Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.
Endocrine. 2018 Mar;59(3):499-505. doi: 10.1007/s12020-018-1532-5. Epub 2018 Jan 31.
Although observational studies suggested that vitamin D plays a role in autoimmune thyroiditis (AIT), intervention trials yielded inconsistent findings. We therefore conducted a systematic review and a meta-analysis to evaluate the effects of Vitamin D on decreasing autoantibodies in patients with AIT.
We identified all studies that assessed the changes of TPO-Ab and Tg-Ab in patients with AIT under the treatment of vitamin D from PubMed, Embase, The Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang, and VIP Database.
Six randomized controlled trials (RCTs) were included in this systematic review representing a total of 344 patients with AIT. The results showed that Vitamin D supplementation significantly dropped TPO-Ab titers [three studies, random effects standardized mean difference (SMD): -1.11, 95% CI -1.52 to -0.70, P < 0.01] at six months, but not at no more than 3 months [random effects SMD: -0.12, 95% CI: -0.69 to 0.44, P = 0.67]. As compared with control group, participants who received vitamin D supplementation demonstrated significantly lower Tg-Ab [random effects SMD: -0.55, 95% CI: -1.05 to -0.04, P = 0.033]. In addition, no serious adverse effect was reported.
The current evidence suggests that vitamin D supplementation could decrease serum TPO-Ab and Tg-Ab titers of patients with AIT in the short-term (about six months). More high quality studies are needed to further confirm the effects, especially the long-term effects of Vitamin D supplementation on thyroid autoantibodies levels in the treatment of AIT.
尽管观察性研究表明维生素 D 在自身免疫性甲状腺炎 (AIT) 中发挥作用，但干预试验得出的结果并不一致。因此，我们进行了系统评价和荟萃分析，以评估维生素 D 对降低 AIT 患者自身抗体的影响。
我们从 PubMed、Embase、The Cochrane Library、中国知网、万方和 VIP 数据库中检索了所有评估维生素 D 治疗 AIT 患者时 TPO-Ab 和 Tg-Ab 变化的研究。
本系统评价共纳入 6 项随机对照试验（RCT），共纳入 344 例 AIT 患者。结果表明，维生素 D 补充剂在 6 个月时显著降低 TPO-Ab 滴度[3 项研究，随机效应标准化均数差（SMD）：-1.11，95%CI：-1.52 至-0.70，P<0.01]，但在不超过 3 个月时无显著降低[随机效应 SMD：-0.12，95%CI：-0.69 至 0.44，P=0.67]。与对照组相比，接受维生素 D 补充剂的参与者 Tg-Ab 显著降低[随机效应 SMD：-0.55，95%CI：-1.05 至-0.04，P=0.033]。此外，未报告严重不良事件。
目前的证据表明，维生素 D 补充剂在短期内（约 6 个月）可降低 AIT 患者的血清 TPO-Ab 和 Tg-Ab 滴度。需要更多高质量的研究进一步证实其效果，特别是维生素 D 补充剂对 AIT 治疗中甲状腺自身抗体水平的长期效果。
