目的： 评估桥本甲状腺炎（Hashimoto’s thyroiditis,HT）及相关因素与25-羟维生素D的相关性。方法：选取2017年1月至2019年12月于我院内分泌科住院治疗的HT患者334例,同时选取同期非HT患者300例作为对照组,2组性别构成及年龄差异均无统计学意义（P>0.05）,分别收集2组患者的肝功能、肾功能、血糖、血脂、电解质水平,以及甲状腺功能、甲状腺抗体及维生素D水平等相关指标并进行分析。结果：2组患者的维生素D水平及维生素D缺乏率差异均无统计学意义（均P>0.05）,但促甲状腺素（thyroid stimulating hormone, TSH）水平及亚临床甲状腺功能减退（甲减）发生率,HT组均显著高于对照组（P<0.05）。女性HT患者的维生素D水平更低且更易出现亚临床甲减（P<0.05）。维生素D不足或缺乏的患者较维生素D正常的HT患者更易出现亚临床甲减（P<0.05）。血清游离三碘甲状腺原氨酸（free triiodothyronine,FT₃）是25-羟维生素D的保护因素[优势比（odds ratio,OR）=0.958,P=0.002],而血清TSH（OR=1.080,P=0.002）、女性（OR=1.167,P=0.001）均为25-羟维生素D的危险因素。结论：维生素D缺乏普遍存在于人群中,尤其女性群体更易出现维生素D缺乏,维生素D降低可导致HT患者TSH水平升高并增加亚临床甲减的发病率。

Objective To evaluate the relationship between Hashimoto’s thyroiditis (HT) and 25-hydroxy vitamin D. Methods A total of 334 HT patients were enrolled from the endocrine department of our hospital from January 2017 to December 2019, and 300 non-HT patients were selected as the control. There was no significant difference in gender and age composition between the two groups(P>0.05). The indexes of liver function, renal function, blood glucose, blood lipid, electrolyte level, thyroid function, thyroid antibody and vitamin D level of the two groups were collected and analyzed. Results Compared with the control group, there was no significant difference in vitamin D level and vitamin D deficiency rate between the HT group and the control group (P>0.05), while the thyroid stimulating hormone (TSH) level and the incidence of subclinical hypothyroidism in the HT group was significantly higher than that in the control group(P<0.05). The vitamin D level of female HT patients was lower and the cases of subclinical hypothyroidism were more(P<0.05). The HT patients with vitamin D deficiency were more likely to show subclinical hypothyroidism than the HT patients with normal vitamin D. Serum free triiodothyronine(FT₃) was a protective factor for 25-hydroxy vitamin D[odds ratio(OR)=0.958, P=0.002], serum TSH(OR=1.080, P=0.002) and female(OR=1.167, P=0.001) were risk factors for 25-hydroxy vitamin D. Conclusions The vitamin D deficiency is prevalent in the population, especially in female. Vitamin D deficiency can lead to higher TSH level and increase the incidence of subclinical hypothyroidism in HT patients.