Kmieć Piotr, Minkiewicz Ilona, Rola Rafał, Sworczak Krzysztof, Żmijewski Michał A, Kowalski Konrad
Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Endokrynol Pol. 2018;69(6):653-660. doi: 10.5603/EP.a2018.0065. Epub 2018 Sep 27.
In the context of pleiotropic vitamin D effects, its role has also been investigated in thyroid pathology, in particular autoimmune thyroid diseases (AITD). However, available data concerning vitamin D status in Polish patients with thyroid disorders are inconclusive. In the study we investigated vitamin D status and adequacy of supplementation, as well as sunlight exposure during summer months among adult patients with thyroid diseases.
Adults with diagnosed or suspected thyroid disease were recruited almost entirely in an ambulatory setting between June and September in Northern Poland. Questionnaire examinations were performed, and serum concentrations of 25(OH)D₂, 25(OH)D₃, 3-epi-25(OH)D₃, and 24,25(OH)2D₃ were determined by LC-MS/MS.
Thirty men and 194 women participated in the study, mean age ± standard deviation (SD): 42 ± 15 years, mean ± SD body mass index (BMI) 26 ± 6 kg/m². Among the participants, 133 declared L-thyroxine treatment, 44 - Hashimoto's thyroiditis, 40 - nodular goitre, and 20 - hyperthyroidism and/or Graves' disease. Mean ± SD 25(OH)D level was 26.9 ± 8.2 ng/ml, and deficiency (< 20 ng/ml) was stated in 12%, insufficiency (20 ≤ 25(OH)D < 30 ng/ml) in 50.4% of study participants. Calcidiol was significantly higher in subjects who declared supplementation, mean ± SD: 29.4 ± 7.5 vs. 25.2 ± 8 ng/ml. Among participants without vitamin D supplementation sunlight exposure correlated with 25(OH)D. The C3 epimer of 25(OH)D₃ was detected in all subjects; its concentration correlated strongly with that of 25(OH)D₃. 24,25(OH)2D₃ levels also strongly correlated with those of 25(OH)D₃.
To our knowledge, the current study is the first in Poland to analyse vitamin D status in summer months among patients with thyroid diseases, as well as serum 3-epi-25(OH)D₃ and 24,25(OH)2D₃ concentrations. The data presented here indicate that vitamin D sufficiency is not attained even in summer months in patients with thyroid diseases.
在维生素D具有多效性作用的背景下,其在甲状腺疾病,尤其是自身免疫性甲状腺疾病(AITD)中的作用也得到了研究。然而,波兰甲状腺疾病患者维生素D状态的现有数据尚无定论。在本研究中,我们调查了成年甲状腺疾病患者的维生素D状态、补充剂的充足性以及夏季的阳光照射情况。
几乎所有被诊断或怀疑患有甲状腺疾病的成年人都是在波兰北部6月至9月期间的门诊环境中招募的。进行了问卷调查,并通过液相色谱-串联质谱法测定了血清中25(OH)D₂、25(OH)D₃、3-表-25(OH)D₃和24,25(OH)₂D₃的浓度。
30名男性和194名女性参与了研究,平均年龄±标准差(SD):42±15岁,平均±SD体重指数(BMI)26±6kg/m²。在参与者中,133人宣称正在接受左甲状腺素治疗,44人患有桥本甲状腺炎,40人患有结节性甲状腺肿,20人患有甲状腺功能亢进和/或格雷夫斯病。平均±SD的25(OH)D水平为26.9±8.2ng/ml,12%的研究参与者存在维生素D缺乏(<20ng/ml),50.4%的参与者存在维生素D不足(20≤25(OH)D<30ng/ml)。宣称补充维生素D的受试者中骨化二醇水平显著更高,平均±SD:29.4±7.5与25.2±8ng/ml。在未补充维生素D的参与者中,阳光照射与25(OH)D相关。在所有受试者中均检测到25(OH)D₃的C3差向异构体;其浓度与25(OH)D₃的浓度密切相关。24,25(OH)₂D₃水平也与25(OH)D₃水平密切相关。
据我们所知,本研究是波兰首次分析甲状腺疾病患者夏季维生素D状态以及血清3-表-25(OH)D₃和24,25(OH)₂D₃浓度的研究。此处呈现的数据表明,即使在夏季,甲状腺疾病患者也未达到维生素D充足状态。