组 TPOAb 阳性率显著更高(P=0.032)。甲状腺功能障碍在碘过量组总人群(P=0.016)和 TPOAb 阴性参与者(P=0.007)中均显著更为常见。在维生素 D 缺乏组中,碘摄入过多与总人群和 TPOAb 阴性参与者甲状腺功能障碍的高患病率显著相关(P=0.021 和 P=0.033)。在维生素 D 不足和充足组中,碘摄入与甲状腺功能障碍之间的关联在总人群和 TPOAb 阴性参与者中消失。

结论

这项全国性调查显示,在碘摄入过多的参与者中,维生素 D 缺乏与甲状腺自身免疫和功能障碍的高患病率之间存在显著关联。我们的研究结果可能有助于阐明维生素 D 补充剂对碘摄入过多的 TPOAb 阴性患者的潜在益处。

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