桥本甲状腺炎患者117例25羟维生素D水平分析

Research on 25-hydroxy vitamin D level in 117 cases of Hashimoto thyroiditis patients

目的探讨桥本甲状腺炎(HT)患者中25羟维生素D[25(OH)D]水平及其与HT关系。方法对个旧地区117例HT患者25(OH)D水平进行横断面研究。根据甲状腺功能将HT患者分为正常甲状腺功能(HT1)组(32例)、亚临床甲状腺减退(HT2)组(51例)及甲状腺减退(HT3)组(34例)。采用liason化学发光法测定25(OH)D水平及甲状腺功能、甲状腺自身抗体等临床指标。采用SPSS 19.0软件包进行统计分析,用t检验、单因素方差分析检验、非参数检验及卡方检验进行组间比较,用Pearson相关性分析及多因素回归分析25(OH)D的相关因素。结果 (1)个旧地区HT人群中血25(OH)D水平基线为(19.85±8.31)ng/ml;25(OH)D充足、不足及缺乏比例分别为14.53%、29.06%、56.41%;(2)男/女性别比例为1/6.3(16/101),男性被初次诊断时年龄[(53.31±17.39)岁]高于女性[(44.44±13.69)岁](P<0.05),不同性别患者25(OH)D水平无统计学差异(P>0.05);(3)38例40岁以下患者、63例40~60岁之间患者及16例60岁以上患者25(OH)D水平分别为(20.16±9.64)ng/ml、(20.19±7.59)ng/ml及(17.76±7.87)ng/ml,3组间比较无统计学差异(P>0.05);(4)HT1、HT2、HT3组患者25(OH)D水平分别为(20.40±7.36)ng/ml、(20.72±9.57)ng/ml和(18.02±6.95)ng/ml,3组间25(OH)D水平及充足、不足及缺乏比例无统计学差异(P>0.05);(5)Pearson单因素相关分析提示FT4与25(OH)D有相关性(r=0.256,P<0.05),多因素线性回归分析提示25(OH)D水平与FT4呈正相关(P=0.003),与女性呈负相关(P=0.044)。结论 (1)个旧地区HT患者存在明显维生素D缺乏;(2)女性较男性易患HT,且初次诊断年龄较男性早;(3)HT人群中25(OH)D水平与FT4呈正相关,与女性呈负相关。

Objective To investigate the 25-hydroxy vitamin D(25(OH)D) level in Hashimoto thyroiditis(HT) patients and the relationship between 25(OH)D and HT. Methods 117 cases of HT patients in Gejiu were selected in the cross-sectional study, which were divided into normal thyroid function(HT1) group(n=32), subclinical hypothyroidism(HT2) group(n=51), clinical hypothyroidism(HT3) group(n=34) according to thyroid functions. The levels of serum 25(OH)D, thyroid functions and thyroid autoantibodies were detected by chemiluminescence method of liason. Clinical data were analyzed by SPSS 19.0 statistical soft packet. t test, single factor analysis of variance test, non-parametric test and Chi-square test were used to make a comparison among groups, Pearson correlation and multiple regression analysis were used to analyze 25(OH)D related factors. Results(1) Mean serum 25(OH)D in HT patients in Gejiu was(19.85±8.31)ng/ml. The prevalence of 25(OH)D adequate/deficiency/insufficiency was 14.53%, 29.06%, 56.41%, respectively.(2) Male/female ratio was 1/6.3(16/101). The first diagnosed age of male [(53.31±17.39)years] were significantly higher than women [(44.44±13.69) years](P<0.05); Mean 25(OH)D levels in HT patients had no statistical gender differences.(3) Mean 25(OH)D levels in 38 patients(age<40 years), 63 patients(age=40-60 years) and 16 patients(age>60 years) were(20.16±9.64) ng/ml,(20.19±7.59) ng/ml and(17.76±7.87) ng/ml, respectively, comparison among the three groups had no statistical difference(P>0.05).(4)Mean serum 25(OH)D in HT1, HT2, HT3 group were(20.40±7.36) ng/ml,(20.72±9.57) ng/ml,(18.02±6.95) ng/ml, respectively. Mean serum 25(OH)D and the prevalence of 25(OH)D adequate/deficiency/insufficiency had no statistical difference among three groups(P>0.05).(5) According to Pearson single factor related analysis, serum 25(OH)D was the only factor positive correlation with the level of FT4(r=0.256, P<0.05). According to the multiple linear regression analysis, serum 25(OH)D had a significant positive correlation with the level of FT4(P=0.003) and had a negative correlation with female(P=0.044). Conclusions(1) HT patients with 25(OH)D deficiency were prevalent in Yunnan Gejiu.(2) Female were predisposed to HT than male. The first diagnosed ages of female were significantly earlier than male.(3) Serum 25(OH)D has a significant positive correlation with the level of FT4 and has a negative correlation with female in HT patients.