1. Department of Endocrinology and Metabolism, the Affiliated Hospital of Kunming University of Science and Technology (the First People’s Hospital of Yunnan Province), Kunming 650000, China
2. Information Center, the Affiliated Hospital of Kunming University of Science and Technology (the First People’s Hospital of Yunnan Province), Kunming 650000, China
3. Department of Biostatistics, School of Public Health (Guangdong Key Laboratory of Tropical Diseases Research), Southern Medical University, Guangzhou 510000, China
| Abstract: | To investigate the differences in vitamin D levels in patients with different types of thyroid disease and to investigate the factors influencing vitamin D levels in patients with thyroid disease, this study collected clinical data from 1603 patients with thyroid disease attending the Department of Endocrinology and Metabolism of the First People's Hospital of Yunnan Province and conducted a retrospective cross-sectional study. The clinical data of 1603 patients with thyroid diseases including Graves' disease (GD), subacute thyroiditis (SAT), autoimmune thyroid disease (AITD) and hypothyroidism (HP) were collected from the Department of Endocrinology and Metabolism of yunnan First People's Hospital. Gender, age, BMI, blood lipids, thyroid hormones, thyroid autoantibodies, and serum 25-hydroxyvitamin D(25(OH)D) levels were measured. Results: (1) The level of 25(OH)D in patients with different thyroid diseases was from high to low, in the following order: GD group (29.54±7.54 ng/ml), SAT group (28.01±7.14 ng/ml), AITD group (26.97±6.58 ng/ml), HP group (25.88±6.75 ng/ml), the differences were statistically significant (P<0.05). The 25(OH)D level in GD group was significantly higher than that in other groups (P<0.05), while the 25(OH)D level in HP group was significantly lower than that in SAT group (P<0.05). (2) The changing trend of thyroid hormone levels (T3, FT3 and FT4) was consistent with that of 25(OH)D (P <0.005). (3) 25(OH)D was established as the dependent variable with multiple linear regression equation, Y = 3.80 gender + 0.058FT3-0.036 age + 28.122(female as control group). Conclusions: There were significant differences in vitamin D levels among patients with thyroid diseases, with the highest vitamin D level in GD patients and the lowest vitamin D level in HP patients. The higher the thyroid hormone level, the higher the 25(OH)D, which may be related to the strength of the immune response or the effect of thyroid hormone on vitamin D synthase. Male and high levels of FT3 were associated with increased 25(OH)D levels in thyroid patients. |
| Keywords: | Thyroid Diseas; Graves' Disease (GD); Subacute Thyroiditis (SAT); Autoimmune Thyroid Diseases (AITD); Hypothyroidism (HP); 25(OH)D |
| DOI: | 10.57237/j.cmf.2023.01.002 |
| [1] | MUSCOGIURI G, TIRABASSI G, BIZZARO G, et al. Vitamin D and thyroid disease: to D or not to D? [J]. Eur J Clin Nutr, 2015, 69 (3): 291-296. |
| [2] | LAMBERG-ALLARDT C, VALTONEN E, POLOJäRVI M, et al. Characterization of a 1,25-dihydroxy-vitamin D receptor in FRTL-5 cells. Evidence for an inhibitory effect of 1,25-dihydroxy-vitamin D on thyrotropin-induced iodide uptake [J]. Mol Cell Endocrinol, 1991, 81 (1-3): 25-31. |
| [3] | MACKAWY A M, AL-AYED B M, AL-RASHIDI B M. Vitamin d deficiency and its association with thyroid disease [J]. Int J Health Sci (Qassim), 2013, 7 (3): 267-275. |
| [4] | XU M Y, CAO B, YIN J, et al. Vitamin D and Graves' disease: a meta-analysis update [J]. Nutrients, 2015, 7 (5): 3813-3827. |
| [5] | LAWNICKA H, GALANT-GDULA A, MOTYLEWSKA E, et al. Estimation of vitamin D status in patients with secondary and primary hypothyroidism of different etiology [J]. Neuro Endocrinol Lett, 2018, 38 (8): 565-564. |
| [6] | CHEN W, ZHANG X, WANG H, et al. The epidemic investigation of serum 25-hydroxy vitamin D levels in the adults in Qujing area of Yunnan province in China [J]. Int J Clin Exp Pathol, 2015, 8 (8): 9597-9601. |
| [7] | YAMASHITA H, NOGUCHI S, TAKATSU K, et al. High prevalence of vitamin D deficiency in Japanese female patients with Graves' disease [J]. Endocr J, 2001, 48 (1): 63-69. |
| [8] | MA J, WU D, LI C, et al. Lower Serum 25-Hydroxyvitamin D Level is Associated With 3 Types of Autoimmune Thyroid Diseases [J]. Medicine (Baltimore), 2015, 94 (39): e1639. |
| [9] | MUSCOGIURI G, PALOMBA S, CAGGIANO M, et al. Low 25 (OH) vitamin D levels are associated with autoimmune thyroid disease in polycystic ovary syndrome [J]. Endocrine, 2016, 53 (2): 538-542. |
| [10] | WANG J, LV S, CHEN G, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease [J]. Nutrients, 2015, 7 (4): 2485-2498. |
| [11] | BAEKE F, TAKIISHI T, KORF H, et al. Vitamin D: modulator of the immune system [J]. Curr Opin Pharmacol, 2010, 10 (4): 482-496. |
| [12] | ADAMS J S, HEWISON M. Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity [J]. Nat Clin Pract Endocrinol Metab, 2008, 4 (2): 80-90. |
| [13] | FLETCHER J, BISHOP E L, HARRISON S R, et al. Autoimmune disease and interconnections with vitamin D [J]. Endocr Connect, 2022, 11 (3): e210554. |
| [14] | MAZZIOTTI G, SORVILLO F, NACLERIO C, et al. Type-1 response in peripheral CD4+ and CD8+ T cells from patients with Hashimoto's thyroiditis [J]. Eur J Endocrinol, 2003, 148 (4): 383-388. |
| [15] | GOPALAKRISHNAN S, SEN S, ADHIKARI J S, et al. The role of T-lymphocyte subsets and interleukin-5 blood levels among Indian subjects with autoimmune thyroid disease [J]. Hormones (Athens), 2010, 9 (1): 76-81. |
| [16] | BLIDDAL H, BECH K, FELDT-RASMUSSEN U, et al. Humoral autoimmune manifestation in subacute thyroiditis [J]. Allergy, 1985, 40 (8): 599-604. |
| [17] | YASUDA T, OKAMOTO Y, HAMADA N, et al. Serum vitamin D levels are decreased and associated with thyroid volume in female patients with newly onset Graves' disease [J]. Endocrine, 2012, 42 (3): 739-741. |
| [18] | YASUDA T, OKAMOTO Y, HAMADA N, et al. Serum vitamin D levels are decreased in patients without remission of Graves' disease [J]. Endocrine, 2013, 43 (1): 230-232. |
| [19] | MEI X, ZENG J, DAI W X, et al. Prevalence of hyperthyroidism with hypercalcemia in Xindu district and the efficacy of vitamin D treatment in these patients: a randomized trial [J]. Ann Palliat Med, 2021, 10 (9): 9640-9649. |
| [20] | KE W, SUN T, ZHANG Y, et al. 25-Hydroxyvitamin D serum level in Hashimoto's thyroiditis, but not Graves' disease is relatively deficient [J]. Endocr J, 2017, 64 (6): 581-587. |
| [21] | CHAKERA A J, PEARCE S H, VAIDYA B. Treatment for primary hypothyroidism: current approaches and future possibilities [J]. Drug Des Devel Ther, 2012, 6 (1-11. |
| [22] | GIRGIS C M, CHAMPION B L, WALL J R. Current concepts in graves' disease [J]. Ther Adv Endocrinol Metab, 2011, 2 (3): 135-144. |
| [23] | BISCOVEANU M, HASINSKI S. Abnormal results of liver function tests in patients with Graves' disease [J]. Endocr Pract, 2000, 6 (5): 367-369. |
| [24] | YOO W S, CHUNG H K. Recent Advances in Autoimmune Thyroid Diseases [J]. Endocrinol Metab (Seoul), 2016, 31 (3): 379-385. |
| [25] | ZHANG Q, WANG Z, SUN M, et al. Association of high vitamin d status with low circulating thyroid-stimulating hormone independent of thyroid hormone levels in middle-aged and elderly males [J]. Int J Endocrinol, 2014, 2014: 631819. |
| [26] | BOTELHO I M B, MOURA NETO A, SILVA C A, et al. Vitamin D in Hashimoto's thyroiditis and its relationship with thyroid function and inflammatory status [J]. Endocr J, 2018, 65 (10): 1029-1037. |
We invite active, qualified and high profile scientists and researchers to join as Editorial Board Members.
Join UsScholars with a strong interest in reviewing are invited to join the reviewer panel to ensure the quality of the research to be published.
Join Us