National Cancer Research Center of Serbia, Belgrade, Serbia.
Hell J Nucl Med. 2023 Sep-Dec;26(3):194-200. doi: 10.1967/s002449912604. Epub 2023 Dec 14.
Vitamin D (VitD) plays various roles, promotes musculoskeletal health, maintains parathyroid hormone levels and supports the immune processes. Vitamin D deficiency is common among cancer patients including thyroid cancer. Since some data indicate that preoperative VitD levels in cancer patients correlate with the further prognosis of the disease. Therefore, it is worthwhile to investigate this in the most common cancer of the thyroid gland, papillary thyroid cancer (PTC). The aim of this study was to evaluate serum VitD levels in patients with PTC concerning age, gender, body mass index (BMI), cancer stage, thyroid hormone levels, thyroglobulin concentration and the efficiency of VitD3 supplementation in these patients.
Our cross-sectional study included 105 patients, and 34 healthy subjects in the control group. After 12 weeks of VitD3 supplementation (insufficient patients received1000IJ/day, deficient patients 2000IJ/day, severe deficient patient 5000IJ/day) along with the lifestyle and dietary management, the response was evaluated according to the personal characteristics, levels of VitD, free thyroxine (FT4), freetriiodothyronine (FT3) hormones and thyroglobulin (TG).
The responders whose median age was 61-year-old, were mostly women (94%), with BMI below 23.7kg/m, which indicates that most of the patients were normally nourished. 70% of patients were in the first stage of PTC, 76% had a vitamin D deficiency, while musculoskeletal disorders were present in 30% patients. VitD supplementation improved serum VitD status, FT3 discretely elevated and the TG levels significantly decreased in our PTC patients.
It should be noted that VitD deficiency is presented in 70% of patients with PTC in our study sample. Dietary recommendation applied as lifestyle changes along with oral VitD3 supplementation, corrected VitD status to the recommended serum level. Although the data from our study is not sufficient to evaluate the VitD level as a prognostic factor for cancer, we have shown that it is necessary to examine its level along with an individual dietary approach for each patient with PTC.
维生素 D（VitD）具有多种作用，可促进骨骼肌肉健康、维持甲状旁腺激素水平并支持免疫过程。维生素 D 缺乏在癌症患者中很常见，包括甲状腺癌患者。由于一些数据表明，癌症患者术前的 VitD 水平与疾病的进一步预后相关。因此，研究最常见的甲状腺癌——甲状腺乳头状癌（PTC）中的这一问题是值得的。本研究旨在评估 PTC 患者的血清 VitD 水平与年龄、性别、体重指数（BMI）、癌症分期、甲状腺激素水平、甲状腺球蛋白浓度以及这些患者补充 VitD3 的效果之间的关系。
本横断面研究纳入了 105 名患者和 34 名对照组的健康受试者。在接受 12 周的 VitD3 补充（摄入不足的患者每天 1000IU，摄入不足的患者每天 2000IU，严重摄入不足的患者每天 5000IU）以及生活方式和饮食管理后，根据个人特征、VitD 水平、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）激素和甲状腺球蛋白（TG）的水平来评估反应。
应答者的中位年龄为 61 岁，大多数为女性（94%），BMI 低于 23.7kg/m2，这表明大多数患者的营养状况正常。70%的患者处于 PTC 的第一阶段，76%的患者存在 VitD 缺乏，30%的患者存在骨骼肌肉疾病。VitD 补充改善了血清 VitD 状况，FT3 略有升高，PTC 患者的 TG 水平显著降低。
值得注意的是，在我们的研究样本中，70%的 PTC 患者存在 VitD 缺乏。应用饮食建议作为生活方式改变，并口服 VitD3 补充，可将 VitD 状态纠正至推荐的血清水平。尽管我们的研究数据不足以评估 VitD 水平作为癌症的预后因素，但我们已经表明，对于每个 PTC 患者，有必要检查其水平并制定个性化的饮食方案。
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