Study on the relationship between vitamin D deficiency and Hashimoto’s thyroiditis

doi:10.16138/j.1673-6087.2021.01.007

Abstract

Abstract:

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.

Key words: Hashimoto’s thyroiditis, Vitamin D, Thyroid stimulating hormone, Immune disease

CLC Number:

R581.4

FU Jiawen, LI Xiaohua, ZHANG Hongli, XU Yanhong, ZHU Yi. Study on the relationship between vitamin D deficiency and Hashimoto’s thyroiditis[J]. Journal of Internal Medicine Concepts & Practice, 2021, 16(01): 27-31.

Figures/Tables 5

References 17

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项目	对照组（n=300）	HT组（n=334）
性别（男/女）	122/178	129/205
年龄(岁)	61.39±12.00	63.10±11.49
ALT(U/L)	22.25(14.70,29.78)	23.40(14.33,30.28)
AST(U/L)	20.70(16.10,27.70)	20.57(16.23,27.18)
肌酐(μmol/L)	59.90(48.52,73.50)	61.20(49.94,72.18)
尿素氮(mmol/L)	5.77±1.70	5.79±1.90
三酰甘油(mmol/L)	1.55(1.00,2.31)	1.59(1.01,2.32)
总胆固醇(mmol/L)	4.49±1.12	4.53±1.11
空腹葡萄糖(mmol/L)	7.18(5.60,9.06)	7.23(5.66,8.80)
糖化血红蛋白(%)	7.61±1.12	7.80±1.25
钙(mmol/L)	2.34±0.12	2.32±0.15
磷(mmol/L)	1.23±0.27	1.21±0.30
PTH(pmol/L)	4.95±1.80	4.80±1.66

项目	对照组（n=300）	HT组（n=334）
FT₃(nmol/L)	4.81±0.60	4.72±0.63
FT₄(pmol/L)	11.34±1.64	11.34±1.80
TGAb(kU/L)	0.00(0.00,0.01)	7.15(0.30,60.65)¹⁾
TPOAb(kU/L)	0.70(0.40,1.50)	34.85(9.55,232.68)¹⁾
TSH(mU/L)	2.04(1.42,3.05)	2.64(1.69,3.96)¹⁾
亚临床甲减[n(%)]	6(2.0)	42（12.6）¹⁾
25-羟维生素D (pmol/L)	16.66(11.98,22.13)	16.84(11.81,23.39)
维生素D缺乏[n(%)]	209(69.7)	214(64.1)

项目	男性(n=129)	女性（n=205）
FT₃(nmol/L)	4.80±0.67	4.67±0.60
FT₄(pmol/L)	11.23±1.84	11.41±1.77
TSH(mU/L)	2.27(1.33,3.52)	2.87(1.92,4.48)¹⁾
亚临床甲减[n(%)]	11(8.5)	31(15.1)¹⁾
TGAb(kU/L)	6.90(0.10,57.10)	8.30(0.70,58.80)
TPOAb(kU/L)	32.40(11.25,235.15)	36.90(3.90,232.00)
25-羟维生素D (pmol/L)	18.62(14.41,24.48)	15.75(10.73,22.77)¹⁾
维生素D缺乏[n(%)]	75(58.1)	139(67.8)¹⁾

项目	维生素D 正常组(n=30)	维生素D 不足组(n=90)	维生素D 缺乏组(n=214)
TSH(mU/L)	2.35(1.49,3.65)	2.63(1.61,4.09)¹⁾	2.78(1.70,4.20)¹⁾
亚临床甲减	2(6.7)	9(10.0)¹⁾	31(14.5)¹⁾

模型	非标准化系数		标准系数			95%置信区间
模型	B	标准误	β	t	P	95%置信区间
(常量)	7.635	2.455		3.110	0.002	2.814~12.456
FT₃	1.520	0.496	0.121	3.065	0.002	0.546~2.494
性别	-2.062	0.621	-0.131	-3.320	0.001	-0.842~-2.494
TSH	-0.720	0.054	-0.081	-2.575	0.002	-0.723~-0.210