Kawakami-Tani T, Fukawa E, Tanaka H, Abe Y, Makino I
Second Department of Internal Medicine, Asahikawa Medical College, Japan.
Metabolism. 1997 Oct;46(10):1184-8. doi: 10.1016/s0026-0495(97)90214-6.
We performed a randomized, open prospective study to determine the effect of 1 alpha-hydroxyvitamin D3 [1 alpha (OH)D3] on hyperthyroidism in patients with untreated Graves' disease. At the time of entry into the study, 30 patients were randomly assigned to receive a daily dose of 30 mg methimazole (MMI) (group A, n = 15) or the same dose of MMI supplemented with 1.5 micrograms 1 alpha (OH)D3 (group B, n = 15). These treatment regimens were continued for 24 weeks, and physicians were allowed to adjust MMI dosage during follow-up visits. Blood samples were collected, and serum concentrations of free triiodothyronine (FT3), free thyroxine (FT4), T3, T4, thyrotropin (TSH), alkaline phosphatase (ALP), and TSH-receptor antibody (TRAb) were determined. During the follow-up periods, all patients became euthyroid. The dose of MMI was not significantly different between these two groups. In contrast, decreases in mean serum FT3 and FT4 levels, as well as in mean serum T3 and T4 levels, were greater in group B. Correspondingly, the reciprocal increase in the mean TSH level was more prominent in group B. Mean TRAb levels did not differ between the two groups. Mean serum ALP levels in group B were significantly lower than in group A at 24 weeks. Thus, we suggest that concomitant administration of 1 alpha (OH)D3 is useful for treating hyperthyroidism in patients with Graves' disease.
我们进行了一项随机、开放的前瞻性研究，以确定1α-羟维生素D3 [1α(OH)D3]对未经治疗的格雷夫斯病患者甲状腺功能亢进的影响。在进入研究时，30例患者被随机分配接受每日30mg甲巯咪唑（MMI）（A组，n = 15）或相同剂量的MMI并补充1.5μg 1α(OH)D3（B组，n = 15）。这些治疗方案持续24周，并且在随访期间允许医生调整MMI剂量。采集血样，测定血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、T3、T4、促甲状腺激素（TSH）、碱性磷酸酶（ALP）和促甲状腺激素受体抗体（TRAb）的浓度。在随访期间，所有患者均变为甲状腺功能正常。两组之间MMI的剂量没有显著差异。相比之下，B组血清FT3和FT4平均水平以及血清T3和T4平均水平的下降幅度更大。相应地，B组平均TSH水平的相应升高更为显著。两组之间TRAb平均水平没有差异。在24周时，B组血清ALP平均水平显著低于A组。因此，我们认为联合使用1α(OH)D3对治疗格雷夫斯病患者的甲状腺功能亢进是有用的。
