不同类型甲状腺疾病患者的维生素D水平差异研究
1. 昆明理工大学附属医院 (云南省第一人民医院), 内分泌代谢科, 云南昆明 650000
2. 昆明理工大学附属医院 (云南省第一人民医院), 信息中心, 云南昆明 650000
3. 南方医科大学, 公共卫生学院生物统计学系 (广东省热带病研究重点实验室), 广东广州 510000
| 摘 要： | 为了调查不同类型甲状腺疾病患者的维生素D水平差异和探讨甲状腺疾病患者的维生素D水平的影响因素，本研究收集云南省第一人民医院内分泌代谢科就诊的1603例甲状腺疾病患者的临床数据，进行了回顾性的横断面研究。甲状腺疾病包括Graves病（GD）、亚急性甲状腺炎（SAT）、自身免疫性甲状腺疾病（AITD）和甲状腺功能减退（HP）。检测项目包括性别、年龄、BMI、血脂、甲状腺激素、甲状腺自身抗体和血清25羟维生素D（25(OH)D）水平。结果：(1)不同甲状腺疾病患者的25(OH)D水平由高到低，依次为：GD组（29.54±7.54 ng/ml）、SAT组（28.01±7.14 ng/ml）、AITD组（26.97±6.58 ng/ml）、HP组（25.88±6.75 ng/ml），差异有统计学意义（p<0.05）。其中，GD组25(OH)D水平显著高于其他组别（p<0.05），HP组25(OH)D水平则明显低于SAT组（p<0.05）。(2)甲状腺激素（T3、FT3和FT4）水平变化趋势与25(OH)D水平一致（p<0.05）。(3) 25(OH)D为因变量建立多元线性回归方程，Y = 3.80性别+0.058 FT3-0.036年龄+28.122（女性为对照组）。结论：不同甲状腺疾病患者的维生素D水平存在明显差异，GD患者维生素D水平最高，HP患者维生素D水平最低。甲状腺激素水平越高25(OH)D越高，这可能与免疫反应强度，或是甲状腺激素对维生素D合成酶影响的有关。男性和高水平FT3与甲状腺患者的25(OH)D水平增高有关。 |
| 关 键 词： | 甲状腺疾病; Graves病（GD）; 亚急性甲状腺炎（SAT）; 自身免疫性甲状腺疾病（AITD）; 甲状腺功能减退（HP）; 25(OH)D |
| DOI： | 10.57237/j.cmf.2023.01.002 |
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收稿日期: 2023-04-05
接受日期: 2023-05-23
在线出版日期: 2023-06-15
Vitamin D Level Among Patients with Different Thyroid Diseases
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 |
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