血清25羟-维生素D、碘营养状况与自身免疫性甲状腺病的相关性

发布时间：2018-05-31 23:51

本文选题：自身免疫性甲状腺疾病 + 羟-维生素D　；参考：《中国老年学杂志》2017年17期

【摘要】：目的探讨25羟-维生素D[25(OH)D]水平、碘营养状况和自身免疫性甲状腺疾病(AITD)的相关性。方法通过检测380例粤中西部地区居民的空腹血清25(OH)D水平、甲状腺功能、甲状腺自身抗体、尿碘等相关指标等,并比较25(OH)D缺乏患者治疗后相关指标的差异,分析血清25(OH)D、碘营养状况对AITD发病的影响。结果 Graves病(GD)组、桥本甲状腺炎(HT)组25(OH)D3水平显著低于健康对照组(P0.05)。GD组血清25(OH)D3水平与促甲状腺激素受体抗体(TRAb)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)呈显著负相关,与促甲状腺激素(TSH)呈显著正相关(P0.01,P0.05)。HT组血清25(OH)D3水平与抗甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)、TSH呈显著负相关,与FT3、FT4呈显著正相关(P0.01,P0.05)。在GD组应用甲巯咪唑和HT组应用左甲状腺素的基础上加用活性维生素D连续治疗3个月后,GD组TRAb抗体水平明显降低,HT组TGAb、TPOAb抗体水平也明显降低(均P0.05)。GD组和HT组尿碘中位数均较对照组高。尿碘高的AITD患者25(OH)D3水平缺乏更明显(P0.05)。结论 AITD初发患者伴低维生素D水平,其中尿碘高的AITD患者25(OH)D3水平缺乏更明显。补充活性维生素D可降低其自身抗体水平。
[Abstract]:Objective to investigate the correlation between 25 hydroxyvitamin D [25(OH)D] level, iodine nutritional status and autoimmune thyroid disease (AITD). Methods the fasting serum 25(OH)D level, thyroid function, thyroid autoantibody, urinary iodine and other related indexes were measured in 380 residents of central and western Guangdong, and the difference of related indexes after treatment with 25(OH)D deficiency was compared. To analyze the effect of serum 25 OHD and iodine nutrition on the pathogenesis of AITD. Results the levels of serum 25(OH)D3 in Graves group and Hashimoto thyroiditis group were significantly lower than those in healthy control group (P 0.05). GD had a negative correlation with thyrotropin receptor antibody, free triiodothyronine FT3 and free thyroxine FT 4. There was a significant positive correlation between serum 25(OH)D3 level and anti-thyroglobulin antibody (25(OH)D3), anti-thyroid peroxidase antibody (TPO), and positive correlation with FT _ 3T _ 3T _ 4 (P _ (0.01) P _ (0.05) in the group of thyroid stimulating hormone (TSH) and thyroid stimulating hormone (TSH) (P _ (0.01) / P _ (0.05). The level of TRAb antibody in GD group was significantly lower than that in HT group (both P0.05).GD group and HT group) after three months of continuous treatment with active vitamin D on the basis of levathyroxine in GD group and HT group. The median iodine level was higher than that in the control group. The deficiency of 25(OH)D3 in AITD patients with high urinary iodine was more obvious (P 0.05). Conclusion the level of 25(OH)D3 in AITD patients with low vitamin D level is more obvious than that in AITD patients with high urinary iodine level. Supplementation of active vitamin D can reduce the level of autoantibodies.
【作者单位】：南方医科大学附属小榄医院急诊科;
【基金】：中山市科技计划项目(2014A1FC088)
【分类号】：R581

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