Gierach Marcin, Junik Roman
Department of Endocrinology and Diabetology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
Cardiometabolic Centre Gierach-Med., Bydgoszcz, Poland.
Endokrynol Pol. 2023;74(2):176-180. doi: 10.5603/EP.a2022.0095. Epub 2023 Mar 14.
Autoimmune thyroid diseases (AITD), including Hashimoto's thyroiditis (HT), are the most common organ specific autoimmune disorders. Vitamin D (vit-D) is a steroid molecule, mainly produced in the skin, which regulates the expression of many genes. The vitamin D receptor (VDR) is found in most tissues and cells in the body. Many studies suggests that vit-D deficiency, which is common worldwide, could also play an important role in autoimmune diseases, including HT. The aim of our study was to show the potential differences in vit-D levels between healthy women and individuals with hypothyroidism and HT. Additionally, we assessed the correlation between vit-D concentration and the level of TSH and anti-thyroid antibodies in females diagnosed with HT.
The study group included 370 subjects. The group was divided into 3 subgroups: (125 - healthy individuals, 111 - hypothyreosis, 134 - HT). Anthropometric measurements including height and weight were obtained in all participants. Body mass index (BMI) was calculated as body weight (in kilograms) divided by the square of body height (in metres). The measurement of the thyroid gland was performed using an ultrasound scan with a 10-MHz linear probe by one endocrinologist (Vivid S60N).
We noticed that a lower level of vit-D was connected with a higher level of TSH in each subgroup. There was also strong, negative correlation between TSH and vit-D levels in all the study groups. Moreover, there was a weak, negative correlation between antithyroid peroxidase antibody (anti-TPO) and antithyroglobulin antibody (anti-TG) and vit-D levels in females with HT regardless of vit-D status: < 20 ng/mL, 20-30 ng/mL, and > 30 ng/mL.
To our knowledge, the current study is the first in Poland to compare vit-D status in healthy patients and patients with hypothyroidism, taking into account the level of antibodies (anti-TPO and anti-TG). The results of our study suggest that vit-D supplementation in patients with hypothyroidism, especially in the course of AITD, although determining its optimal, safe dose requires further research.
自身免疫性甲状腺疾病（AITD），包括桥本甲状腺炎（HT），是最常见的器官特异性自身免疫性疾病。维生素D（vit-D）是一种类固醇分子，主要在皮肤中产生，可调节许多基因的表达。维生素D受体（VDR）存在于人体的大多数组织和细胞中。许多研究表明，全球普遍存在的vit-D缺乏在包括HT在内的自身免疫性疾病中也可能起重要作用。我们研究的目的是揭示健康女性与甲状腺功能减退症患者及HT患者之间vit-D水平的潜在差异。此外，我们评估了被诊断为HT的女性中vit-D浓度与促甲状腺激素（TSH）水平及抗甲状腺抗体之间的相关性。
研究组包括370名受试者。该组被分为3个亚组：（125名健康个体，111名甲状腺功能减退症患者，134名HT患者）。所有参与者均进行了身高和体重等人体测量。体重指数（BMI）计算为体重（千克）除以身高（米）的平方。由一名内分泌科医生（Vivid S60N）使用10MHz线性探头通过超声扫描测量甲状腺。
我们注意到每个亚组中vit-D水平较低与TSH水平较高相关。在所有研究组中，TSH与vit-D水平之间也存在强烈的负相关。此外，无论vit-D状态如何（<20 ng/mL、20 - 30 ng/mL和>30 ng/mL），HT女性中抗甲状腺过氧化物酶抗体（抗-TPO）和抗甲状腺球蛋白抗体（抗-TG）与vit-D水平之间均存在弱的负相关。
据我们所知，本研究是波兰首个考虑抗体（抗-TPO和抗-TG）水平比较健康患者与甲状腺功能减退症患者vit-D状态的研究。我们的研究结果表明，甲状腺功能减退症患者，尤其是在AITD病程中，补充vit-D是必要的，尽管确定其最佳、安全剂量还需要进一步研究。
