Graves病患者血清25(OH)D水平及其与甲状腺激素和自身抗体的相关性

Abnormality of serum 25(OH) D level and its associations with thyroid hormones and auto-antibody in patients with Graves disease

目的探讨25-羟维生素D[25(OH)D](一种评价体内维生素D水平的主要指标)水平对Graves病(GD)患者甲状腺激素及自身抗体的影响。方法对30例GD病患者的血清25(OH)D、促甲状腺素受体抗体(TRAb)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平进行检测,并与20例健康人群的25(OH)D水平作对照。分析GD患者血清25(OH)D水平与FT3、FT4、TSH、TRAb的相关性。结果 GD组血清25(OH)D水平明显低于对照组(P<0.01)。30例GD患者中,维生素D缺乏和不足28例(93.33%),其中维生素D缺乏患者的血清25(OH)D、TSH水平均较维生素D不足患者明显下降(P均<0.01),TRAb、FT3及FT4均较维生素D不足患者明显上升(P<均0.01)。GD患者血清25(OH)D水平与TSH呈正相关(r=0.381,P<0.05),与FT4(r=-0.64,P<0.01)、FT3(r=-0.73,P<0.01)、TRAb(r=-0.58,P<0.01)均呈负相关。结论 GD患者普通存在维生素D缺乏和不足,其水平与甲状腺激素水平及甲状腺自身免疫反应密切相关。

Objective To investigate the effect of serum 25-hydroxyvitamin D[25（OH） D]level,a principal maker assessing vitamin D level in vivo,on thyroid hormones and its auto-antibody in patients with Graves disease （GD） . Methods Thirty GD patients （GD group） and 20 healthy subjects （control group） were enrolled in this study. Serum 25（OH） D,thyrotrophin receptor antibody （TRAb） ,free triiodothyronine （FT3 ） ,free thyroxine （FT4 ） and thyroid-stimulating hormone （TSH） in GD group as well as serum 25（OH） D in control group were detected. The associations between serum 25（OH） D level and FT3 ,FT4 ,TSH,TRAb were analyzed. Results Serum 25（OH） D level in GD group was significantly lower than that in control group （P0. 01） . In GD group,the patients with 25（OH） D deficiency （vitamin D deficiency group） or insufficiency （vitamin D insufficiency group） were 28 cases （93. 33% ） . The 25（OH） D and TSH levels in vitamin D deficiency group were significantly lower than those in vitamin D insufficiency group （all P0. 01） ,while the levels of TRAb,FT3 and FT4 were significantly higher than those in vitamin D insufficiency group （all P0. 01） . In GD group,the levels of 25 （OH） D and TSH were positively related （r=0. 381,P0. 05） ,but 25（OH） D level and levels of FT4 （r=-0. 64,P0. 01） , FT3 （r=-0. 73,P0. 01） and TRAb （r=-0. 58,P0. 01） were negatively related,respectively. Conclusions Vitamin D deficiency or insufficiency universally exists in GD patients,and its level is closely correlated with thyroid hormones levels and thyroid autoimmunity reaction.