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生理血清 25-羟维生素 D 浓度与改善甲状腺功能相关——一项基于社区的研究观察。

Physiological serum 25-hydroxyvitamin D concentrations are associated with improved thyroid function-observations from a community-based program.

机构信息

Pure North S'Energy Foundation, 326 11th Avenue SW, Suite 800, Calgary, AB, T2R 0C5, Canada.

Naturmend Integrative Medical Clinic, 905 1st Ave NE, Calgary, AB, T2E 2L3, Canada.

出版信息

Endocrine. 2017 Dec;58(3):563-573. doi: 10.1007/s12020-017-1450-y. Epub 2017 Oct 24.

Abstract

PURPOSE

Vitamin D deficiency has been associated with an increased risk of hypothyroidism and autoimmune thyroid disease. Our aim was to investigate the influence of vitamin D supplementation on thyroid function and anti-thyroid antibody levels.

METHODS

We constructed a database that included 11,017 participants in a health and wellness program that provided vitamin D supplementation to target physiological serum 25-hydroxyvitmain D [25(OH)D] concentrations (>100 nmol/L). Participant measures were compared between entry to the program (baseline) and follow-up (12 ± 3 months later) using an intent-to-treat analysis. Further, a nested case-control design was utilized to examine differences in thyroid function over 1 year in hypothyroid individuals and euthyroid controls.

RESULTS

More than 72% of participants achieved serum 25(OH)D concentrations >100 nmol/L at follow-up, with 20% above 125 nmol/L. Hypothyroidism was detected in 2% (23% including subclinical hypothyroidism) of participants at baseline and 0.4% (or 6% with subclinical) at follow-up. Serum 25(OH)D concentrations ≥125 nmol/L were associated with a 30% reduced risk of hypothyroidism and a 32% reduced risk of elevated anti-thyroid antibodies. Hypothyroid cases were found to have higher mean serum 25(OH)D concentrations at follow-up, which was a significant positive predictor of improved thyroid function.

CONCLUSION

The results of the current study suggest that optimal thyroid function might require serum 25(OH)D concentrations above 125 nmol/L. Vitamin D supplementation may offer a safe and economical approach to improve thyroid function and may provide protection from developing thyroid disease.

摘要

目的

维生素 D 缺乏与甲状腺功能减退症和自身免疫性甲状腺疾病的风险增加有关。我们旨在研究维生素 D 补充对甲状腺功能和抗甲状腺抗体水平的影响。

方法

我们构建了一个数据库,其中包含 11017 名参加健康和健康计划的参与者,该计划提供维生素 D 补充剂以达到生理血清 25-羟维生素 D [25(OH)D]浓度(>100nmol/L)。使用意向治疗分析比较参与者在进入该计划(基线)和随访(12±3 个月后)时的测量值。此外,还利用巢式病例对照设计来检查甲状腺功能在 1 年内的变化,比较甲状腺功能减退患者和甲状腺功能正常对照组。

结果

超过 72%的参与者在随访时达到血清 25(OH)D 浓度>100nmol/L,其中 20%的人浓度超过 125nmol/L。基线时有 2%(包括亚临床甲状腺功能减退症的 23%)的参与者出现甲状腺功能减退症,随访时有 0.4%(或亚临床甲状腺功能减退症的 6%)。血清 25(OH)D 浓度≥125nmol/L与甲状腺功能减退症风险降低 30%和抗甲状腺抗体升高风险降低 32%相关。甲状腺功能减退症病例在随访时的平均血清 25(OH)D 浓度较高,这是甲状腺功能改善的显著正向预测因子。

结论

本研究结果表明,最佳甲状腺功能可能需要血清 25(OH)D 浓度>125nmol/L。维生素 D 补充可能是一种安全且经济的改善甲状腺功能的方法,并可能提供预防甲状腺疾病的保护。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c67d/5693977/b2fa0433483e/12020_2017_1450_Fig1_HTML.jpg

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