Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China.
Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
Endocrine. 2021 Aug;73(2):447-454. doi: 10.1007/s12020-021-02688-z. Epub 2021 Mar 23.
The pathogenesis of Hashimoto's thyroiditis (HT) is unclear, although some studies have identified an association between vitamin D deficiency and thyroid autoantibody positivity. This study aimed to investigate vitamin D status, and its relationships with thyroid autoantibody positivity and HT, via a large epidemiological survey.
The epidemiological survey was conducted in Tianjin, China. All participants underwent testing for serum 25-hydroxyvitamin D (25OHD), thyroid function, and thyroid autoantibodies, and some participants underwent testing to evaluate CD4 T-cell differentiation and concentrations of related cytokines.
The study included 1812 participants and revealed prevalences of 13.1% for thyroid peroxidase antibodies (i-TPOAb) and 14.0% for thyroglobulin antibodies (i-TgAb). Logistic regression analysis revealed that thyroid autoantibody positivity was associated with sex, age, and 25OHD classification. An increased likelihood of i-TPOAb positivity was associated with 25OHD deficiency (odds ratio [OR]: 2.428, 95% confidence interval [CI]: 1.383-4.261) and 25OHD inadequacy (OR: 1.198, 95% CO: 0.828-1.733; p = 0.008). An increased likelihood of i-TgAb positivity was associated with 25OHD deficiency (OR: 2.366, 95% CI: 1.366-4.099) and 25OHD inadequacy (OR: 1.263, 95% CI: 0.883-1.807; p = 0.009). Relative to healthy subjects, patients with HT had significantly higher proportions of Th1 and Th17 cells, as well as higher concentrations of related cytokines.
This study revealed that vitamin D deficiency was associated with thyroid autoantibody positivity, and that vitamin D deficiency seems to be involved in the pathological mechanism underlying HT. Large randomized controlled trials are needed to investigate the effects of vitamin D supplementation on HT.
桥本甲状腺炎（HT）的发病机制尚不清楚，尽管一些研究已经发现维生素 D 缺乏与甲状腺自身抗体阳性之间存在关联。本研究旨在通过一项大型流行病学调查，研究维生素 D 状态及其与甲状腺自身抗体阳性和 HT 的关系。
该流行病学调查在中国天津进行。所有参与者均接受血清 25-羟维生素 D（25OHD）、甲状腺功能和甲状腺自身抗体检测，部分参与者还接受了检测以评估 CD4 T 细胞分化和相关细胞因子浓度。
该研究纳入了 1812 名参与者，甲状腺过氧化物酶抗体（i-TPOAb）和甲状腺球蛋白抗体（i-TgAb）的阳性率分别为 13.1%和 14.0%。Logistic 回归分析显示，甲状腺自身抗体阳性与性别、年龄和 25OHD 分类有关。i-TPOAb 阳性的可能性与 25OHD 缺乏（比值比[OR]：2.428，95%置信区间[CI]：1.383-4.261）和 25OHD 不足（OR：1.198，95%CI：0.828-1.733；p=0.008）有关。i-TgAb 阳性的可能性与 25OHD 缺乏（OR：2.366，95%CI：1.366-4.099）和 25OHD 不足（OR：1.263，95%CI：0.883-1.807；p=0.009）有关。与健康受试者相比，HT 患者 Th1 和 Th17 细胞比例明显升高，相关细胞因子浓度也升高。
本研究表明，维生素 D 缺乏与甲状腺自身抗体阳性有关，维生素 D 缺乏似乎参与了 HT 的病理机制。需要进行大规模随机对照试验来研究维生素 D 补充对 HT 的影响。
