Departmetn of Medicine, Ivane Javakhishvili Tbilisi State University. Tbilisi, Georgia.
School of Medicine and Dentistry, David Agmashenebeli University of Georgia, Tbilisi, Georgia.
Endocr Metab Immune Disord Drug Targets. 2023;23(1):86-94. doi: 10.2174/1871530322666220627145635.
Autoimmune thyroid diseases (AITD) are the most prevalent organ-specific autoimmune disorders. Vitamin B12 plays an important role in the proper functioning of the immune system. The aim of this study was therefore to investigate the correlation between vitamin B12 deficiency and AITD.
A total of 306 patients (aged 18-65 years, mean - 37.6 ± 11.3 years and comprising 87 males and 219 females) were studied retrospectively (observational study). Patients were divided into groups: with and without vitamin B12 deficiency, and with and without AITD. Differences between groups were evaluated by Fisher's exact test for qualitative variables and by Student's t-test for quantitative variables. Correlations for quantitative factors were determined by the Pearson correlation coefficient and for qualitative factors by Spearman correlation analysis. The sensitivity and specificity of vitamin B12 deficiency for AITD were calculated by ROC analysis.
The vitamin B12 level was significantly lower in patients with AITD (and 200.70 + 108.84) compared to controls (393.41+150.78 p<0.0001). Patients with vitamin B12 deficiency were characterized by significantly higher mean values of anti-TPO (236.60+455.74) compared to controls (39.51+165.57 p<0.0001). Vitamin B12 levels were inversely correlated to anti-TPO levels (r=- 0.233, p<0.001). Roc analysis of vitamin B12 as a diagnostic test for AITD gave the area under curve as 0.881 (95% CI: 0.839-0.924), a sensitivity of - 0.947, a specificity of - 0.768, and a cutoff value of - 178.9.
The vitamin B12 level correlates significantly to AITD. The concentration of vitamin B12 should therefore be determined in patients with autoimmune thyroiditis as a diagnostic test with high sensitivity and good specificity.
自身免疫性甲状腺疾病（AITD）是最常见的器官特异性自身免疫性疾病。维生素 B12 在免疫系统的正常功能中发挥着重要作用。因此，本研究旨在探讨维生素 B12 缺乏与 AITD 之间的相关性。
共回顾性研究了 306 名（年龄 18-65 岁，平均 37.6±11.3 岁，包括 87 名男性和 219 名女性）患者（观察性研究）。患者分为维生素 B12 缺乏组和不缺乏组，以及有 AITD 组和无 AITD 组。采用 Fisher 确切概率法比较组间的差异，采用 Student's t 检验比较计量资料的差异。采用 Pearson 相关系数分析计量资料的相关性，采用 Spearman 相关分析分析计数资料的相关性。采用 ROC 分析计算维生素 B12 缺乏对 AITD 的灵敏度和特异度。
AITD 患者的维生素 B12 水平明显低于对照组（分别为 200.70+108.84 和 393.41+150.78，p<0.0001）。维生素 B12 缺乏的患者的抗甲状腺过氧化物酶抗体（anti-TPO）均值明显高于对照组（分别为 236.60+455.74 和 39.51+165.57，p<0.0001）。维生素 B12 水平与 anti-TPO 水平呈负相关（r=-0.233，p<0.001）。ROC 分析维生素 B12 作为 AITD 的诊断试验，曲线下面积为 0.881（95%CI：0.839-0.924），灵敏度为-0.947，特异度为-0.768，截断值为-178.9。
维生素 B12 水平与 AITD 显著相关。因此，在自身免疫性甲状腺炎患者中，应将维生素 B12 浓度作为一种具有高灵敏度和良好特异性的诊断试验进行检测。
