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Nodehi M, Ajami A, Izad M, Asgarian Omran H, Chahardoli R, Amouzegar A, Yekaninejad S, Hemmatabadi M, Azizi F, Esfahanian F, Mansouri F, Mazaheri Nezhad Fard R, Saboor-Yaraghi AA. Effects of vitamin D supplements on frequency of CD4 + T-cell subsets in women with Hashimoto's thyroiditis: a double-blind placebo-controlled study. Eur J Clin Nutr 2019; 73:1236-1243. [PMID: 30696977 DOI: 10.1038/s41430-019-0395-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/26/2018] [Accepted: 12/19/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Vitamin D is a modulator of immune functions. Investigations on the mechanisms of vitamin D action and pathogenesis of Hashimoto's thyroiditis (HT) have revealed that vitamin D can reduce damages to thyroid cells caused by autoreactive immune cells. METHODS Totally, 48 female patients with HT disease were introduced to the study by endocrinologists. Patients were divided into two major groups of 24 individuals and treated weekly with 50,000 IU of cholecalciferol (vitamin D group) or placebo (placebo group) using oral administration for 3 months. Eventually, 17 of the 24 patients in each group finished the study. Before and after supplementation, frequencies of Th1, Th17, Th2 and Tr1 cells and mean fluorescent intensity (MFI) of the associated cytokines, including IFN-γ, IL-17, IL-4 and IL-10, were assessed using flow cytometry. Furthermore, gene expression of IL-10 was assessed using real-time PCR. RESULTS Results of this study showed that cholecalciferol supplementation caused a significant decrease in Th17/Tr1 ratio. The proportion and MFI of Th1, Th2, Tr1 and Th17 cells included no significant changes in vitamin D group, compared to those in placebo group. Expression rate and MFI of IL-10 increased in both groups. This increase was higher in vitamin D group than placebo group with no significance. CONCLUSIONS In this novel preliminary clinical trial study, supplementation with cholecalciferol in HT patients for 3 months changed the balance of CD4+ T-cell subsets to improve the disease control. However, further studies are necessary to investigate effects of vitamin D on immune functions in HT patients.
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Affiliation(s)
- Masoumeh Nodehi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abolghasem Ajami
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Izad
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Asgarian Omran
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Chahardoli
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbobeh Hemmatabadi
- Department of Endocrinology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereydoon Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Esfahanian
- Department of Endocrinology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mansouri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Mazaheri Nezhad Fard
- Division of Food Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Food Microbiology Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Saboor-Yaraghi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Cyranska-Chyrek E, Olejarz M, Szczepanek-Parulska E, Stajgis P, Pioch A, Ruchala M. Severe unilateral orbitopathy in a patient with Hashimoto's thyroiditis - a case report. BMC Ophthalmol 2019; 19:9. [PMID: 30621642 PMCID: PMC6325776 DOI: 10.1186/s12886-018-1018-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/21/2018] [Indexed: 12/13/2022] Open
Abstract
Background Thyroid-associated orbitopathy (TAO) constitutes an immune-mediated inflammation of the orbital tissues of unclear etiopathogenesis. TAO is most prevalent in hyperthyroid patients with Graves’ disease (GD); however, severe cases of orbitopathy associated with Hashimoto’s thyroiditis (HT) have rarely been described. Case presentation Herewith we report an unusual case of a middle-aged clinically and biochemically euthyroid woman with a stable HT, who developed a severe unilateral left-sided TAO. Thyrotropin receptor antibodies (TRAb) concentration was negative. Intraocular pressure in the left eye was mildly elevated (24 mmHg), while vision acuity was not compromised. Abnormal positioning of the eyeball suggested the extraocular muscles involvement. Unilaterally, von Graefe’s, Stellwag’s, Kocher’s and Moebius' signs were positive. Conjunctival erythema, redness and edema of the eyelid and an enlarged, swollen lacrimal caruncle were visible. She received 4/7 points in the Clinical Activity Scale (CAS) and class IV in the NO SPECS severity scale for the left eye (I-0, II-a, III-0, IV-b, V-0, VI-0). Magnetic resonance imaging (MRI) revealed thickening of the left medial rectus muscle with an increase in T2 signal intensity and prolonged T2 relaxation indicating an active form of TAO. The patient received therapy with glucocorticosteroids intravenously, followed by intramuscular injections with a cumulative dose of 3.24 g of methylprednisolone during a 9-week period with good tolerance. The applied therapy, combined with adequate L-thyroxine substitution, as well as vitamin D and selenium supplementation, resulted in a complete remission of ophthalmic symptoms. Conclusions Unilateral exophthalmos in TRAb-negative patients with HT is not a typical manifestation of the disease, and requires a wider differential diagnosis with MRI of the orbits. Scheme of three iv. pulses of methylprednisolone intravenously and the continuation of treatment with im. injections seems to be an effective and safe method of treatment in this group of patients. What is more, adequate vitamin D supplementation and the maintenance of biochemical euthyroidism may help to achieve an ultimate therapeutic effect. Patients with TAO in the course of HT need a careful and continued interdisciplinary approach both ophthalmological and endocrinological. Further studies are needed to elucidate the etiopathogenesis of TAO in TRAb-negative patients.
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Affiliation(s)
- Ewa Cyranska-Chyrek
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland.
| | - Michal Olejarz
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
| | - Ewelina Szczepanek-Parulska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
| | - Piotr Stajgis
- Department of General Radiology and Neuroradiology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
| | - Anna Pioch
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
| | - Marek Ruchala
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland
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Krysiak R, Kowalcze K, Okopień B. Selenomethionine potentiates the impact of vitamin D on thyroid autoimmunity in euthyroid women with Hashimoto's thyroiditis and low vitamin D status. Pharmacol Rep 2018; 71:367-373. [PMID: 30844687 DOI: 10.1016/j.pharep.2018.12.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/14/2018] [Accepted: 12/14/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Both exogenous vitamin D and selenium reduce thyroid antibody titers. The aim of the study was to investigate whether the impact of vitamin D on thyroid autoimmunity is affected by selenium intake. METHODS The study included 47 euthyroid women with Hashimoto's thyroiditis and low vitamin D status, 23 of whom had been treated with selenomethionine (200 μg daily) for at least 12 months before the beginning of the study. During the study, all patients were treated with vitamin D preparations (4000 IU daily). Serum titers of thyroid peroxidase and thyroglobulin antibodies, as well as circulating levels of thyrotropin, free thyroid hormones and 25-hydroxyvitamin D were measured before vitamin D supplementation and 6 months later. Moreover, at the beginning and at the end of the study, we calculated Jostel's thyrotropin index, the SPINA-GT index and the SPINA-GD index. RESULTS With the exception of the free triiodothyronine/free thyroxine ratio and the SPINA-GD index, there were no differences between the study groups. In both groups, vitamin D increased 25-hydroxyvitamin D levels, reduced thyroid peroxidase and thyroglobulin antibody titers, as well as increased the SPINA-GT index. The effects on antibody titers and the SPINA-GT index were more pronounced in women receiving selenomethionine. Neither in selenomethionine-treated nor in selenomethionine-naïve women vitamin D affected serum hormone levels, Jostel's index and the SPINA-GD index. CONCLUSIONS The results of the study suggest that selenium intake enhances the effect of vitamin D on thyroid autoimmunity.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Karolina Kowalcze
- Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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Botelho IMB, Moura Neto A, Silva CA, Tambascia MA, Alegre SM, Zantut-Wittmann DE. Vitamin D in Hashimoto's thyroiditis and its relationship with thyroid function and inflammatory status. Endocr J 2018; 65:1029-1037. [PMID: 30058600 DOI: 10.1507/endocrj.ej18-0166] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Several studies have shown the correlation between vitamin D [25(OH)D] deficiency and thyroid autoimmunity and reducing of thyroid autoantibodies in patients with normal levels of vitamin D combining with thyroid hormone replacement. However, other authors not agree with this association. It is still unclear whether the low 25(OH)D levels are the result of HT disease or a part of its cause. We studied 88 patients with HT regarding vitamin D status and thyroid autoimmunity markers as well as the relationship with cytokines produced by Th1, Th2, and Th17 cells compared with a control group of 71 euthyroid healthy subjects. The present study demonstrated that vitamin D concentrations were similar in patients HT and the control group. The reduction of free T4 levels was a predictor of vitamin D insufficiency for Hashimoto's thyroiditis, but not for the control group. Lower concentrations of TNF-α was a predictor of lower levels of vitamin D. Differences in the association between HT and vitamin D insufficiency remain unresolved in the literature. The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
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Affiliation(s)
- Ilka Mara Borges Botelho
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, San Paulo, Brazil
| | - Arnaldo Moura Neto
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, San Paulo, Brazil
| | | | - Marcos Antônio Tambascia
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, San Paulo, Brazil
| | - Sarah Monte Alegre
- Metabolic Unit, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas Campinas, San Paulo, Brazil
| | - Denise Engelbrecht Zantut-Wittmann
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, San Paulo, Brazil
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Krysiak R, Szkróbka W, Okopień B. The effect of vitamin D and selenomethionine on thyroid antibody titers, hypothalamic-pituitary-thyroid axis activity and thyroid function tests in men with Hashimoto's thyroiditis: A pilot study. Pharmacol Rep 2018; 71:243-247. [PMID: 30818086 DOI: 10.1016/j.pharep.2018.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/22/2018] [Accepted: 10/23/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Both selenium and vitamin D were found to reduce thyroid antibody titers in women with Hashimoto's thyroiditis. METHODS The study enrolled 37 young drug-naïve euthyroid men with autoimmune thyroiditis, who were treated for 6 months with either exogenous vitamin D (group A, n = 20) or selenomethionine (group B, n = 17). Serum titers of thyroid peroxidase and thyroglobulin antibodies, serum levels of thyrotropin and free thyroid hormones, serum levels of 25-hydroxyvitamin D, as well Jostel's thyrotropin, the SPINA-GT and the SPINA-GD indices were determined at the beginning and at the end of the study. RESULTS At baseline, there were no differences between the study groups. Both vitamin D and selenomethionine reduced antibody titers and increased the SPINA-GT index. Only selenomethionine affected the SPINA-GD index, while only vitamin D increased 25-hydroxyvitamin D levels. Neither selenomethionine nor vitamin D significantly affected thyrotropin and free thyroid hormone levels. The effect of vitamin D on antibody titers correlated with baseline and treatment-induced changes in serum levels of 25-hydroxivitamin D. CONCLUSIONS Both vitamin D and selenomethionine have a beneficial effect on thyroid autoimmunity in drug-naïve men with Hashimoto's thyroiditis.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Witold Szkróbka
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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Bozdag H, Akdeniz E. Does severe vitamin D deficiency impact obstetric outcomes in pregnant women with thyroid autoimmunity? J Matern Fetal Neonatal Med 2018; 33:1359-1369. [PMID: 30173587 DOI: 10.1080/14767058.2018.1519017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Purpose: Vitamin D plays an important role in the modulation of the immune system and anti-autoimmune activities. Autoimmune thyroid diseases related to endocrine disorders are associated with poor obstetric outcomes in pregnancy. Herein, we aimed to investigate the contribution of vitamin D hypovitaminosis to poor pregnancy outcomes in pregnant women with the positive autoimmune antibody.Materials and methods: This was a prospective case-control study that enrolled pregnant women at their first trimester. The pregnant women were divided based on thyroid antibody (TA) status (TA-positive pregnant group (TAs (+)) and negative group (TAs (-)). Vitamin D status was categorized as sufficient, insufficient, and deficient (severe and moderate).Results: A total of 283 pregnant women were enrolled in this study. A total of 219 pregnant women were assigned to the TAs (-) group and 64 to the TAs (+) group. The rate of vitamin D insufficiency was 8.7, and 7.8% in the pregnant with TAs (-), and the pregnant with TAs (+) groups, respectively. Vitamin D deficiency was highly prevalent in all groups. Specifically, the prevalence rate was 91 and 92% in the pregnant with TAs (-) and the pregnant with TAs (+) groups, respectively. Admission to the neonatal intensive care unit (NICU) was more prevalent in the pregnant with TAs (+) group than in the pregnant with TAs (-) group (40.6 versus 25%; p = .0187; effect size (ES) = 0.134). The rate of gestational diabetes mellitus (GDM) was significantly higher in the pregnant women with TAs (+) group than that in the pregnant women with TAs (-) group (12.5 versus 4.1%; p = .03; ES =0.13). The rate of NICU admission and GDM was significantly higher in the severe vitamin D-deficient pregnant group with TAs (+) than that in the severe vitamin D-deficient pregnant group with TAs (-) (47 versus 23%; p = .007; ES =0.207 and 19.4% versus 4.1%; p = .006; ES =0.214, respectively).Conclusions: Severe vitamin D deficiency may contribute to increase the prevalence of GDM and need for NICU admission in pregnant women with positive TA.
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Affiliation(s)
- Halenur Bozdag
- Department of Obstetrics and Gynecology, Göztepe Teaching and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Esra Akdeniz
- Faculty of Medicine, Division of Biostatistics, Marmara University, Istanbul, Turkey
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Bener A, Ozdenkaya Y, Al-Hamaq AO, Barisik CC, Ozturk M. Low Vitamin D Deficiency Associated With Thyroid Disease Among Type 2 Diabetic Mellitus Patients. J Clin Med Res 2018; 10:707-714. [PMID: 30116441 PMCID: PMC6089577 DOI: 10.14740/jocmr3507w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 06/18/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the relationship between vitamin D deficiency and thyroid diseases among type 2 diabetes mellitus (T2DM) patients. METHODS This was a cohort case and control study, 546 T2DM patients and 546 control study participants were enrolled, aged between 25 and 65 years. The subjects were also investigated for fasting blood glucose levels (FBG), post prandial glucose (PPG,) glycosylated hemoglobin (HbA1c), thyroid stimulating hormone (TSH), T3, T4, and presence of other comorbid conditions. Thyroid fine needle aspiration biopsy was suggested to patients whose thyroid nodules were greater than 1.00 cm. RESULTS There were significant differences between T2DM patients and control subjects regarding BMI (kg/m2), physical activity, cigarette smoking, sheesha smoking, family history of diabetes, hypertension and family history of thyroid nodules. The clinical biochemistry values among T2DM for vitamin D, calcium, magnesium, potassium, phosphorous, fasting blood glucose, cholesterol, HbA1c, HLDL, LDL, triglyceride, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower than control subjects, but higher in creatinine, albumin, TSH, T3, and T4 which appeared statistically significant differences (P < 0.001). Also, the study revealed statistically significant differences between subjects vitamin D deficiency and with thyroid nodules for calcium, magnesium, phosphorous, HbA1c, high density lipoprotein (HDL), SBP and DBP, TSH, T3, and T4 among T2DM patients and control subjects (P < 0.001). Multivariable stepwise logistic regression analysis showed that TSH, HbA1c, vitamin D deficiency, SBP (mm Hg), BMI, family history of DM, serum calcium level and family history of thyroid were considered at higher risk as predictors of thyroid among T2DM patients. CONCLUSIONS This study suggests that obesity, HbA1c, the environment, and genetic susceptibility among T2DM, may increase the risk of thyroid disease and cancer. Although evidence has shown that thyroid cancer incidence has been rising more rapidly over time than the occurrence of cancers of other sites, due to an increase of obesity, diabetes and lack of physical activity, this study lacks of direct evidence supporting this conclusion.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics and Medical Informatics, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The university of Manchester, Manchester, UK
- Department. of Endocrinology, Medipol International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Yasar Ozdenkaya
- Qatar Diabetic Associations and Qatar National Research Foundation, Doha, Qatar
| | - Abdulla O.A.A. Al-Hamaq
- Department of Surgery, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Cem Cahit Barisik
- Department of Radiology and Pathology, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Ozturk
- Department. of Endocrinology, Medipol International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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A case report of a novel, integrative approach to Hashimoto’s thyroiditis with unexpected results. ADVANCES IN INTEGRATIVE MEDICINE 2018. [DOI: 10.1016/j.aimed.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Krysiak R, Szkróbka W, Okopień B. Moderate-dose simvastatin therapy potentiates the effect of vitamin D on thyroid autoimmunity in levothyroxine-treated women with Hashimoto’s thyroiditis and vitamin D insufficiency. Pharmacol Rep 2018; 70:93-97. [DOI: 10.1016/j.pharep.2017.07.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 07/19/2017] [Accepted: 07/25/2017] [Indexed: 01/20/2023]
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Mirhosseini N, Brunel L, Muscogiuri G, Kimball S. Physiological serum 25-hydroxyvitamin D concentrations are associated with improved thyroid function-observations from a community-based program. Endocrine 2017; 58:563-573. [PMID: 29067607 PMCID: PMC5693977 DOI: 10.1007/s12020-017-1450-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/04/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Vitamin D deficiency has been associated with an increased risk of hypothyroidism and autoimmune thyroid disease. Our aim was to investigate the influence of vitamin D supplementation on thyroid function and anti-thyroid antibody levels. METHODS We constructed a database that included 11,017 participants in a health and wellness program that provided vitamin D supplementation to target physiological serum 25-hydroxyvitmain D [25(OH)D] concentrations (>100 nmol/L). Participant measures were compared between entry to the program (baseline) and follow-up (12 ± 3 months later) using an intent-to-treat analysis. Further, a nested case-control design was utilized to examine differences in thyroid function over 1 year in hypothyroid individuals and euthyroid controls. RESULTS More than 72% of participants achieved serum 25(OH)D concentrations >100 nmol/L at follow-up, with 20% above 125 nmol/L. Hypothyroidism was detected in 2% (23% including subclinical hypothyroidism) of participants at baseline and 0.4% (or 6% with subclinical) at follow-up. Serum 25(OH)D concentrations ≥125 nmol/L were associated with a 30% reduced risk of hypothyroidism and a 32% reduced risk of elevated anti-thyroid antibodies. Hypothyroid cases were found to have higher mean serum 25(OH)D concentrations at follow-up, which was a significant positive predictor of improved thyroid function. CONCLUSION The results of the current study suggest that optimal thyroid function might require serum 25(OH)D concentrations above 125 nmol/L. Vitamin D supplementation may offer a safe and economical approach to improve thyroid function and may provide protection from developing thyroid disease.
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Affiliation(s)
- Naghmeh Mirhosseini
- Pure North S’Energy Foundation, 326 11th Avenue SW, Suite 800, Calgary, AB T2R 0C5 Canada
| | - Ludovic Brunel
- Naturmend Integrative Medical Clinic, 905 1st Ave NE, Calgary, AB T2E 2L3 Canada
| | - Giovanna Muscogiuri
- IOS and Coleman Medicina Futura Medical Center, via Alcide De Gasperi 107/109/111, 80011 Acerra (Napoli), Italy
| | - Samantha Kimball
- Pure North S’Energy Foundation, 326 11th Avenue SW, Suite 800, Calgary, AB T2R 0C5 Canada
- St. Mary’s University, 14500 Bannister Road, Calgary, AB T2X1Z4 Canada
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Vahabi Anaraki P, Aminorroaya A, Amini M, Momeni F, Feizi A, Iraj B, Tabatabaei A. Effect of Vitamin D deficiency treatment on thyroid function and autoimmunity markers in Hashimoto's thyroiditis: A double-blind randomized placebo-controlled clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:103. [PMID: 29026419 PMCID: PMC5629831 DOI: 10.4103/jrms.jrms_1048_16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/15/2017] [Accepted: 06/20/2017] [Indexed: 12/22/2022]
Abstract
Background: The link between autoimmune thyroid diseases and Vitamin D deficiency has been reported. However, there are controversies in this regard. We conducted a double-blind randomized placebo-controlled clinical trial to investigate the effect of Vitamin D deficiency treatment on thyroid function and autoimmunity marker (thyroid peroxidase antibody [TPO-Ab]) in patients with Hashimoto's thyroiditis. Materials and Methods: Fifty-six patients with Hashimoto's thyroiditis and Vitamin D deficiency (25-hydroxyvitamin D level ≤20 ng/mL) were randomly allocated into two groups to receive Vitamin D (50000 IU/week, orally) or placebo for 12 weeks, as Vitamin D-treated (n = 30) and control (n = 26) groups, respectively. TPO-Ab, thyroid-stimulating hormone (TSH), parathormone, calcium, albumin, and creatinine concentrations were compared before and after trial between and within groups. The data were presented as mean (standard error [SE]) and analyzed by appropriate tests. Results: Mean (SE) of Vitamin D was increased in Vitamin D-treated group (45.5 [1.8] ng/mL vs. 12.7 [0.7] ng/mL, P = 0.01). Mean (SE) of TPO-Ab did not significantly change in both groups (734 [102.93] IU/mL vs. 820.25 [98.92] IU/mL, P = 0.14 in Vitamin D-treated and 750.03 [108.7] [IU/mL] vs. 838.07 [99.4] [IU/mL] in placebo-treated group, P = 0.15). Mean (SE) of TSH was not changed in both groups after trial, P = 0.4 and P = 0.15 for Vitamin D-treated and control groups, respectively. No significant difference was observed between two study groups in none studied variables (P > 0.05). Conclusion: Vitamin D treatment in Vitamin D deficient patients with Hashimoto's thyroiditis could not have significant effect on thyroid function and autoimmunity.
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Affiliation(s)
- Parichehr Vahabi Anaraki
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Massoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Momeni
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bijan Iraj
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azamosadat Tabatabaei
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Kim D. The Role of Vitamin D in Thyroid Diseases. Int J Mol Sci 2017; 18:ijms18091949. [PMID: 28895880 PMCID: PMC5618598 DOI: 10.3390/ijms18091949] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/06/2017] [Accepted: 09/07/2017] [Indexed: 01/12/2023] Open
Abstract
The main role of vitamin D is regulating bone metabolism and calcium and phosphorus homeostasis. Over the past few decades, the importance of vitamin D in non-skeletal actions has been studied, including the role of vitamin D in autoimmune diseases, metabolic syndromes, cardiovascular disease, cancers, and all-cause mortality. Recent evidence has demonstrated an association between low vitamin D status and autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Graves’ disease, and impaired vitamin D signaling has been reported in thyroid cancers. This review will focus on recent data on the possible role of vitamin D in thyroid diseases, including autoimmune thyroid diseases and thyroid cancers.
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Affiliation(s)
- Dohee Kim
- Division of Endocrinology, Department of Internal Medicine, Dankook University College of Medicine, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam 330-714, Korea.
- Department of Kinesiologic Medical Science, Graduate, Dankook University, Cheonan 330-714, Korea.
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Abstract
Vitamin D exerts its canonical roles on the musculoskeletal system and in the calcium/phosphorus homeostasis. In the last years, increasing evidences suggested several extra-skeletal actions of this hormone, indicating that vitamin D may produce effects in almost all the body tissues. These are mediated by the presence of vitamin D receptor (VDR) and thanks to the presence of the 1-α-hydroxylase, the protein that converts the 25-hydroxyvitamin (calcidiol) to the active form 1,25-dihydroxyvitamin (calcitriol). Several studies evaluated the possible role of vitamin D in the pathogenesis of thyroid diseases, and this review will focus on the available data of the literature evaluating the association between vitamin D and thyroid function, vitamin D and autoimmune thyroid diseases, including Hashimoto's thyroiditis, Graves' disease and post-partum thyroiditis, and vitamin D and thyroid cancer.
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Affiliation(s)
- Immacolata Cristina Nettore
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Via S. Pansini, 5, 80131, Napoli, Italy
| | - Luigi Albano
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Napoli, Italy
| | - Paola Ungaro
- Istituto di Endocrinologia ed Oncologia Sperimentale del CNR (IEOS-CNR) "G. Salvatore", Napoli, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Via S. Pansini, 5, 80131, Napoli, Italy
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Via S. Pansini, 5, 80131, Napoli, Italy.
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Abstract
Graves disease is the most common cause of thyrotoxicosis. Although medical intervention with antithyroid drugs (ATDs) is commonly the first choice of treatment in Korea, the remission rate associated with this approach is not satisfactory. During ATD therapy, low or undetectable serum levels of thyroid-stimulating hormone (TSH) receptor antibodies (TRAbs) have been reported to affect the incidence of Graves disease remission. This study evaluated the correlation between serum 25-hydroxyvitamin D levels and TRAb levels, as well as the effect of 25-hydroxyvitamin D on the recurrence of Graves disease.A total of 143 patients, who were diagnosed with Graves disease and treated with ATDs, were retrospectively included in our observational study. These patients were followed for more than 1 year after ATD discontinuation. The levels of serum 25-hydroxyvitamin D and TRAb (ie, thyroid-stimulating antibody [TSAb], as detected by bioassay, and TSH-binding inhibitory immunoglobulins [TBIIs]) were measured, and a thyroid function test was performed upon ATD discontinuation. Recurrence was evaluated every 3 months, and was defined as an occurrence of overt thyrotoxicosis during the follow-up period.A total of 95 patients (66.4%) experienced recurrence with a median latency period of 182 days (ranging 28-1219 days). The serum 25-hydroxyvitamin D levels at the time of ATD discontinuation were not correlated with either TBII or TSAb. In the Cox proportional hazard regression analysis, higher free T4 levels (>1.4 ng/dL; hazard ratio [HR], 3.252; 95% confidence interval [CI], 1.022-10.347) and low levels of 25-hydroxyvitamin D (≤14.23 ng/mL) were associated with a higher probability of Graves disease recurrence (HR, 3.016; 95% CI, 1.163-7.819).Lower serum 25-hydroxyvitamin D levels were associated with a higher incidence of Graves disease recurrence. Therefore, serum 25-hydroxyvitamin D might be an independent risk factor for predicting Graves disease recurrence after ATD discontinuation.
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Abstract
BACKGROUND Hashimoto's thyroiditis (HT) is considered to be the most common autoimmune disease. It is currently accepted that genetic susceptibility, environmental factors, and immune disorders contribute to its development. With regard to nutritional factors, evidence implicates high iodine intake and deficiencies of selenium and iron with a potential relevance of vitamin D status. To elucidate the role of nutritional factors in the risk, pathogenesis, and treatment of HT, PubMed and the Cochrane Library were searched for publications on iodine, iron, selenium, and vitamin D and risk/treatment of HT. SUMMARY Chronic exposure to excess iodine intake induces autoimmune thyroiditis, partly because highly iodinated thyroglobulin (Tg) is more immunogenic. Recent introduction of universal salt iodization can have a similar, though transient, effect. Selenoproteins are essential to thyroid action. In particular, the glutathione peroxidases protect the thyroid by removing excessive hydrogen peroxide produced for Tg iodination. Genetic data implicate the anti-inflammatory selenoprotein S in HT risk. There is evidence from observational studies and randomized controlled trials that selenium/selenoproteins can reduce thyroid peroxidase (TPO)-antibody titers, hypothyroidism, and postpartum thyroiditis. Iron deficiency impairs thyroid metabolism. TPO, the enzyme responsible for the production of thyroid hormones, is a heme (iron-containing) enzyme which becomes active at the apical surface of thyrocytes only after binding heme. HT patients are frequently iron deficient, since autoimmune gastritis, which impairs iron absorption, is a common co-morbidity. Treatment of anemic women with impaired thyroid function with iron improves thyroid-hormone concentrations, while thyroxine and iron together are more effective in improving iron status. Lower vitamin D status has been found in HT patients than in controls, and inverse relationships of serum vitamin D with TPO/Tg antibodies have been reported. However, other data and the lack of trial evidence suggest that low vitamin D status is more likely the result of autoimmune disease processes that include vitamin D receptor dysfunction. CONCLUSIONS Clinicians should check patients' iron (particularly in menstruating women) and vitamin D status to correct any deficiency. Adequate selenium intake is vital in areas of iodine deficiency/excess, and in regions of low selenium intake a supplement of 50-100 μg/day of selenium may be appropriate.
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Affiliation(s)
- Shiqian Hu
- 1 Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey , Guildford, United Kingdom
- 2 Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Margaret P Rayman
- 1 Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey , Guildford, United Kingdom
- 2 Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an, Shaanxi, China
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66
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Vitamin D deficiency as a risk factor for the development of autoantibodies in patients with ASIA and silicone breast implants: a cohort study and review of the literature. Clin Rheumatol 2017; 36:981-993. [PMID: 28303359 PMCID: PMC5400796 DOI: 10.1007/s10067-017-3589-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/14/2017] [Accepted: 02/21/2017] [Indexed: 01/04/2023]
Abstract
The development of autoimmunity and/or autoimmune diseases is multifactorial. Vitamin D is one of the factors that might play a role. We postulated that both the presence of adjuvants and insufficient levels of vitamin D may result in the development of autoimmunity in patients with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) in relation to silicone implant incompatibility. We measured vitamin D levels in 135 patients with ASIA in relation to silicone implant incompatibility and related findings to the presence of autoantibodies that are commonly used to diagnose systemic autoimmune diseases. Furthermore, we systematically reviewed the literature regarding vitamin D deficiency as a risk factor for the development of autoantibodies. Vitamin D measurements were available for analysis in 131 of 135 patients with ASIA in relation to SIIS. Twenty-three patients (18%) tested positive for autoantibodies, from which 18 patients (78%) had either a vitamin D deficiency or insufficiency (median vitamin D level 60.5 mmol/L), whereas five patients (22%) had sufficient vitamin D levels. The risk to develop autoantibodies was significantly increased in vitamin D deficient and/or insufficient patients [RR 3.14; 95% CI, 1.24–7.95; p = 0.009]. Reviewed literature suggested an association between vitamin D levels and the presence and/or titer levels of autoantibodies in different autoimmune diseases. From our current study and from our review of the literature, we conclude that vitamin D deficiency is related to the presence of autoantibodies. Whether vitamin D supplementation results in a decrease of autoimmunity needs to be studied prospectively.
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Giovinazzo S, Vicchio TM, Certo R, Alibrandi A, Palmieri O, Campennì A, Cannavò S, Trimarchi F, Ruggeri RM. Vitamin D receptor gene polymorphisms/haplotypes and serum 25(OH)D 3 levels in Hashimoto's thyroiditis. Endocrine 2017; 55:599-606. [PMID: 27043843 DOI: 10.1007/s12020-016-0942-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 03/24/2016] [Indexed: 02/07/2023]
Abstract
Vitamin D deficiency and/or reduced function, as per certain polymorphisms of the vitamin D receptor (VDR) gene, have been related to several autoimmune disorders. The present study was aimed to investigate the association of Hashimoto's thyroiditis with vitamin D status and functional polymorphisms (SNPs) of the VDR gene. In this case-control study, 200 euthyroid subjects were enrolled: 100 newly diagnosed HT patients (87 F, 13 M; mean age ± SD 42 ± 15 year) and 100 healthy individuals, matched for age, sex, BMI, and month of blood sampling. Serum 25(OH)D3 was measured by HPLC. The VDR SNPs BsmI, ApaI, and TaqI, in strong linkage disequilibrium with each other, were detected by restriction fragment length polymorphism-PCR. The prevalence of vitamin D deficiency in HT patients was significantly higher than that in the control group (70 vs 18.2 %; p < 0.0001), and median serum 25(OH)D3 level was significantly lower in HT patients than controls (median value: 16.2 vs 37.4 ng/ml; p = 0.026). Moreover, there was a significant inverse correlation between serum 25(OH)D3 and TPOAb concentration (r = -0.669; p = 0.034). Contrarily, the genotype distribution of the studied SNPs was not different in the two groups (BsmI p = 0.783; ApaI p = 0.512; TaqI p = 0.471), as was the allelic frequency [f(B) p = 0.776, f(b) p = 0.887; f(A) p = 0.999, f(a) p = 0.999; f(T) p = 0.617; f(t) p = 0.617]. The present study first investigates newly diagnosed untreated HT and suggests that vitamin D deficiency may contribute to HT development and/or progression, acting as an environmental trigger, while the VDR locus does not appear to be involved in conditioning the genetic susceptibility to the disease, at least in Caucasians.
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Affiliation(s)
- Salvatore Giovinazzo
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico "G. Martino" (Pad H, Floor 4), Via Consolare Valeria, 1, 98125, Messina, Italy
| | - Teresa M Vicchio
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico "G. Martino" (Pad H, Floor 4), Via Consolare Valeria, 1, 98125, Messina, Italy
| | - Rosaria Certo
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico "G. Martino" (Pad H, Floor 4), Via Consolare Valeria, 1, 98125, Messina, Italy
| | | | - Orazio Palmieri
- Casa Sollievo Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - Alfredo Campennì
- Department of Biomedical Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Salvatore Cannavò
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico "G. Martino" (Pad H, Floor 4), Via Consolare Valeria, 1, 98125, Messina, Italy
| | - Francesco Trimarchi
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico "G. Martino" (Pad H, Floor 4), Via Consolare Valeria, 1, 98125, Messina, Italy
- Accademia Peloritana dei Pericolanti, University of Messina, Messina, Italy
| | - Rosaria Maddalena Ruggeri
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico "G. Martino" (Pad H, Floor 4), Via Consolare Valeria, 1, 98125, Messina, Italy.
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68
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Wang X, Cheng W, Ma Y, Zhu J. Vitamin D receptor gene FokI but not TaqI, ApaI, BsmI polymorphism is associated with Hashimoto's thyroiditis: a meta-analysis. Sci Rep 2017; 7:41540. [PMID: 28134349 PMCID: PMC5278388 DOI: 10.1038/srep41540] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 12/22/2016] [Indexed: 02/05/2023] Open
Abstract
Four VD receptor (VDR) gene polymorphisms (TaqI, ApaI, FokI and BsmI) have been reported to influence Hashimoto’s thyroiditis (HT) risk. However, individual studies have produced inconsistent results. We conducted a comprehensive meta-analysis of eleven case-control studies to better understand roles of the four polymorphisms in HT development. The results showed only FokI polymorphism was significantly associated with the risk of HT (F vs f: OR = 1.44, 95% CI = 1.09–1.91, P = 0.010; FF vs Ff + ff: OR = 1.72, 95% CI = 1.09–2.70, P = 0.019). Subgroup analyses demonstrated the significant effect was only present in Asian population (F vs f: OR = 1.45, 95% CI = 1.07–1.95, P = 0.016; FF vs ff: OR = 1.64, 95% CI = 1.03–2.59, P = 0.036; FF + Ff vs ff: OR = 1.34, 95% CI = 1.00–1.80, P = 0.047; FF vs Ff + ff: OR = 1.64, 95% CI = 1.03–2.64, P = 0.039), but not in Caucasian. For TaqI, ApaI and BsmI polymorphisms, no significant association was found in any model comparison. Based on the current literature, it appears that only VDR FokI polymorphism is associated with HT risk in Asian population, but not in Caucasians; and the TaqI, ApaI and BsmI polymorphisms have not positive association neither in the overall population, nor when stratified by ethnicity. Further well-designed studies with larger sample sizes and different ethnic population are needed to clarify the present findings.
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Affiliation(s)
- Xiaofei Wang
- Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chendu, China.,Department of General Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Wenli Cheng
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yu Ma
- Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chendu, China
| | - Jingqiang Zhu
- Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chendu, China
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Ariganjoye R. Pediatric Hypovitaminosis D: Molecular Perspectives and Clinical Implications. Glob Pediatr Health 2017; 4:2333794X16685504. [PMID: 28229097 PMCID: PMC5308534 DOI: 10.1177/2333794x16685504] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 11/26/2016] [Indexed: 12/16/2022] Open
Abstract
Vitamin D, a secosteroid, is essential for the development and maintenance of healthy bone in both the adult and pediatric populations. Low level of 25-hydroxy vitamin D (25-(OH)-D) is highly prevalent in children worldwide and has been linked to various adverse health outcomes including rickets, osteomalacia, osteomalacic myopathy, sarcopenia, and weakness, growth retardation, hypocalcemia, seizure and tetany, autism, cardiovascular diseases, diabetes mellitus, cancers (prostate, colon, breast), infectious diseases (viral, tuberculosis), and autoimmune diseases, such as multiple sclerosis and Hashimoto’s thyroiditis. Risk factors for hypovitaminosis D are people with darker skin pigmentation, use of sunscreen, insufficient ultraviolet B exposure, prematurity, living in northern latitudes, malnutrition, obesity, exclusive breastfeeding, low maternal vitamin D level, certain medications, drinking unfortified cow’s milk, liver failure, chronic renal insufficiency, cystic fibrosis, asthma, and sickle cell hemoglobinopathy. This review highlights and summarizes the molecular perspectives of vitamin D deficiency and its potential adverse health outcomes in pediatric age groups. The recommended treatment regimen is beyond the scope of this review.
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Affiliation(s)
- Rafiu Ariganjoye
- Dr. Sulaiman Al-Habib Medical Group Al Takhassusi Hospital, Riyadh, Kingdom of Saudi Arabia
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70
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Abstract
In this review we summarize recent opinions on the possible role of vitamin D in the risk of thyroid diseases development. It may be concluded from the available data that vitamin D deficiency, particularly levels below 12.5 ng/ml should be considered as an additional, but important risk factor for development of thyroid autoimmunity, both chronic autoimmune thyroiditis and Graves' disease. A higher risk of Graves' disease development is also associated with several polymorphisms in the gene encoding for vitamin D binding protein and for the specific receptor of active form of vitamin D - 1,25-(OH)(2)D(3) in the respective target cells. Important for development of thyroid cancer appeared polymorphisms of genes encoding for vitamin D receptors and of genes encoding for the participating hydroxylating enzymes in thyroid tissue, leading to a diminished local 1,25-(OH)(2)D(3) formation capacity with following alteration of antiproliferatory, antiapoptotic and prodifferentiating efficacy of the latter. Whether supplementation with high doses of vitamin D or its analogues possesses preventive or therapeutic effect is an object of intensive studies.
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Affiliation(s)
- K Vondra
- Institute of Endocrinology, Prague, Czech Republic.
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71
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Şıklar Z, Karataş D, Doğu F, Hacıhamdioğlu B, İkincioğulları A, Berberoğlu M. Regulatory T Cells and Vitamin D Status in Children with Chronic Autoimmune Thyroiditis. J Clin Res Pediatr Endocrinol 2016; 8:276-81. [PMID: 27086659 PMCID: PMC5096490 DOI: 10.4274/jcrpe.2766] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE It is suggested that vitamin D is one of the factors that can regulate the function of Treg cells. In this study, the relationships between Treg cells and vitamin D levels was investigated in pediatric chronic autoimmune thyroiditis (CAT) patients. METHODS Thirty-two children with CAT and 24 healthy subjects were studied. FOXP3 expressing CD4+CD25+high Foxp3+T cells were identified as Treg cells. At diagnosis, 25-hydroxycholecalciferol (25OHD3) levels were determined in all patients. FOXP3 expression was measured before and after vitamin D replacement therapy in patients having low levels of 25OHD3. RESULTS In the CAT patients, Treg cell levels did not differ from the control group, while the frequency of vitamin D deficiency was higher and FOXP3 molecule expression was lower. FOXP3 molecule expression significantly increased in CAT patients having vitamin D deficiency who were given vitamin D replacement. CONCLUSION FOXP3 expression is decreased in pediatric CAT patients. This reduction seems to be associated with vitamin D levels. Vitamin D can play a role in enhancing natural Treg cell functions.
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Affiliation(s)
- Zeynep Şıklar
- Ankara University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey, E-mail:
| | - Deniz Karataş
- Ankara University Faculty of Medicine, Department of Pediatric Immunology-Allergy, Ankara, Turkey
| | - Figen Doğu
- Ankara University Faculty of Medicine, Department of Pediatric Immunology-Allergy, Ankara, Turkey
| | - Bülent Hacıhamdioğlu
- Ankara University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Aydan İkincioğulları
- Ankara University Faculty of Medicine, Department of Pediatric Immunology-Allergy, Ankara, Turkey
| | - Merih Berberoğlu
- Ankara University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
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72
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25 Hydroxyvitamin D Deficiency and Its Relationship to Autoimmune Thyroid Disease in the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13090850. [PMID: 27571093 PMCID: PMC5036683 DOI: 10.3390/ijerph13090850] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 11/17/2022]
Abstract
Background: Low 25(OH) vitamin D levels have been associated with several autoimmune diseases and recently with autoimmune thyroiditis (AT). The aim of the study was to investigate the association of AT with low 25(OH) vitamin D levels in the elderly. Methods: One hundred sixty-eight elderly subjects (mean age: 81.6 ± 9.4 years) were enrolled. Serum levels of 25(OH) vitamin D, anti-thyroid peroxidase (TPO-Ab), anti-thyroglobulin (TG-Ab) antibodies, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured. Results: The prevalence of AT was significantly higher in subjects with vitamin D deficiency (25(OH) vitamin D < 20 ng/mL) when compared with subjects with normal 25(OH) vitamin D (25(OH) vitamin D ≥ 20 ng/mL) levels (28% vs. 8%, respectively, p = 0.002). Patients with AT and vitamin D deficiency had a comparable hormonal profile compared to patients with AT and vitamin D sufficiency in terms of TSH (p = 0.39), FT3 (p = 0.30), FT4 (p = 0.31), TG-Ab (0.44) and TPO-Ab (0.35). Interestingly, a significant correlation between 25(OH) vitamin D and TPO-Ab (r = −0.27, p = 0.03) and FT3 (r = 0.35, p = 0.006) has been found in subjects with AT while no correlation was found between 25(OH) vitamin D levels and TG-Ab (r = −0.15, p = 0.25), TSH (r = −0.014, p = 0.09) and FT4 (r = 0.13, p = 0.32). Conclusions: These findings suggest that vitamin D deficiency was significantly associated with AT in the elderly. Therefore, the screening for AT should be suggested in subjects with vitamin D deficiency.
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73
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Muscogiuri G, Palomba S, Caggiano M, Tafuri D, Colao A, Orio F. Low 25 (OH) vitamin D levels are associated with autoimmune thyroid disease in polycystic ovary syndrome. Endocrine 2016; 53:538-42. [PMID: 26433740 DOI: 10.1007/s12020-015-0745-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 09/16/2015] [Indexed: 12/31/2022]
Abstract
Low 25(OH) vitamin D levels have been associated with several autoimmune diseases and recently with autoimmune thyroid disease (AITD). The aim of the study was to investigate the association of AITD with 25(OH) vitamin D levels in women with polycystic ovary syndrome (PCOS). Fifty women with PCOS were consecutively enrolled and underwent routine health checkups, which included measurements of 25(OH) vitamin D, anti-thyroid peroxidase (TPO-Ab), anti-thyreoglobulin (TG-Ab) antibodies, FT3, FT4, and TSH. Selecting 50 nmol/L as cut-off point, low 25(OH) vitamin D levels were detected in 23 of 50 patients (46 %). AITD was diagnosed when TPO-Ab levels exceeding 80 U/ml and/or TG-Ab levels exceeding 70 U/ml. AITD was detected in 12 of 50 patients (24 %). The levels of 25(OH) vitamin D were significantly lower in women with PCOS and AITD when compared with women with PCOS and without AITD (p = 0.02). In women with AITD no correlation was found between 25(OH) vitamin D and TG-Ab (r = 0.48; p = 0.16), TPO-Ab (r = 0.43; p = 0.21), TSH (r = 0.38; p = 0.27), FT3 (r = -0.40; p = 0.25) and FT4 levels (r = -0.54; p = 0.10). These findings suggest that low levels of 25(OH) vitamin D were significantly associated with AITD in women with PCOS.
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Affiliation(s)
- Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, via S. Pansini 5, 80131, Naples, Italy.
| | - Stefano Palomba
- Department of Obstetrics and Gynecology, IRCCS, Arcispedale S. Maria Nuova of Reggio Emilia, Reggio Emilia, Italy
| | - Mario Caggiano
- SSD Odontoiatria AOU "S. Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Domenico Tafuri
- Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, via S. Pansini 5, 80131, Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
- Endocrinology and Diabetology, Fertility Techniques Structure, University Hospital "S. Giovanni di Dio e Ruggi d'Aragona", Largo Città d'Ippocrate, Salerno, Italy
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Zhou P, Cai J, Markowitz M. Absence of a relationship between thyroid hormones and vitamin D levels. J Pediatr Endocrinol Metab 2016; 29:703-7. [PMID: 26812774 DOI: 10.1515/jpem-2015-0210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 11/23/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vitamin D is an immune modulator that may play a role in thyroid related autoimmunity. METHODS We analyzed a US population based dataset to determine the relationship between serum 25-hydroxyvitamin D (25OHD) and thyroid hormones while assessing the effects of autoimmunity and BMI. RESULTS 25OHD did not correlate significantly with any thyroid related measure. 25OHD levels stratified by thyroid antibody status were not statistically different between antibody positive and negative groups. The mean 25OHD levels of lean, overweight, and obese groups defined by BMI were lower than those of the normal group. Only the mean thyroid stimulating hormone (TSH) value in the obese group was significantly higher than the normal group. CONCLUSIONS We conclude that thyroid related measures and 25OHD serum levels are not related.
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Armanini D, Andrisani A, Ambrosini G, Donà G, Camozzi V, Bordin L, Sabbadin C. Interrelationship Between Vitamin D Insufficiency, Calcium Homeostasis, Hyperaldosteronism, and Autoimmunity. J Clin Hypertens (Greenwich) 2016; 18:614-6. [DOI: 10.1111/jch.12822] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Decio Armanini
- Department of Medicine - Endocrinology (DIMED); University of Padua; Padua Italy
| | | | - Guido Ambrosini
- Department of Women's Health-Salus Pueri; University of Padua; Padua Italy
| | - Gabriella Donà
- Department of Molecular Medicine - Biological Chemistry; University of Padua; Padua Italy
| | - Valentina Camozzi
- Department of Medicine - Endocrinology (DIMED); University of Padua; Padua Italy
| | - Luciana Bordin
- Department of Molecular Medicine - Biological Chemistry; University of Padua; Padua Italy
| | - Chiara Sabbadin
- Department of Medicine - Endocrinology (DIMED); University of Padua; Padua Italy
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Yasmeh J, Farpour F, Rizzo V, Kheradnam S, Sachmechi I. HASHIMOTO THYROIDITIS NOT ASSOCIATED WITH VITAMIN D DEFICIENCY. Endocr Pract 2016; 22:809-13. [PMID: 27018618 DOI: 10.4158/ep15934.or] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Vitamin D deficiency is associated with several autoimmune diseases. This study assessed whether vitamin D deficiency is associated with Hashimoto thyroiditis (HT). METHODS Two groups of patients were selected for which serum 25-hydroxyvitamin D (25(OH)D) levels had been measured: (1) a study group of patients diagnosed with HT as indicated by thyroid antibodies, and (2) a healthy control group. Each group was separated by sex and then controlled for age and body mass index (BMI). Groups' mean 25(OH)D levels were compared by analysis of variance (ANOVA), and percent frequencies of vitamin D sufficiency, insufficiency, and deficiency were compared with a Z-test. The correlations between 25(OH)D levels and thyroid antibodies and thyroid-stimulating hormone (TSH) levels were also tested. RESULTS The mean 25(OH)D levels for the HT and control groups were significantly different in females (30.75 vs. 27.56 ng/mL, respectively) but not in males (14.24 vs. 13.26 ng/mL). HT females had a higher rate of vitamin D sufficiency (51.7% vs. 31.1%) and a lower rate of insufficiency (48.3% vs. 68.9%) relative to control females. No such differences were found in the male groups. None of the females were vitamin D deficient, but almost all males were. A significant (P = .016) positive correlation (rs = 0.436) between 25(OH)D and TPOAb was observed in males. CONCLUSION HT is not associated with higher rates of vitamin D deficiency relative to a control group. ABBREVIATIONS BMI = body mass index HT = Hashimoto thyroiditis 25(OH)D = 25-hydroxyvitamin D TgAb = thyroglobulin antibody TSH = thyroid-stimulating hormone TPOAb = thyroid-peroxidase antibody VDR = Vitamin D receptor.
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77
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Krysiak R, Kowalcze K, Okopien B. The effect of vitamin D on thyroid autoimmunity in non-lactating women with postpartum thyroiditis. Eur J Clin Nutr 2016; 70:637-9. [DOI: 10.1038/ejcn.2015.214] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/10/2015] [Accepted: 11/13/2015] [Indexed: 11/09/2022]
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78
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Bizzaro G, Shoenfeld Y. Vitamin D and thyroid autoimmune diseases: the known and the obscure. Immunol Res 2015; 61:107-9. [PMID: 25403697 DOI: 10.1007/s12026-014-8591-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Giorgia Bizzaro
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 52621, Tel-Hashomer, Tel Aviv, Israel
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79
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Bizzaro G, Shoenfeld Y. Vitamin D and autoimmune thyroid diseases: facts and unresolved questions. Immunol Res 2015; 61:46-52. [PMID: 25407646 DOI: 10.1007/s12026-014-8579-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency (levels lower than 20 ng/ml) is becoming a global health problem, since it is increasingly represented even among healthy subjects. Vitamin D, as an environmental factor, is involved in many biological processes, like perception of chronic pain and response to infections. In recent years, evidence has emerged pointing to an involvement of vitamin D in the development of many autoimmune diseases, and a severe vitamin D deficiency has been especially demonstrated in patients affected with autoimmune thyroid disease (AITD). Low levels of vitamin D were found associated with antithyroid antibody presence, abnormal thyroid function, increased thyroid volume, increased TSH levels, and adverse pregnancy outcome in women with AITD. Vitamin D mediates its effect through binding to vitamin D receptor (VDR), which is harbored on many human immune cells, and in this way is able to modulate immune cells activity, triggering both innate and adaptive immune responses. As VDR gene polymorphisms were found to associate with AITD, the evidence links vitamin D deficiency to AITD either through gene polymorphism or by environmental factors (lack of dietary uptake and sun exposure). Vitamin D supplementation may be offered to AITD patients, but further research is needed to define whether it should be introduced in clinical practice.
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Affiliation(s)
- Giorgia Bizzaro
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 52621, Tel-Hashomer, Tel Aviv, Israel
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80
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Ma J, Wu D, Li C, Fan C, Chao N, Liu J, Li Y, Wang R, Miao W, Guan H, Shan Z, Teng W. Lower Serum 25-Hydroxyvitamin D Level is Associated With 3 Types of Autoimmune Thyroid Diseases. Medicine (Baltimore) 2015; 94:e1639. [PMID: 26426654 PMCID: PMC4616844 DOI: 10.1097/md.0000000000001639] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Autoimmune thyroid diseases (AITD) are common autoimmune disorders. A few studies have analyzed the association between serum vitamin D levels and AITD, and available data remain inconclusive. The aim of this study was to evaluate the association between serum vitamin D levels and 3 types of AITD, that is Graves' disease (GD), Hashimoto's thyroiditis (HT), and postpartum thyroiditis (PPT). Two independent case-control studies were designed. The first is a cross-sectional case-control study in which we examined the levels of 25(OH)D in patients with newly diagnosed GD or HT and in controls; the second is a nested case-control study in which we compared 25(OH)D levels in 610 women who developed PPT during the follow-up after delivery and those who did not. Compared with the controls, GD patients and HT patients had significantly lower 25(OH)D levels. PPT cases also had a lower serum 25(OH)D concentration than controls. Serum 25(OH)D levels were associated with neither antithyroid peroxidase antibody nor antithyroglobulin antibody in GD and HT. There was no significant relationship between thyroid-stimulating hormone and 25(OH)D levels. Every 5 nmol/L increase in serum 25(OH)D concentrations was associated with a 1.55-, 1.62-, and 1.51-fold reduction in GD, HT, and PPT risk, respectively. We observed a lower serum vitamin D levels in AITD patients compared with controls. The lower the vitamin D level is, not vitamin D deficiency per se, the higher the risk for developing AITD will be. However, vitamin D does not have strong association with the titers of thyroid antibodies or the levels of thyroid hormones.
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Affiliation(s)
- Jie Ma
- From the Department of Endocrinology and Metabolism, The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases (JM, DW, CF, NC, JL, YL, RW, WM, HG, ZS, WT), The First Affiliated Hospital of China Medical University; and Department of Gynecology and Obstetrics (CL), Shenyang Women's and Children's Hospital, Shenyang, Liaoning, PR China
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81
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Bellastella G, Maiorino MI, Petrizzo M, De Bellis A, Capuano A, Esposito K, Giugliano D. Vitamin D and autoimmunity: what happens in autoimmune polyendocrine syndromes? J Endocrinol Invest 2015; 38:629-33. [PMID: 25576459 DOI: 10.1007/s40618-014-0233-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 12/18/2014] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the Vitamin D status of patients with a single autoimmune disease and of patients with several autoimmune diseases. METHODS We enrolled 35 patients with isolated type 1 diabetes mellitus (T1DM), 60 with autoimmune polyendocrine syndromes (APS) including T1DM and 72 control subjects. Among patients with APS, 10 were classified as type 2 (Addison's disease + T1DM), whereas the other 50 as type 3 (autoimmune thyroid disease + T1DM + other autoimmune diseases). Vitamin D (25-OHD) levels were assessed by a chemiluminescent immunoassay in all patients and controls on samples drawn in the morning of the same months. RESULTS Both groups of APS and T1DM patients showed 25-OHD levels significantly lower than healthy controls (p < 0.001 for both vs controls), without any significant difference between the two groups (p = 0.80). The highest prevalence of vitamin D deficiency (values <20 ng/ml) was observed in APS type 3 subgroup (8 out of 50 patients, 16%). CONCLUSIONS Patients with APS present reduced vitamin D circulating levels, but the vitamin D status is not different between patients with single or multiple autoimmune diseases. The kind of autoimmune disease, rather than the association of several autoimmune diseases, may influence negatively the levels of vitamin D. Further prospective studies are needed to clarify if impaired vitamin D level is a causal factor in the pathogenesis of autoimmune diseases or a consequence of them.
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Affiliation(s)
- G Bellastella
- Endocrinology and Metabolic Diseases Unit, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Piazza L. Miraglia 2, 80138, Naples, Italy.
| | - M I Maiorino
- Endocrinology and Metabolic Diseases Unit, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Piazza L. Miraglia 2, 80138, Naples, Italy
| | - M Petrizzo
- IOS and Coleman Medicina Futura Medical Center, Centro Direzionale, Naples, Italy
| | - A De Bellis
- Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy
| | - A Capuano
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - K Esposito
- Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
| | - D Giugliano
- Endocrinology and Metabolic Diseases Unit, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Piazza L. Miraglia 2, 80138, Naples, Italy
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82
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Evliyaoğlu O, Acar M, Özcabı B, Erginöz E, Bucak F, Ercan O, Kucur M. Vitamin D Deficiency and Hashimoto's Thyroiditis in Children and Adolescents: a Critical Vitamin D Level for This Association? J Clin Res Pediatr Endocrinol 2015; 7:128-33. [PMID: 26316435 PMCID: PMC4563184 DOI: 10.4274/jcrpe.2011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Vitamin D has been suggested to be active as an immunomodulator in autoimmune diseases such as Hashimoto's thyroiditis (HT). The goal of the present study was to investigate the vitamin D status in HT patients. METHODS This prevalence case-control study was conducted on 90 patients with HT (of ages 12.32 ± 2.87 years) and 79 age-matched healthy controls (11.85 ± 2.28 years). Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were measured in all 169 subjects. RESULTS The prevalence of vitamin D deficiency in HT patients (64 of 90; 71.1%) was significantly higher than that in the control group (41 of 79; 51.9%) (p=0.025). Mean serum 25(OH)D3 level in the HT group was significantly lower compared to the control group (16.67 ± 11.65 vs. 20.99 ± 9.86 ng/mL, p=0.001). HT was observed 2.28 times more frequently in individuals with 25(OH)D3 levels <20 ng/mL (OR: 2.28, CI: 1.21-4.3). CONCLUSION Vitamin D deficiency is associated with HT in children and adolescents. Levels lower than 20 ng/mL seem to be critical. The mechanism for this association is not clear.
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Affiliation(s)
- Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 533 633 15 64 E-mail:
| | - Manolya Acar
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Ethem Erginöz
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Public Health, İstanbul, Turkey
| | - Feride Bucak
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Mine Kucur
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Biochemistry, İstanbul, Turkey
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83
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Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients 2015; 7:2485-98. [PMID: 25854833 PMCID: PMC4425156 DOI: 10.3390/nu7042485] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 02/10/2015] [Accepted: 03/16/2015] [Indexed: 01/13/2023] Open
Abstract
Although emerging evidence suggests that low levels of vitamin D may contribute to the development of autoimmune disease, the relationship between vitamin D reduction and autoimmune thyroid disease (AITD), which includes Graves’ disease (GD) and Hashimoto thyroiditis (HT), is still controversial. The aim was to evaluate the association between vitamin D levels and AITD through systematic literature review. We identified all studies that assessed the association between vitamin D and AITD from PubMed, Embase, CENTRAL, and China National Knowledge Infrastructure (CNKI) databases. We included studies that compared vitamin D levels between AITD cases and controls as well as those that measured the odds of vitamin D deficiency by AITD status. We combined the standardized mean differences (SMD) or the odds ratios (OR) in a random effects model. Twenty case-control studies provided data for a quantitative meta-analysis. Compared to controls, AITD patients had lower levels of 25(OH)D (SMD: −0.99, 95% CI: −1.31, −0.66) and were more likely to be deficient in 25(OH)D (OR 2.99, 95% CI: 1.88, 4.74). Furthermore, subgroup analyses result showed that GD and HT patients also had lower 25(OH)D levels and were more likely to have a 25(OH)D deficiency, suggesting that low levels of serum 25(OH)D was related to AITD.
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84
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Djurovic J, Stojkovic O, Ozdemir O, Silan F, Akurut C, Todorovic J, Savic K, Stamenkovic G. Association betweenFokI,ApaIandTaqIRFLP polymorphisms in VDR gene and Hashimoto's thyroiditis: preliminary data from female patients in Serbia. Int J Immunogenet 2015; 42:190-4. [PMID: 25817800 DOI: 10.1111/iji.12199] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 03/05/2015] [Indexed: 01/22/2023]
Affiliation(s)
- J. Djurovic
- Institute of Forensic Medicine; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - O. Stojkovic
- Institute of Forensic Medicine; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - O. Ozdemir
- Department of Medical Genetics; Faculty of Medicine; Cumhuriyet University; Sivas Turkey
- Department of Medical Genetics; Faculty of Medicine; Canakkale Onsekiz Mart University; Canakkale Turkey
| | - F. Silan
- Department of Medical Genetics; Faculty of Medicine; Canakkale Onsekiz Mart University; Canakkale Turkey
| | - C. Akurut
- Department of Medical Genetics; Faculty of Medicine; Canakkale Onsekiz Mart University; Canakkale Turkey
| | - J. Todorovic
- Private Consulting Room ‘Thyreomedicus’; Belgrade Serbia
| | - K. Savic
- Institute of Forensic Medicine; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - G. Stamenkovic
- Institute of Biological Research ‘Sinisa Stankovic’; University of Belgrade; Belgrade Serbia
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85
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Abstract
AbstractObjectiveLow iodine intake during pregnancy may cause thyroid dysfunction, which results in inadequate fetal brain development. In the absence of a universal salt iodization programme, we conducted a nationwide survey of iodine deficiency in pregnant women in Latvia.DesignA countrywide twenty-cluster survey, with at least twenty women per cluster. Participants completed a questionnaire on dietary habits concerning iodine intake (n 739). Thyroid function (thyroid-stimulating hormone, free thyroxine and thyroperoxidase antibodies) was measured (n 550). Urinary iodine was measured using the ammonium persulfate method (n 696).SettingThe survey was performed in all regions of Latvia during the spring and autumn seasons in 2013.SubjectsPregnant women (n 829).ResultsThe median creatinine (Cr)-standardized urinary iodine concentration (UIC) was 80·8 (interquartile range (IQR) 46·1–130·6) µg/g Cr or 69·4 (IQR 53·9–92·6) µg/l during pregnancy, and 81 % of pregnant women had UIC levels below the WHO recommended range of 150–250 µg/g Cr. The UIC was lowest during the first trimester of pregnancy, 56·0 (IQR 36·4–100·6) µg/g Cr, reaching higher concentrations of 87·5 (IQR 46·4–141·7) µg/g Cr and 86·9 (IQR 53·8–140·6) µg/g Cr in the second and third trimesters, respectively. Women taking supplements containing ≥150 µg iodine (6·8 % of respondents) had non-significantly higher UIC than did women without supplementation (96·2 v. 80·3 µg/g Cr, respectively, P=NS). Thyroperoxidase antibody concentration did not correlate significantly with UIC: Spearman’s ρ=−0·012, P=0·78.ConclusionsThe median UIC indicates iodine deficiency in pregnant women in Latvia. Iodine supplementation (150 µg daily) and regular UIC monitoring should be suggested to overcome iodine deficiency and to reach the recommended levels without inducing autoimmune processes.
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86
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Toubi E. Diagnostics and environmental factors. Immunol Res 2015; 61:104-6. [PMID: 25550084 DOI: 10.1007/s12026-014-8611-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Elias Toubi
- Division of Allergy and Clinical Immunology, Faculty of Medicine, Technion, Haifa, Israel,
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87
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Toulis K, Tsekmekidou X, Potolidis E, Didangelos T, Gotzamani-Psarrakou A, Zebekakis P, Daniilidis M, Yovos J, Kotsa K. Thyroid Autoimmunity in the Context of Type 2 Diabetes Mellitus: Implications for Vitamin D. Int J Endocrinol 2015; 2015:710363. [PMID: 26078759 PMCID: PMC4452355 DOI: 10.1155/2015/710363] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 12/29/2014] [Indexed: 11/17/2022] Open
Abstract
Vitamin D deficiency has been associated with both type 2 diabetes mellitus (T2DM) and autoimmune disorders. The association of vitamin D with T2DM and thyroid autoimmunity (TAI) has not been investigated. Thus, we aimed to explore the putative association between T2DM and thyroid autoimmunity (TAI) focusing on the role of 25-hydroxy-vitamin D (25(OH)D). Study population included 264 T2DM patients and 234 controls. To explore the potential association between 25(OH)D and thyroid autoimmunity while controlling for potential confounders-namely, age, gender, body mass index, and presence of T2DM-multivariate logistic regression analyses were undertaken. Patients with T2DM were younger (P < 0.001) and had significantly lower 25(OH)D levels (P < 0.001) and higher anti-TPO titers (P = 0.005). Multivariable logistic regression analyses suggested that T2DM and 25(OH)D levels were significantly associated with the presence of thyroid autoimmunity. In an elderly population of diabetic patients and controls with a high prevalence of vitamin D deficiency/insufficiency, a patient with T2DM was found to be 2.5 times more likely to have thyroid autoimmunity compared to a nondiabetic individual and the higher the serum 25(OH)D levels were, the higher this chance was.
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Affiliation(s)
- Konstantinos Toulis
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Xanthippi Tsekmekidou
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Evangelos Potolidis
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Triantafyllos Didangelos
- First Propaedeutic Department of Internal Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | | | - Pantelis Zebekakis
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Michael Daniilidis
- First Department of Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - John Yovos
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Kalliopi Kotsa
- Diabetes Center, Department of Endocrinology and Metabolism, AHEPA University Hospital, 54636 Thessaloniki, Greece
- *Kalliopi Kotsa:
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88
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Wang X, Zynat J, Guo Y, Osiman R, Tuhuti A, Zhao H, Abdunaimu M, Wang H, Jin X, Xing S. Low Serum Vitamin D Is Associated with Anti-Thyroid-Globulin Antibody in Female Individuals. Int J Endocrinol 2015; 2015:285290. [PMID: 26681939 PMCID: PMC4670662 DOI: 10.1155/2015/285290] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/16/2015] [Accepted: 09/30/2015] [Indexed: 01/09/2023] Open
Abstract
Objectives. Some evidence has pointed out that vitamin D plays a significant role in reducing the incidence of autoimmune diseases, especially autoimmune thyroid diseases. The authors aimed to examine the relationship between circulating 25-hydroxyvitamin D and thyroid autoantibody in a population-based health survey of Xinjiang Chinese population. Subjects and Methods. A total of 1714 Chinese adults were analyzed. 25(OH)D, anti-thyroid antibodies, and thyroid function were measured. Results. The prevalence of vitamin D insufficiency was 28.3% in Hans and 9.3% in Uyghurs, and the prevalence of vitamin D deficiency was 61.6% in Hans and 87.6% in Uyghurs. Overall prevalence of TgAb positivity was 6.2% (0.9% males; 5.3% females). In female subjects, mean serum 25(OH)D levels were significantly lower in Hans and Uyghurs compared with males, and the difference was statistically significant. Importantly, after adjusting for age and ethnicity, a negative correlation (r = -0.121, P = 0.014) was recognized between 25(OH)D and TgAb levels only in female subjects. Conclusion. Vitamin D insufficiency and deficiency are prevalent among Chinese adults. Low serum 25(OH)D is related to the presence of TgAb in females. The causal effect of low vitamin D level on thyroid autoimmunity should be studied further more.
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Affiliation(s)
- Xinling Wang
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
| | - Jazyra Zynat
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
| | - Yanying Guo
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
- *Yanying Guo:
| | - Reziwan Osiman
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
| | - Aihemaitjan Tuhuti
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
| | - Hongli Zhao
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
| | - Munira Abdunaimu
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
| | - Huili Wang
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
| | - Xiaoping Jin
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
| | - Shuqing Xing
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830000, China
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Krysiak R, Kowalska B, Okopien B. Serum 25-Hydroxyvitamin D and Parathyroid Hormone Levels in Non-Lactating Women with Post-Partum Thyroiditis: The Effect of L-Thyroxine Treatment. Basic Clin Pharmacol Toxicol 2014; 116:503-7. [PMID: 25395280 DOI: 10.1111/bcpt.12349] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/06/2014] [Indexed: 12/13/2022]
Abstract
Vitamin D deficiency seems to be implicated in the onset and progression of some autoimmune disorders. No previous study has investigated vitamin D homeostasis in post-partum thyroiditis. We compared 25-hydroxyvitamin D and parathyroid hormone (PTH) levels between four groups of non-lactating women who gave birth within 12 months before the beginning of the study: hypothyroid women with post-partum thyroiditis (group A; n = 14), euthyroid females with post-partum thyroiditis (group B; n = 14), women with non-autoimmune hypothyroidism (group C; n = 16) and healthy euthyroid females without thyroid autoimmunity (group D; n = 15). In the second part of the study, groups A and C were treated for 6 months with L-thyroxine. Serum levels of 25-hydroxyvitamin D were lower, while PTH higher in patients with post-partum thyroiditis than in patients without thyroid autoimmunity. They were also lower (25-hydroxyvitamin D) or higher (PTH) in group A than in group B, as well as in group C in comparison with group D. L-thyroxine treatment increased 25-hydroxyvitamin D and reduced PTH levels only in hypothyroid women with post-partum thyroiditis. Baseline levels of 25-hydroxyvitamin D correlated with thyroid antibody titres, thyroid function and circulating PTH levels, while the effect of L-thyroxine on serum levels of this vitamin correlated with the changes in thyroid antibody titres and PTH levels. The results of our study suggest the association of vitamin D status with post-partum thyroiditis and L-thyroxine treatment of this disorder.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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90
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Vitamin D deficiency is related to thyroid antibodies in autoimmune thyroiditis. Cent Eur J Immunol 2014; 39:493-7. [PMID: 26155169 PMCID: PMC4439962 DOI: 10.5114/ceji.2014.47735] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 10/15/2014] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION It has been known that vitamin D has some immunomodulatory effects and in autoimmune thyroid diseases, vitamin D deficiency was more prevalent. In this study, our aim was to investigate the relationship between thyroid autoantibodies and vitamin D. MATERIAL AND METHODS Group 1 and 2 consisted of 254 and 27 newly diagnosed Hashimoto's thyroiditis (HT) and Graves' disease (GD) cases, respectively; age-matched 124 healthy subjects were enrolled as controls (group 3). All subjects (n = 405) were evaluated for 25OHD and thyroid autoantibody [anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-tg)] levels. RESULTS Group 2 and group 1 patients had lower 25OHD levels than group 3 subjects 14.9 ±8.6 ng/ml, 19.4 ±10.1 ng/ml and 22.5 ±15.4 ng/ml, respectively (p < 0.001). Serum 25OHD levels inversely correlated with anti-tg (r = -0.136, p = 0.025), anti-TPO (r = -0.176, p = 0.003) and parathormone (PTH) (r = -0.240, p < 0.001). Group 2 patients had higher anti-tg and anti-TPO levels than group 1 and 3 (p < 0.001). CONCLUSIONS In this study, we found that patients with autoimmune thyroid disease (AITD) present with lower vitamin D levels and GD patients have higher prevalence. Since we found an inverse correlation between vitamin D levels and thyroid antibody levels, we may suggest that vitamin D deficiency is one of the potential factors in pathogenesis of autoimmune thyroid disorders.
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91
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Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients. Sci Rep 2014; 4:7371. [PMID: 25487609 PMCID: PMC5376985 DOI: 10.1038/srep07371] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/03/2014] [Indexed: 12/27/2022] Open
Abstract
Uremia results in a relatively immunocompromised status, and patients under chronic dialysis have an elevated risk of developing herpes zoster (HZ). We sought to investigate the relationship between vitamin D status and immunity to varicella-zoster virus (VZV). A multicenter prevalent hemodialysis cohort was assembled between 2012 and 2013. We assayed the biochemical parameters, 25-hydroxy- (25-OH-D) and 1,25-dihydroxyvitamin D, vitamin D-binding protein levels in the sera. VZV immunity was quantitated using VZV-specific glycoprotein IgG and IgM titers. Eighty-eight patients were enrolled and their sera were analyzed. Chronic hemodialysis patients with 25-OH-D < 30 ng/ml (insufficiency or deficiency) had significantly lower VZV-IgG than those with sufficient 25-OH-D (p = 0.04). This discrepancy became more prominent if active vitamin D users alone were analyzed (p = 0.01). Generalized additive modeling showed that those with 25-OH-D higher than 27.8 ng/ml or bioavailable 25-OH-D higher than 3.88 ng/ml had significantly higher VZV-IgG levels than those with lower values. Linear regression suggested that both total and bioavailable 25-OH-D were significantly associated with higher VZV-IgG levels (p = 0.003 [total] and 0.01 [bioavailable]), whereas patients with cancer had lower VZV-IgG. Vitamin D may therefore be a potentially useful choice for raising VZV immunity in chronic dialysis patients.
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92
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Moon HW, Chung HJ, Hur M, Yun YM. Vitamin D status and thyroid autoimmunity in Korean pregnant women. J Matern Fetal Neonatal Med 2014; 28:2210-3. [DOI: 10.3109/14767058.2014.982530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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D'Aurizio F, Villalta D, Metus P, Doretto P, Tozzoli R. Is vitamin D a player or not in the pathophysiology of autoimmune thyroid diseases? Autoimmun Rev 2014; 14:363-9. [PMID: 25308530 DOI: 10.1016/j.autrev.2014.10.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 09/22/2014] [Indexed: 01/12/2023]
Abstract
1,25-Dihydroxyvitamin D is a steroid hormone derived from vitamin D, playing an important role in maintaining an adequate serum level of calcium and phosphorus. It is now clear that vitamin D exerts an endocrine action on the cells of the immune system, generating anti-inflammatory and immunoregulatory effects. The mechanisms underlying the role of vitamin D in autoimmunity are not completely understood. Lower vitamin D levels have been found in several autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, type 1 diabetes mellitus, multiple sclerosis, inflammatory bowel diseases, autoimmune thyroid diseases (i.e. Hashimoto's thyroiditis and Graves' disease) and autoimmune gastritis. Several genetic studies have demonstrated an association between thyroid autoimmunity susceptibility and gene polymorphisms of vitamin D receptor, vitamin D binding protein, 1-alpha-hydroxylase and 25-hydroxylase. Of note, some papers do not confirm this connection. With regard to the role of vitamin D in autoimmune thyroid diseases, available data remain controversial. Only few reports have analyzed the supposed association between autoimmune thyroid diseases and vitamin D concentration with inconclusive results. In our experience, low serum levels of vitamin D do not correlate either with Hashimoto's thyroiditis or with Graves' disease. The inability to achieve an unambiguous conclusion is in part due to the limitations in study design. In fact, most of the studies are cross-sectional surveys with a small number of subjects. In addition, the heterogeneity of the study population, seasonal variation of blood sampling, inter-method analytical variability of vitamin D assays and different definitions of vitamin D deficiency/insufficiency contribute to contradicting results. Therefore, further randomized, controlled, prospective trials are needed in order to demonstrate the causality of vitD in AITD and consequently the role of vitamin D supplementation in prevention or improvement of AITD, providing also information on the best formulation, dose and timing of supplementation.
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Affiliation(s)
- Federica D'Aurizio
- Clinical Pathology Laboratory, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy
| | - Danilo Villalta
- Allergology and Immunology, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy
| | - Paolo Metus
- Clinical Pathology Laboratory, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy
| | - Paolo Doretto
- Clinical Pathology Laboratory, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy
| | - Renato Tozzoli
- Clinical Pathology Laboratory, Department of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone, Italy.
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94
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Muscogiuri G, Mitri J, Mathieu C, Badenhoop K, Tamer G, Orio F, Mezza T, Vieth R, Colao A, Pittas A. Mechanisms in endocrinology: vitamin D as a potential contributor in endocrine health and disease. Eur J Endocrinol 2014; 171:R101-10. [PMID: 24872497 DOI: 10.1530/eje-14-0158] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE It has been suggested that vitamin D may play a role in the pathogenesis of several endocrine diseases, such as hyperparathyroidism, type 1 diabetes (T1DM), type 2 diabetes (T2DM), autoimmune thyroid diseases, Addison's disease and polycystic ovary syndrome (PCOS). In this review, we debate the role of vitamin D in the pathogenesis of endocrine diseases. METHODS Narrative overview of the literature synthesizing the current evidence retrieved from searches of computerized databases, hand searches and authoritative texts. RESULTS Evidence from basic science supports a role for vitamin D in many endocrine conditions. In humans, inverse relationships have been reported not only between blood 25-hydroxyvitamin D and parathyroid hormone concentrations but also with risk of T1DM, T2DM, and PCOS. There is less evidence for an association with Addison's disease or autoimmune thyroid disease. Vitamin D supplementation may have a role for prevention of T2DM, but the available evidence is not consistent. CONCLUSIONS Although observational studies support a potential role of vitamin D in endocrine disease, high quality evidence from clinical trials does not exist to establish a place for vitamin D supplementation in optimizing endocrine health. Ongoing randomized controlled trials are expected to provide insights into the efficacy and safety of vitamin D in the management of endocrine disease.
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Affiliation(s)
- Giovanna Muscogiuri
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Joanna Mitri
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Chantal Mathieu
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Klaus Badenhoop
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Gonca Tamer
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Francesco Orio
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, CanadaDepartment of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Teresa Mezza
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Reinhold Vieth
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, CanadaDepartment of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Annamaria Colao
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Anastassios Pittas
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
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Mansournia N, Mansournia MA, Saeedi S, Dehghan J. The association between serum 25OHD levels and hypothyroid Hashimoto's thyroiditis. J Endocrinol Invest 2014; 37:473-6. [PMID: 24639121 DOI: 10.1007/s40618-014-0064-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 02/11/2014] [Indexed: 01/14/2023]
Abstract
BACKGROUND Vitamin D is shown to be a potent immunomodulator. Considering the potential role of low serum vitamin D levels in autoimmune disorder, we evaluated the association between Hashimoto's thyroiditis (HT) (with subclinical or overt hypothyroidism) and serum 25-hydroxyvitamin D (25OHD) levels in an Iranian population. METHODS A total number of 86 individuals were enrolled. The case group included 41 patients with hypothyroid HT (overt or subclinical). The control group comprised 45 healthy euthyroid persons. Serum 25OHD levels were measured in all subjects. THE CASE control ratio of geometric means of 25OHD levels was 0.66 (95 % CI: 0.49-0.90; P = 0.008). There was a significant inverse association between serum 25OHD levels and HT (OR: 0.81 for 5 ng/ml increase in 25OHD level, 95 % CI: 0.68-0.96; P = 0.018). This association remained significant after adjustment for potential confounding factors including age, sex and BMI. CONCLUSIONS Our study suggested that higher serum 25OHD levels was associated with decreased risk of HT so that each 5 ng/ml increase in the serum 25OHD levels results in 19 % decrease in odds of HT.
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Affiliation(s)
- Nasrin Mansournia
- Department of Endocrinology, AJA University of Medical Sciences, Tehran, Iran
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96
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Choi YM, Kim WG, Kim TY, Bae SJ, Kim HK, Jang EK, Jeon MJ, Han JM, Lee SH, Baek JH, Shong YK, Kim WB. Low levels of serum vitamin D3 are associated with autoimmune thyroid disease in pre-menopausal women. Thyroid 2014; 24:655-61. [PMID: 24320141 PMCID: PMC3993051 DOI: 10.1089/thy.2013.0460] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Low serum vitamin D levels have been associated with several autoimmune diseases, but their association with thyroid autoimmunity is unclear. We evaluated the association of serum vitamin D levels with the prevalence of autoimmune thyroid disease (AITD). METHODS Our cross-sectional study included subjects who underwent routine health checkups, which included assays of serum 25-hydroxy vitamin D3 [25(OH)D3] and anti-thyroid peroxidase antibody (TPO-Ab), as well as thyroid ultrasonography (US) between 2008 and 2012 at the Asan Medical Center. We defined AITD according to the levels of TPO-Ab and US findings. RESULTS A total of 6685 subjects (58% male; 42% female) were enrolled for this study. Overall prevalence of TPO-Ab positivity and both TPO-Ab/US positivity were 10.1% (6.3% male; 15.3% female) and 5.4% (2.3% male; 9.7% female) respectively. In female subjects, mean serum 25(OH)D3 levels were significantly lower in the TPO-Ab(+) (22.0 vs. 23.5 ng/mL, p=0.030) and TPO-Ab(+)/US(+) groups (21.6 vs. 23.4 ng/mL, p=0.027) compared with the control group, respectively. According to the levels of serum 25(OH)D3, the prevalence of TPO-Ab positivity (21.2%, 15.5%, and 12.6% in deficient, insufficient, and sufficient group, respectively; p=0.001) and both TPO-Ab and US positivity (14.7%, 9.9%, and 7.1% in deficient, insufficient, and sufficient group, respectively; p<0.001) decreased in female subjects. Interestingly, this pattern was significant only in pre-menopausal women (p=0.003 and p<0.001; respectively), but not in postmenopausal women. Multivariate analysis indicated that the adjusted odds ratios (OR) for AITD among those in the 25(OH)D3-deficient [TPO-Ab(+): OR 1.95, p=0.001; TPO-Ab(+)/US(+): OR 2.36, p<0.001] and -insufficient groups [TPO-Ab(+): OR 1.31, p=0.043; TPO-Ab(+)/US(+): OR 1.50, p=0.017] were significantly increased when compared with the sufficient group. CONCLUSIONS The levels of serum vitamin D were significantly lower in pre-menopausal women with AITD. Vitamin D deficiency and insufficiency were significantly associated with AITD in pre-menopausal women.
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Affiliation(s)
- Yun Mi Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Jin Bae
- Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong-Kyu Kim
- Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Kyung Jang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Min Han
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Hun Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Hwan Baek
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Kee Shong
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Impact of vitamin D supplementation on health-care use in a 25-hydroxyvitamin D-tested population in France: a population-based descriptive cohort study. Public Health Nutr 2014; 18:554-61. [PMID: 24685254 DOI: 10.1017/s136898001400038x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Chronic vitamin D deficiency has been associated in some patients with diffuse musculoskeletal pain. These unspecific symptoms may partly explain why vitamin D deficiency is often diagnosed late. Our aim was to analyse health-care claims after vitamin D supplementation in patients likely to have vitamin D deficiency. DESIGN Ambulatory health-care claims were compared before and after a vitamin D supplementation prescribed following a 25-hydroxyvitamin D assay. SETTING Health Insurance Fund (FHIF) database of the Rhône-Alpes area, France. SUBJECTS Among patients reimbursed for a 25-hydroxyvitamin D assay between 1 December 2008 and 31 January 2009, those supplemented with vitamin D after the assay were matched on the date of assay to patients who did not receive vitamin D. RESULTS Among the 3023 patients who had a 25-hydroxyvitamin D assay, 935 were consequently supplemented and matched to 935 patients not supplemented. Their median age was 50·0 and 49·5 years, respectively. Patients supplemented decreased their muscle relaxant consumption whereas no change was observed in the reference group, the difference between the two groups was significant (P=0·03). Second and third Pain Relief Ladder prescriptions decreased in both groups but not significantly differently between groups (P=0·58). There was a decrease in prescriptions of biological examination in both groups with no significant difference. CONCLUSIONS Besides a decrease in muscle relaxant prescriptions in the supplemented group, it was difficult to assess the impact of vitamin D supplementation in patients likely to have vitamin D deficiency. Prospective cohort studies and randomized trials are needed to assess the efficiency of screening and supplementing vitamin D deficiency.
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98
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Vitamin D3 levels and insulin resistance in papillary thyroid cancer patients. Med Oncol 2013; 30:589. [PMID: 23645546 DOI: 10.1007/s12032-013-0589-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 04/23/2013] [Indexed: 12/14/2022]
Abstract
Both insulin resistance (IR) and vitamin D deficiency (VDD) are found to be associated with many cancer types. In this study, we evaluated the presence of IR and VDD in thyroid cancer patients based on controls. Total 344 papillary thyroid cancer and 116 controls were part of the study. Glucose, insulin, homeostasis model analysis-insulin resistance (HOMA-IR) (control group 2.12 ± 0.9 and patient group 3.6 ± 1.1; p < 0.0001), LDL were significantly high; HOMA-S and vitamin D3 levels (control group 19.11 ± 8 and patient group 17 ± 16; p = 0.004) were significantly low in the patient group. Vitamin D deficiency (64/108 in controls vs 166/235; p = 0.026) and insulin resistance (24/108; 115/235; p < 0.0001) were more frequent in papillary thyroid cancer patients. After regression analysis, tumor diameter showed significant association with log-HOMA-IR (B = 0.315; p = 0.017) and log-vitamin D3 (B = 0.207; p = 0.04). Vitamin D deficiency and insulin resistance frequencies show no difference between micro- and macropapillary thyroid cancers. Receiver operating characteristic curve shows the best cutoff point for tumor diameter showing that the presence of lymph node metastasis was 0.65 cm with 81.2 % sensitivity and 52 % specificity. Best cutoff point for the capsular invasion tumor diameter was 0.75 cm with 83.3 % sensitivity and 60.4 % specificity. No difference between follicular and classical type papillary thyroid carcinomas has been yet discovered. As a result, thyroid cancer patients are more insulin resistant and vitamin D3 deficient. Vitamin D3 levels and HOMA-IR index may affect tumor diameter. Tumor size that is lower than 1 cm (0.65-0.75 cm) may be related with capsular invasion and lymph node involvement.
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99
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Ginanjar E, Sumariyono, Setiati S, Setiyohadi B. Vitamin D and autoimmune disease. ACTA MEDICA INDONESIANA 2007. [PMID: 17699936 DOI: 10.5772/intechopen.89707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Vitamin D as a part of the endocrine system is an important component in the interaction between the kidney, bone, parathyroid hormone, and the intestine, which maintains extracellular calcium level within normal limits, in order to keep the vital physiologic process and skeletal integrity. Vitamin D is also associated with hypertension, muscular function, immunity, and ability to encounter infection, autoimmune disease, and cancer. The role of vitamin D in immunity is a feedback reaction of paracrine to eliminate inflammation or to influence CD4 T-cell differentiation and or to increase the function of T suppressor cell or combination between both. The active form of vitamin D produces and maintains self immunologic tolerance, some studies show that 1,25(OH)2D inhibits induction of disease in autoimmune encephalomyelitis, thyroiditis, type-1 diabetes mellitus, inflammatory bowel disease (IBD), systemic lupus erythematosus, and collagen-induced arthritis and Lyme arthritis.
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Affiliation(s)
- Eka Ginanjar
- Department of Internal Medicine, Faculty of Medicine, University of Indonesia, dr. Cipto Mangunkusumo Hospital, Jakarta
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