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维生素D缺乏治疗对桥本甲状腺炎患者甲状腺功能及自身免疫标志物的影响:一项双盲随机安慰剂对照临床试验

Effect of Vitamin D deficiency treatment on thyroid function and autoimmunity markers in Hashimoto's thyroiditis: A double-blind randomized placebo-controlled clinical trial.

作者信息

Vahabi Anaraki Parichehr, Aminorroaya Ashraf, Amini Massoud, Momeni Fatemeh, Feizi Awat, Iraj Bijan, Tabatabaei Azamosadat

机构信息

Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2017 Sep 26;22:103. doi: 10.4103/jrms.JRMS_1048_16. eCollection 2017.

Abstract

BACKGROUND

The link between autoimmune thyroid diseases and Vitamin D deficiency has been reported. However, there are controversies in this regard. We conducted a double-blind randomized placebo-controlled clinical trial to investigate the effect of Vitamin D deficiency treatment on thyroid function and autoimmunity marker (thyroid peroxidase antibody [TPO-Ab]) in patients with Hashimoto's thyroiditis.

MATERIALS AND METHODS

Fifty-six patients with Hashimoto's thyroiditis and Vitamin D deficiency (25-hydroxyvitamin D level ≤20 ng/mL) were randomly allocated into two groups to receive Vitamin D (50000 IU/week, orally) or placebo for 12 weeks, as Vitamin D-treated ( = 30) and control ( = 26) groups, respectively. TPO-Ab, thyroid-stimulating hormone (TSH), parathormone, calcium, albumin, and creatinine concentrations were compared before and after trial between and within groups. The data were presented as mean (standard error [SE]) and analyzed by appropriate tests.

RESULTS

Mean (SE) of Vitamin D was increased in Vitamin D-treated group (45.5 [1.8] ng/mL vs. 12.7 [0.7] ng/mL, = 0.01). Mean (SE) of TPO-Ab did not significantly change in both groups (734 [102.93] IU/mL vs. 820.25 [98.92] IU/mL, = 0.14 in Vitamin D-treated and 750.03 [108.7] [IU/mL] vs. 838.07 [99.4] [IU/mL] in placebo-treated group, = 0.15). Mean (SE) of TSH was not changed in both groups after trial, = 0.4 and = 0.15 for Vitamin D-treated and control groups, respectively. No significant difference was observed between two study groups in none studied variables ( > 0.05).

CONCLUSION

Vitamin D treatment in Vitamin D deficient patients with Hashimoto's thyroiditis could not have significant effect on thyroid function and autoimmunity.

摘要

背景

自身免疫性甲状腺疾病与维生素D缺乏之间的关联已有报道。然而,这方面存在争议。我们进行了一项双盲随机安慰剂对照临床试验,以研究维生素D缺乏治疗对桥本甲状腺炎患者甲状腺功能和自身免疫标志物(甲状腺过氧化物酶抗体 [TPO-Ab])的影响。

材料与方法

56例患有桥本甲状腺炎且维生素D缺乏(25-羟维生素D水平≤20 ng/mL)的患者被随机分为两组,分别接受维生素D(50000 IU/周,口服)或安慰剂治疗12周,即维生素D治疗组(n = 30)和对照组(n = 26)。比较两组组间及组内试验前后的TPO-Ab、促甲状腺激素(TSH)、甲状旁腺激素、钙、白蛋白和肌酐浓度。数据以均值(标准误 [SE])表示,并通过适当的检验进行分析。

结果

维生素D治疗组的维生素D均值(SE)升高(45.5 [1.8] ng/mL 对 12.7 [0.7] ng/mL,P = 0.01)。两组的TPO-Ab均值(SE)均无显著变化(维生素D治疗组为734 [102.93] IU/mL 对 820.25 [98.92] IU/mL,P = 0.14;安慰剂治疗组为750.03 [108.7] [IU/mL] 对 838.07 [99.4] [IU/mL],P = 0.15)。试验后两组的TSH均值均未改变,维生素D治疗组和对照组的P分别为0.4和0.15。在所有研究变量中,两个研究组之间均未观察到显著差异(P > 0.05)。

结论

维生素D缺乏的桥本甲状腺炎患者接受维生素D治疗对甲状腺功能和自身免疫无显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a93/5629831/644b381e6a75/JRMS-22-103-g001.jpg

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