Krysiak Robert, Szkróbka Witold, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Exp Clin Endocrinol Diabetes. 2019 Jan;127(1):23-28. doi: 10.1055/a-0669-9309. Epub 2018 Aug 27.
Both vitamin D preparations and high-dose statin therapy were found to reduce thyroid antibody titers.
The purpose of this study was to assess whether vitamin D status determines the effect of statin therapy on thyroid autoimmunity.
The study population consisted of 39 euthyroid women with Hashimoto's thyroiditis and moderate or moderately high cardiovascular risk divided into two groups: women with vitamin D deficiency or insufficiency (group A; n=19) and women with normal vitamin D status (group B, n=20). All patients received atorvastatin therapy (20-40 mg daily) for the following 6 months. Plasma lipids, circulating levels of thyrotropin, free thyroid hormones, prolactin and 25-hydroxyvitamin D, titers of thyroid peroxidase and thyroglobulin antibodies, as well as Jostel's, the SPINA-GT and the SPINA-GD indices were assessed at the beginning and at the end of the study.
The study completed all women. At baseline, with the exception of 25-hydroxyvitamin D, there were no significant differences between both study groups in plasma lipids, circulating hormone levels and titers of thyroid peroxidase and thyroglobulin antibodies. Despite improving plasma lipids in both study groups, atorvastatin reduced thyroid antibody titers only in women with normal vitamin D status. Moreover, in this group of patients, atorvastatin increased the SPINA-GT index. Circulating levels of the measured hormones, Jostel's thyrotropin index and the SPINA-GD index remained at a similar level throughout the study.
The results of the study suggest that the effect of atorvastatin therapy on thyroid autoimmunity depends on vitamin D status.
维生素D制剂和大剂量他汀类药物治疗均被发现可降低甲状腺抗体滴度。
本研究旨在评估维生素D状态是否决定他汀类药物治疗对甲状腺自身免疫的影响。
研究人群包括39名患有桥本甲状腺炎且心血管风险为中度或中度偏高的甲状腺功能正常的女性，分为两组：维生素D缺乏或不足的女性（A组；n = 19）和维生素D状态正常的女性（B组，n = 20）。所有患者在接下来的6个月内接受阿托伐他汀治疗（每日20 - 40毫克）。在研究开始和结束时评估血浆脂质、促甲状腺激素、游离甲状腺激素、催乳素和25 - 羟维生素D的循环水平、甲状腺过氧化物酶和甲状腺球蛋白抗体滴度，以及约斯特尔指数、SPINA - GT指数和SPINA - GD指数。
研究完成了所有女性。在基线时，除25 - 羟维生素D外，两组在血浆脂质、循环激素水平以及甲状腺过氧化物酶和甲状腺球蛋白抗体滴度方面均无显著差异。尽管两组的血浆脂质均有所改善，但阿托伐他汀仅降低了维生素D状态正常女性的甲状腺抗体滴度。此外，在这组患者中，阿托伐他汀增加了SPINA - GT指数。在整个研究过程中，所测激素的循环水平、约斯特尔促甲状腺激素指数和SPINA - GD指数保持在相似水平。
研究结果表明，阿托伐他汀治疗对甲状腺自身免疫的影响取决于维生素D状态。
