Copari-Vargas Eligio, Copari-Vargas Tania Libertad, Domínguez-Valdez Luis Fernando, Copari-Vargas Luisa Elena, Copari-Jimenez Eligio
Endocrinology, Diabetes, and Metabolism, Hospital General de México "Dr. Eduardo Liceaga", Mexico, MEX.
Internal Medicine, Hospital de Clínicas, La Paz, BOL.
Cureus. 2025 May 3;17(5):e83419. doi: 10.7759/cureus.83419. eCollection 2025 May.
Introduction Hashimoto's thyroiditis (HT), the most common autoimmune thyroid disorder, involves chronic lymphocytic infiltration and thyroid dysfunction. Vitamin D deficiency has been linked to autoimmune thyroid diseases, suggesting an immunomodulatory role. This study examines the association between serum vitamin D levels and HT severity in patients at a secondary-level hospital in Mexico. Methods A retrospective observational study was conducted on adult patients diagnosed with HT from January 2022 to January 2024. Clinical and laboratory data, including serum 25-hydroxyvitamin D (25(OH)D), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and anti-thyroid peroxidase (anti-TPO) antibodies, were collected. Patients were classified by thyroid function and vitamin D status. Statistical analyses were performed to evaluate correlations and group associations to determine the relationship between vitamin D deficiency and HT severity. Results A total of 114 patients were included in the study: 1.8% (n=2) were classified as euthyroid, 18.4% (n=21) as having subclinical hypothyroidism, and 79.8% (n=91) as having overt hypothyroidism. Vitamin D deficiency, defined as serum 25(OH)D levels below 20 ng/mL, was highly prevalent, affecting 49.5% (n=45) of patients with overt hypothyroidism and 42.9% (n=9) of those with subclinical hypothyroidism. A significant inverse correlation was observed between 25(OH)D levels and anti-TPO antibody titers (p=0.01), suggesting an association between lower vitamin D concentrations and increased autoimmune activity. Additionally, vitamin D-deficient patients exhibited significantly higher TSH levels compared to those with sufficient vitamin D (p=0.01). No significant differences were found in FT4 levels across the different vitamin D categories. Conclusions This study suggests an inverse correlation between vitamin D deficiency and the severity of HT, supporting the potential immunomodulatory role of vitamin D. However, due to the observational nature of the study, causal relationships cannot be inferred. Given the high prevalence of vitamin D deficiency among patients with HT, further research is warranted to explore the therapeutic implications of vitamin D supplementation on disease progression and management.
引言 桥本甲状腺炎（HT）是最常见的自身免疫性甲状腺疾病，涉及慢性淋巴细胞浸润和甲状腺功能障碍。维生素D缺乏与自身免疫性甲状腺疾病有关，提示其具有免疫调节作用。本研究在墨西哥一家二级医院中，探讨血清维生素D水平与HT严重程度之间的关联。
方法 对2022年1月至2024年1月期间诊断为HT的成年患者进行回顾性观察研究。收集临床和实验室数据，包括血清25-羟维生素D（25(OH)D）、促甲状腺激素（TSH）、游离甲状腺素（FT4）和抗甲状腺过氧化物酶（抗-TPO）抗体。根据甲状腺功能和维生素D状态对患者进行分类。进行统计分析以评估相关性和组间关联，以确定维生素D缺乏与HT严重程度之间的关系。
结果 本研究共纳入114例患者：1.8%（n=2）被分类为甲状腺功能正常，18.4%（n=21）为亚临床甲状腺功能减退，79.8%（n=91）为显性甲状腺功能减退。血清25(OH)D水平低于20 ng/mL定义为维生素D缺乏，其发生率很高，影响了49.5%（n=45）的显性甲状腺功能减退患者和42.9%（n=9）的亚临床甲状腺功能减退患者。观察到25(OH)D水平与抗-TPO抗体滴度之间存在显著负相关（p=0.01），表明维生素D浓度较低与自身免疫活性增加之间存在关联。此外，与维生素D充足的患者相比，维生素D缺乏的患者TSH水平显著更高（p=0.01）。不同维生素D类别之间的FT4水平未发现显著差异。
结论 本研究提示维生素D缺乏与HT严重程度之间存在负相关，支持维生素D的潜在免疫调节作用。然而，由于本研究的观察性质，无法推断因果关系。鉴于HT患者中维生素D缺乏的高发生率，有必要进一步研究探索补充维生素D对疾病进展和管理的治疗意义。
