血清25-羟基维生素D与桥本甲状腺炎的相关性研究

A Study of the Correlation Between Serum 25-Hydroxy-vitamin D and Hashimoto’s Thyroiditis

目的分析血清25-羟基维生素D[25(OH)D]水平与桥本甲状腺炎之间的相关性,为桥本甲状腺炎的发病、治疗和预防提供新的思路和理论依据。方法采用队列研究设计,回顾性分析2021年1月至2023年5月于南京医科大学第一附属医院内分泌科就诊的201例桥本甲状腺炎初诊患者作为研究组,并同期收集195例于健康管理中心进行健康体检且生化指标和甲状腺功能正常者作为对照组,比较两组血清25(OH)D及甲状腺功能指标的差异,并进一步研究桥本甲状腺炎患者血清25(OH)D水平与甲状腺功能指标的相关性。结果桥本甲状腺炎组的25(OH)D、FT_(3)及FT_(4)水平显著低于对照组,TSH、TPO-Ab及TG-Ab水平显著高于对照组(P<0.05),维生素D(vitamin D,VD)缺乏者患病率高于对照组;25(OH)D与FT_(3)、FT_(4)呈正相关,与TSH呈负相关,与TPO-Ab、TG-Ab呈弱负相关(P<0.05);甲功正常组25(OH)D、FT_(3)及FT_(4)水平均高于亚临床甲减组和甲减组,TSH水平低于亚临床甲减组和甲减组(P<0.05)。结论VD缺乏会导致桥本甲状腺炎患病的风险增加,在桥本甲状腺炎的治疗过程中应监测并科学合理地补充VD水平来改善预后,进而可以减少甲状腺功能减退症及亚临床甲减的患病率。

Objective To analyze the correlation between serum 25-hydroxy-vitamin D[25(OH)D]levels and Hashimoto’s thyroiditis,and to provide novel thoughts and theoretical basis for the pathogenesis,treatment,and prevention of Hashimoto’s thyroiditis.Methods A cohort study design was utilized to retrospectively analyze the dataset of 201 patients with Hashimoto’s thyroiditis attending the Department of Endocrinology of the First Affiliated Hospital of Nanjing Medical University from January,2021 to May,2023 as the study group.We collected related data of 195 cases who underwent physical examinations in the Health Management Center and had normal biochemical indicators and thyroid function during the same period as the control group.The differences in serum 25(OH)D and thyroid function indexes between the two groups were evaluated,and the correlation between serum 25(OH)D and thyroid function indexes in patients with Hashimoto’s thyroiditis was further analyzed.Results In the Hashimoto’s thyroiditis group,levels of 25(OH)D,FT_(3) and FT_(4) were significantly lower than those in the control group,while levels of TSH,TPO-Ab and TG-Ab were significantly higher(P<0.05).The prevalence rate of VD-deficient individuals was higher than that of the control group;25(OH)D was positively correlated with FT_(3) and FT_(4),while negatively correlated with TSH,and weakly negatively correlated with TPO-Ab and TG-Ab(P<0.05);Levels of 25(OH)D,FT_(3),and FT_(4) in the normal thyroid function group were significantly higher than those in the subclinical hypothyroidism group and the hypothyroidism group,while levels of TSH were significantly lower than those in the subclinical hypothyroidism group and the hypothyroidism group(P<0.05).Conclusion Vitamin D deficiency can increase the risk of developing Hashimoto’s thyroiditis,and vitamin D levels should be monitored and supplemented accordingly during the treatment of Hashimoto’s thyroiditis to improve prognosis,which in turn could reduce the prevalence of subclinical hypothyroidism and hypothyroidism.