Kim Choon-Young, Lee Yeon Ji, Choi Ji-Ho, Lee Soo Yeon, Lee Hye Young, Jeong Da Hye, Choi Yeon Jun
Department of Family Medicine, Inha University School of Medicine, Incheon, Korea.
Korean J Fam Med. 2019 Sep;40(5):323-328. doi: 10.4082/kjfm.18.0075. Epub 2019 Sep 3.
This study aimed to analyze the association of low vitamin D status with thyroid autoimmunity and dysfunction in the Korean population according to sex and menopausal status in women.
This study was based on the data acquired from the 6th Korea National Health and Nutrition Examination Survey. We enrolled 4,356 subjects who had data of thyroid function, antithyroid peroxidase antibody (TPOAb), and serum 25-hydroxyvitamin D (25[OH]D) levels. We excluded subjects who were pregnant and who had a history of thyroid disease or thyroid cancer, and those with transient thyroid dysfunction who tested negative for TPOAb (TPOAb[-]).
TPOAb positivity (TPOAb[+]) with thyroid dysfunction (subclinical and overt hypothyroidism) was more prevalent in the vitamin D deficient group than in the vitamin D insufficient and sufficient groups including premenopausal (P=0.046) and postmenopausal women (P=0.032), although no significant differences were observed in men. The mean serum 25(OH)D level was significantly lower in the TPOAb(+) with thyroid dysfunction group than in the TPOAb(+) with euthyroidism and TPOAb(-) groups of premenopausal women (P=0.001), although no significant differences were observed in men and postmenopausal women. Multivariate binary logistic regression analysis, adjusted for age, body mass index, and current smoking status, showed that vitamin D insufficiency and deficiency were significantly associated with TPOAb(+) with thyroid dysfunction in premenopausal women (P<0.001), although no significant associations were observed in men and postmenopausal women.
Low vitamin D status was significantly associated with thyroid autoimmunity and dysfunction in the Korean population, especially in premenopausal women.
本研究旨在根据韩国人群的性别及女性的绝经状态，分析维生素D水平低下与甲状腺自身免疫及功能障碍之间的关联。
本研究基于从第六次韩国国家健康与营养检查调查中获取的数据。我们纳入了4356名具有甲状腺功能、抗甲状腺过氧化物酶抗体（TPOAb）及血清25-羟基维生素D（25[OH]D）水平数据的受试者。我们排除了怀孕、有甲状腺疾病或甲状腺癌病史的受试者，以及TPOAb检测为阴性（TPOAb[-]）的短暂性甲状腺功能障碍患者。
维生素D缺乏组中，伴有甲状腺功能障碍（亚临床和显性甲状腺功能减退）的TPOAb阳性（TPOAb[+]）在绝经前（P=0.046）和绝经后女性（P=0.032）中比维生素D不足和充足组更为普遍，尽管在男性中未观察到显著差异。绝经前女性中，伴有甲状腺功能障碍的TPOAb(+)组的平均血清25(OH)D水平显著低于伴有甲状腺功能正常的TPOAb(+)组和TPOAb(-)组（P=0.001），尽管在男性和绝经后女性中未观察到显著差异。在对年龄、体重指数和当前吸烟状态进行校正的多因素二元逻辑回归分析中，结果显示维生素D不足和缺乏与绝经前女性中伴有甲状腺功能障碍的TPOAb(+)显著相关（P<0.001），尽管在男性和绝经后女性中未观察到显著关联。
在韩国人群中，尤其是绝经前女性，维生素D水平低下与甲状腺自身免疫及功能障碍显著相关。
