Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Pharmacol Rep. 2019 Oct;71(5):798-803. doi: 10.1016/j.pharep.2019.04.010. Epub 2019 Apr 15.
Autoimmune (Hashimoto's thyroiditis) is characterized by a strong female preponderance, which may suggest that sex hormones have an impact on thyroid autoimmunity. The aim of this study was to investigate whether testosterone determines vitamin D action on thyroid antibody titers and thyroid function tests in men with autoimmune thyroiditis and low testosterone levels.
The study included 36 men with testosterone deficiency, 17 of whom had been treated for at least 26 weeks with oral testosterone undecanoate (120 mg daily). Because of coexistent euthyroid Hashimoto's thyroiditis, all participants were then treated with vitamin D (100 μg daily). Serum titers of thyroid peroxidase and thyroglobulin antibodies, serum levels of thyrotropin, free thyroid hormones, testosterone and 25-hydroxyvitamin D, as well as Jostel's thyrotropin index, SPINA-GT and SPINA-GD were assessed before vitamin D treatment and 26 weeks later.
With the exception of testosterone levels, there were no significant differences between both study groups in serum hormone levels, antibody titers and thyroid function tests. All participants completed the study. In addition to increasing 25-hydroxyvitamin D levels, vitamin D increased SPINA-GT and reduced thyroid peroxidase and thyroglobulin antibody titers. In testosterone-treated men, vitamin D increased testosterone levels. Vitamin D did not affect serum levels of thyrotropin, free thyroid hormones, Jostel's thyrotropin index and SPINA-GD. Treatment-induced changes in thyroid antibody titers and SPINA-GT were more pronounced in testosterone-treated than testosterone-naïve men.
The obtained results suggest that the beneficial effect on thyroid autoimmunity and thyroid secretory function is stronger in men receiving testosterone therapy.
自身免疫性疾病(桥本甲状腺炎)的特征是强烈的女性优势,这可能表明性激素对甲状腺自身免疫有影响。本研究的目的是研究男性自身免疫性甲状腺炎和低睾酮水平患者的睾酮是否决定维生素 D 对甲状腺抗体滴度和甲状腺功能试验的作用。
该研究纳入了 36 名睾酮缺乏症男性,其中 17 名男性接受了至少 26 周的口服十一酸睾酮(每日 120mg)治疗。由于同时存在甲状腺功能正常的桥本甲状腺炎,所有参与者随后接受了维生素 D(每日 100μg)治疗。治疗前和 26 周后评估了甲状腺过氧化物酶和甲状腺球蛋白抗体的血清滴度、促甲状腺激素水平、游离甲状腺激素、睾酮和 25-羟维生素 D,以及 Jostel 的促甲状腺激素指数、SPINA-GT 和 SPINA-GD。
除了睾酮水平外,两组患者的血清激素水平、抗体滴度和甲状腺功能试验均无显著差异。所有参与者均完成了研究。除了增加 25-羟维生素 D 水平外,维生素 D 还增加了 SPINA-GT 并降低了甲状腺过氧化物酶和甲状腺球蛋白抗体滴度。在接受睾酮治疗的男性中,维生素 D 增加了睾酮水平。维生素 D 对促甲状腺激素、游离甲状腺激素、Jostel 的促甲状腺激素指数和 SPINA-GD 无影响。与未接受睾酮治疗的男性相比,在接受睾酮治疗的男性中,甲状腺抗体滴度和 SPINA-GT 的治疗诱导变化更为明显。
研究结果表明,在接受睾酮治疗的男性中,对甲状腺自身免疫和甲状腺分泌功能的有益影响更强。