25羟维生素D与桥本甲状腺炎的关系研究

Research on the relationship between 25-hydroxyvitamin D level and hashimoto's thyroiditis

目的探讨25羟维生素D[25(OH)D]水平与桥本甲状腺炎的关系。方法选取个旧地区106例桥本甲状腺炎患者作为患者组,41例健康体检者作为健康组,采用liason化学发光法测定2组血清25(OH)D及甲状腺功能[总三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT_3)、总甲状腺素(TT_4)、游离甲状腺素(FT_4)、促甲状腺激素(TSH)]、甲状腺自身抗体[甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺微粒体抗体(TM-Ab)、甲状腺球蛋白抗体(TG-Ab)]指标水平并进行比较分析,应用多元线性逐步回归分析25(OH)D水平的影响因素。结果患者组女性多于健康组(P<0.05),血清TT_4、FT_3、FT_4水平均明显低于健康组(P均<0.05),TSH、ATPO-Ab、ATG-Ab、ATM-Ab水平均明显高于健康组(P均<0.05),而2组年龄,血清25(OH)D、TT3水平和25(OH)D充足和不足所占比例比较差异均无统计学意义(P均>0.05);健康组25(OH)D缺乏的比例高于患者组(P<0.05),但仅患者组出现25(OH)D严重缺乏。Pearson单因素相关分析(P=0.01)和多因素线性回归分析(P=0.002)均提示FT_4与25(OH)D水平正相关。结论个旧地区人群中普遍存在维生素D不足和缺乏;25(OH)D严重缺乏可能是桥本甲状腺炎患者的重要临床特征,并可能和甲状腺功能减退症有关。

Objective It is to investigate the relationship between 25-hydroxyvitamin D （25 （OH）D） level and haahimoto＇ s thyroiditis （HT）. Methods 106 cases of HT patients（ HT group） and 41 cases of healthy peoples （ NT group） were selected. The levels of serum 25 （OH） D, thyroid functions（TT3 , FT3 , TT4, FT4 , TSH and thyroid autoantibodys （TPO-Ab, TM-Ab, TG-Ab） were detected by chemiluminescence method of liason. The clinical datas were recorded and compared. The effect factors of 25 （OH） D were analyzed by multiple linear stepwise regression. Results The proportion of women in HT group was higher than that in NT group （ P 〈 0. 05 ）. The levels of serum TT4, FT3 , FT4 in HT group were lower while the levels of TSH, ATPO-Ab, ATG-Ab, ATM-Ab were higher than those in NT group （P 〈 0.05 ）. There was no significant differences in age, serum 25 （OH） D, TT3 and adequate 25 （OH） D and insufficient 25 （ OH ） D between the two groups （ P 〉 0.05 ）. The proportion of deficiency 25 （OH） D in HT group was significantly higher than that in NT group, but severe deficiency 25 （OH） D only occurred in HT group. According to the Pearson single factor correlation analysis and multiple linear regression analysis showed that FT4 was positively related with 25 （OH） D （ P = 0.01, P = 0. 002 respectively）. Conclusion 25 （OH） D deficiency and insufficient were widespread in the people in Gejiu area. 25 （OH） D serious deficiency is an important characteristic of patients with HT and may be closely related to the occurrence of hypothyroidism.