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Yu Y, Yang X, Wu J, Shangguan X, Bai S, Yu R. A Mendelian randomization study of the effect of serum 25-hydroxyvitamin D levels on autoimmune thyroid disease. Front Immunol 2024; 14:1298708. [PMID: 38259461 PMCID: PMC10800945 DOI: 10.3389/fimmu.2023.1298708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Objective The influence of vitamin D on autoimmune thyroid disease (AITD) remains a subject of ongoing debate. This study employs Mendelian randomization (MR) to investigate the causal correlations of serum 25-hydroxyvitamin D (25[OH]D) levels with autoimmune thyroiditis (AIT), autoimmune hyperthyroidism (AIH), and Graves disease (GD). Methods Data on single nucleotide polymorphisms related to serum 25(OH)D levels, AIT, AIH, and GD were sourced from UK Biobank and FinnGen. Inverse variance weighted, MR-Egger, and weighted median were employed to test the exposure-outcome causal relationship. Assessments of horizontal pleiotropy, heterogeneity, and stability were performed using the MR-Egger intercept, Cochran's Q test, and leave-one-out sensitivity analysis, respectively. Results The results of MR analysis showed increased serum 25(OH)D levels was associated with a reduced risk of AIT (OR 0.499, 95% CI 0.289 to 0.860, p = 0.012) but not causal associated with AIH (OR 0.935, 95% CI 0.695 to 1.256, p = 0.654) and GD (OR 0.813, 95% CI 0.635 to 1.040, p = 0.100). Intercept analysis showed no horizontal pleiotropy (p > 0.05), and Cochran's Q test showed no heterogeneity (p > 0.05). Sensitivity analysis suggested that these results were robust. Conclusion An increased serum 25(OH)D level is associated with AIT risk reduction but unrelated to AIH and GD. This finding suggests that vitamin D supplementation can be valuable for preventing and treating AIT.
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Affiliation(s)
- Yunfeng Yu
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xinyu Yang
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jingyi Wu
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xueli Shangguan
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Siyang Bai
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Rong Yu
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
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Zhang M, Ni W, Zhang L, Fan K, Sun Y, Liu C, Xu S. Age-specific association between thyroid autoimmunity and hypothyroidism in Chinese adults aged over 65 years: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1216308. [PMID: 37564984 PMCID: PMC10410462 DOI: 10.3389/fendo.2023.1216308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/05/2023] [Indexed: 08/12/2023] Open
Abstract
Background The correlation between thyroid autoimmune (TAI) disease and hypothyroidism in the elderly of different ages remains unclear. This study aimed to investigate the epidemiological characteristics of hypothyroidism, including subclinical hypothyroidism (Shypo) and overt hypothyroidism (Ohypo) in those aged ≥65 years from iodine-adequate areas and reveal the correlation between TAI and hypothyroidism in the elderly of different ages. Methods It was a cross-sectional study involving 2,443 subjects aged ≥65 years from two iodine-adequate areas in China by cluster sampling. They were assigned to the 65-69-, 70-79-, and ≥80-year-old age group. All subjects were surveyed by questionnaires and received physical examinations, laboratory testing, and thyroid ultrasound. Epidemiological characteristics of thyroid diseases in the elderly were compared among the three groups. Risk factors for hypothyroidism were predicted by binary logistic regression analysis. Results The median urinary iodine level was 238.70 (197.00, 273.70) μg/L. Thyroid peroxidase antibody or thyroglobulin antibody positivity (11.87%) and Shypo (9.13%) were common in the elderly. The prevalence of hypothyroidism in the elderly increases with age. TAI was a risk factor for Shypo (OR, 1.94; 95% CI, 1.35, 2.80; p < 0.01) and Ohypo (OR, 7.64; 95% CI, 3.40, 17.19; p < 0.01) in elderly Chinese. There was an age-specific correlation between TAI and hypothyroidism in the elderly. However, a significant correlation was not identified between TAI and hypothyroidism in ≥80-year-old age group (p > 0.05). Conclusion Hypothyroidism, particularly Shypo, is common in the elderly from iodine-adequate areas in China. TAI serves as a risk factor for hypothyroidism in the elderly, with an age-specific correlation with hypothyroidism.
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Affiliation(s)
- Mengjie Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Wenjing Ni
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Lina Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Kuanlu Fan
- Department of Endocrinology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yu Sun
- Department of Endocrinology and Metabolism, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Chao Liu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- Key Laboratory of Traditional Chinese Medicine Syndrome and Treatment of Yingbing (Thyroid Disease) of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Shuhang Xu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
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Shimmi SC, Eldosouky HF, Hossain Parash MT, Wan Saudi WS. Probability of Concurrent Deficiency of Vitamin D and Iron in Hypothyroidism: A Cross-Sectional Study. Cureus 2023; 15:e37152. [PMID: 37153231 PMCID: PMC10161284 DOI: 10.7759/cureus.37152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Hypothyroidism is the most common pathophysiological condition that affects mostly females in both developed and developing countries. Data on hypothyroidism among adult females are essential to understand the underactive status of the thyroid gland among the female population and its correlated effects on a deficiency of vitamin D and iron, as effective prevention of osteoporotic changes and iron deficiency anemia is possible. Therefore, the present study was designed to investigate the probability of concurrent iron and vitamin D deficiency among the adult hypothyroid female population of Abu Dhabi, UAE. MATERIALS AND METHODS This cross-sectional study was carried out from September 2019 to July 2021 among 500 adult females aged 18 to 45 years old in Sheikh Shakhbout Medical City (SSMC) and Sheikh Khalifa Medical City (SKMC), Abu Dhabi, UAE. After obtaining written informed consent, subjects' demographic characteristics (sun exposure, dressing code, food consumption), anthropometry (height, weight, BMI), and biochemical parameters (thyroid profile, vitamin D profile, iron profile, and blood indices) were measured. RESULTS In this study, serum vitamin D and iron levels were significantly (p<0.01) decreased in the hypothyroid female group (study group). The serum vitamin D and iron levels showed a significant negative (p<0.01) correlation with thyroid-stimulating hormone (TSH). Out of 250 study group participants, 61 had a concurrent deficiency of serum vitamin D and iron, yielding a probability (P of low vitamin D and iron and hypothyroidism) of 0.244, which indicates that if 1000 hypothyroid patients are tested for serum vitamin D and iron levels, 24 patients are probable to have low vitamin D and iron. CONCLUSION The study concluded that vitamin D and iron bi-deficiency were observed in adult hypothyroid females in Abu Dhabi, UAE. So, the routine check-up of thyroid function and vitamin D and iron profiles should be done early. Therefore, early vitamin D and iron deficiencies can be detected, and supplements can be given to prevent further health complications like osteoporosis and iron deficiency anemia.
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Affiliation(s)
- Sadia Choudhury Shimmi
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - Hossameldin F Eldosouky
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - M Tanveer Hossain Parash
- Anatomy Unit, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - Wan Salman Wan Saudi
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
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Evaluating Risk: Benefit Ratio of Fat-Soluble Vitamin Supplementation to SARS-CoV-2-Infected Autoimmune and Cancer Patients: Do Vitamin–Drug Interactions Exist? Life (Basel) 2022; 12:life12101654. [PMID: 36295089 PMCID: PMC9604733 DOI: 10.3390/life12101654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary This review brings attention to a crucial yet under-investigated subject which is vitamin–drug interactions. Fat-soluble vitamins such as vitamins A, D, E, and K have been proven to possess many beneficial effects in the treatment and prevention of COVID-19. Moreover, it has been reported that deficiencies of fat-soluble vitamins have been directly linked to COVID-19 infection-related morbidity and mortality, especially in high-risk populations such as cancer and autoimmune patients. However, many vitamin–drug interactions exist between most of the newly COVID-19 FDA-approved medications and fat-soluble vitamins. Hence, this mandates personalizing the COVID-19 treatment protocols, especially for patients who have any deficiency in any of these vital vitamins. Weighing the risk-to-benefit ratio of supplementing any of these fat-soluble vitamins with COVID-19 medications is considered crucial to maximize the therapeutic benefit and decrease the side effects of these drugs. Abstract COVID-19 is a recent pandemic that mandated the scientific society to provide effective evidence-based therapeutic approaches for the prevention and treatment for such a global threat, especially to those patients who hold a higher risk of infection and complications, such as patients with autoimmune diseases and cancer. Recent research has examined the role of various fat-soluble vitamins (vitamins A, D, E, and K) in reducing the severity of COVID-19 infection. Studies showed that deficiency in fat-soluble vitamins abrogates the immune system, thus rendering individuals more susceptible to COVID-19 infection. Moreover, another line of evidence showed that supplementation of fat-soluble vitamins during the course of infection enhances the viral clearance episode by promoting an adequate immune response. However, more thorough research is needed to define the adequate use of vitamin supplements in cancer and autoimmune patients infected with COVID-19. Moreover, it is crucial to highlight the vitamin–drug interactions of the COVID-19 therapeutic modalities and fat-soluble vitamins. With an emphasis on cancer and autoimmune patients, the current review aims to clarify the role of fat-soluble vitamins in SARS-CoV-2 infection and to estimate the risk-to-benefit ratio of a fat-soluble supplement administered to patients taking FDA-approved COVID-19 medications such as antivirals, anti-inflammatory, receptor blockers, and monoclonal antibodies.
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KALAN SARI I, COŞKUNER MA. The relationship between subclinical hypothyroidism and vitamin D. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1124332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: Vitamin D (vitD) is primarily responsible for bone formation and mineralization. However, in recent years, it has been suggested that vitD may play a role as an immune modulator in the development of numerous diseases, including autoimmune diseases. It has been observed that there is an association between chronic autoimmune thyroiditis (AIT) and vitD levels. This study aims to investigate whether there are differences in the levels of 25-hydroxy vitamin D [25(OH)D], calcium, and phosphorus in patients with subclinical hypothyroidism (SCH) due to AIT, in patients with antibody-negative subclinical hypothyroidism (ANSCH), and in healthy control subjects.
Material and Method: Data from 50 newly diagnosed patients with SCH (35 of whom AIT) and 50 euthyroid and antibody-negative healthy controls who presented to the Department of Endocrinology and Internal Medicine at our hospital between 2018 and 2020 were retrospectively reviewed. Calcium, phosphorus, and 25(OH)D levels of patients and controls were compared.
Results: Serum 25(OH)D levels were significantly lower in patients compared to controls (16.2±7.8 ng/ml and 20.4±8.2 ng/ml, respectively; p=0.024). Serum levels of calcium (p=0.081) and phosphorus (p=0.712) did not differ between groups. In a subgroup analysis, patients with AIT had significantly lower 25(OH)D values than controls (p=0.009). Compared to controls, 25(OH)D levels were comparable in the ANSCH group (p=0.096). 25(OH)D level was higher in the AIT group than in the ANSCH group (p=0.01).
Conclusion: Our results show that patients with SCH have lower 25(OH)D levels than healthy controls. However, this difference is significant in patients with AIT. It is recommended to screen for vitD deficiency in patients with SCH due to AIT.
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Li Q, Yang W, Li J, Shan Z. Emerging trends and hot spots in autoimmune thyroiditis research from 2000 to 2022: A bibliometric analysis. Front Immunol 2022; 13:953465. [PMID: 36032148 PMCID: PMC9402901 DOI: 10.3389/fimmu.2022.953465] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/22/2022] [Indexed: 11/26/2022] Open
Abstract
Background Autoimmune thyroiditis (AIT) is the most common autoimmune disease, affecting 3-5% patients worldwide. In recent years, approximately 200 articles on AIT have been published annually in various journals. However, to date, no article has systematically assessed the related literature. Therefore, we conducted a bibliometric analysis on AIT to reveal the dynamic scientific developments and help researchers gain a global perspective while exploring the hotspots and development trends. Methods AIT-related articles and reviews from 2000 to 2022 were retrieved from the Web of Science Core Collection (WoSCC). The following search terms were used to extract document data: TS= (“ autoimmune thyroiditi*”) OR TI= (“chronic lymphocytic thyroiditi*”) OR TI=(hashimoto*) OR TI= (“postpartum thyroiditis”). We selected articles and reviews published in English from 2000 to 2022. Three software programs (VOSviewer, CiteSpace, Pajek) were employed to analyze the contribution and co-occurrence relationships of different references, countries/regions, institutes, journals and also keywords in this field. Results This scientometric study included 2290 English papers published in 723 journals with 39661 co-cited references from 561 institutions in 120 countries/regions. Based on the reference and keyword analysis, researchers used to focus on “apoptosis”, “insulin resistance”, “encephalopathy”, “IFN-γ” related to AIT during the past 20 years. However, with the development of other novel directions such as “papillary thyroid cancer” (2018-2022), “Vitamin D” (2016-2022), “oxidative stress” (2018-2022), “polymorphism” (2019-2022) and “association” (2020-2022), researchers are more interested in the relationship between papillary thyroid carcinoma and AIT, the effect of vitamin D supplementation on AIT, the oxidative stress in thyroid disease as well as the influence of polymorphism. Conclusion Bibliometric analysis of the outputs of AIT shows an overview of the current status of the research on AIT. The associations between papillary thyroid carcinoma, vitamin D, oxidative stress, polymorphism and AIT are major research frontiers. However, further research and collaboration are still required worldwide. Our findings can help researchers grasp the research status of AIT and quickly determine new directions for future research.
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Prediction of the cognitive impairment development in patients with autoimmune thyroiditis and hypothyroidism. Endocr Regul 2022; 56:178-189. [DOI: 10.2478/enr-2022-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective. The aim of the present work is to define the risk factors that can affect the presence of a cognitive impairment and analyze the associations of the brain-derived neurotrophic factor (BDNF) gene polymorphism (rs6265), vitamin D receptor (VDR) gene polymorphism (rs2228570), and N-methyl-D-aspartate (NMDA) receptor gene polymorphism (rs4880213) with the cognitive impairment in patients with autoimmune thyroiditis and hypothyroidism in the Western Ukraine population and predict the development of cognitive disorders in these patients.
Methods. The study involved 153 patients with various forms of thyroid pathology (hypothyroidism, autoimmune thyroiditis, elevated serum antibodies anti-thyroglobulin and anti-thyroid peroxidase). Cognitive impairment in the examined patients was evaluated based on the results of the Mini-Mental State Examination (MMSE) test. BDNF, GRIN2B, and 25-OH Vitamin D levels in the serum of the patients and healthy individuals were quantified using highly sensitive commercial enzyme-linked immunosorbent assay kits. Genotyping of the VDR (rs2228570), BDNF (rs6265), and NMDA receptor (rs4880213) gene polymorphism was performed using TaqMan probes and Taq-Man Genotyping Master Mix (4371355) on CFX96™Real-Time PCR Detection System. Polymerase chain reaction (PCR) for TaqMan genotyping was carried out according to the kit instructions.
Results. Strong direct relationship between the “Level GRIN2B” and cognitive impairments (p=0.006) was established after evaluating the complex model based on the values of the regression coefficient. An increase in the likelihood of cognitive impairment by 24.898-fold (p=0.012) was seen after assessing the effect of the CT rs6265 genotype. In addition, direct relationship between the influence of the TT rs6265 genotype and an increase in the likelihood of cognitive impairment by a factor of 21.734 (p=0.024) was also established.
Conclusion. The present data indicate that the BDNF, TSH, fT4, and vitamin D levels prognostically belong to the significant indicators of the cognitive impairment development.
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Metabolic Characteristics of Hashimoto's Thyroiditis Patients and the Role of Microelements and Diet in the Disease Management-An Overview. Int J Mol Sci 2022; 23:ijms23126580. [PMID: 35743024 PMCID: PMC9223845 DOI: 10.3390/ijms23126580] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 02/05/2023] Open
Abstract
Hashimoto’s thyroiditis (HT) is the most common autoimmune disease and the leading cause of hypothyroidism, in which damage to the thyroid gland occurs due to the infiltration of lymphocytes. It is characterized by increased levels of antibodies against thyroid peroxidase and thyroglobulin. In this review, we present the metabolic profile, the effectiveness of micronutrient supplementation and the impact of dietary management in patients with HT. For this current literature review, the databases PubMed, Cochrane, Medline and Embase were reviewed from the last ten years until March 2022. This article provides a comprehensive overview of recent randomized controlled trials, meta-analyses, and clinical trials. Many patients with HT, even in the euthyroid state, have excess body weight, metabolic disorders, and reduced quality of life. Due to frequent concomitant nutritional deficiencies, the role of vitamin D, iodine, selenium, magnesium, iron and vitamin B12 is currently debated. Several studies have underlined the benefits of vitamin D and selenium supplementation. There is still no specific diet recommended for patients with HT, but a protective effect of an anti-inflammatory diet rich in vitamins and minerals and low in animal foods has been suggested. There is insufficient evidence to support a gluten-free diet for all HT patients. Pharmacotherapy, along with appropriate nutrition and supplementation, are important elements of medical care for patients with HT. The abovementioned factors may decrease autoantibody levels, improve thyroid function, slow down the inflammatory process, maintain proper body weight, relieve symptoms, and prevent nutritional deficiencies and the development of metabolic disorders in patients with HT.
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Kim MJ, Kim D, Koo JS, Lee JH, Nam KH. Vitamin D Receptor Expression and its Clinical Significance in Papillary Thyroid Cancer. Technol Cancer Res Treat 2022; 21:15330338221089933. [PMID: 35379049 PMCID: PMC8988685 DOI: 10.1177/15330338221089933] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective: This study aimed to evaluate the association between vitamin D receptor (an essential component in the vitamin D signaling pathway) and serum vitamin D as well as its clinical significance in papillary thyroid cancer. Methods: This prospective cohort study comprised patients with thyroid tumors who visited our hospital, from 2017 to 2018. The level of vitamin D receptor expression from thyroid tissue was measured in patients with thyroid tumor and evaluated for correlation with serum vitamin D levels and clinicopathologic characteristics of papillary thyroid cancer. Data from 501 patients with papillary thyroid cancer from The Cancer Genome Atlas database were analyzed. Results: Increased vitamin D receptor protein and mRNA expression were observed in papillary thyroid cancer compared to those in normal and benign tissues. Lower vitamin D receptor protein expression was associated with high TNM stage papillary thyroid cancer and low p21 protein expression. Lower relative vitamin D receptor mRNA expression in papillary thyroid cancer was associated with low serum 25-hydroxyvitamin D level. The Cancer Genome Atlas database showed a positive correlation among mRNA expression of vitamin D receptor, CYP24A1, and p21. Conclusions: An association between decreased vitamin D receptor protein expression and advanced stage papillary thyroid cancer, and a correlation between low vitamin D receptor mRNA expression with low serum 25-hydroxyvitamin D level was observed. Low vitamin D receptor expression in papillary thyroid cancer was shown to positively correlate with low serum vitamin D level and disease aggressiveness.
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Affiliation(s)
- Min Jhi Kim
- Department of Surgery, CHA Ilsan Medical Center, 65470CHA University School of Medicine, Goyang-si, Gyeonggi-do, South Korea.,Department of Surgery, Graduate School, 37991Yonsei University College of Medicine, Seoul, South Korea
| | - Daham Kim
- Department of Internal Medicine, Institute of Endocrine Research, 37991Yonsei University College of Medicine, Seoul, South Korea
| | - Ja Seung Koo
- Department of Pathology, 37991Yonsei University College of Medicine, Seoul, South Korea
| | - Ju Hee Lee
- Department of Dermatology, 37991Yonsei University College of Medicine, Seoul, South Korea
| | - Kee-Hyun Nam
- Department of Surgery, 37991Yonsei University College of Medicine, Seoul, South Korea
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Chen Y, Han B, Zhu C, Li Q, Chen C, Zhai H, Wang N, Chen Y, Lu Y. Bidirectional Mendelian Randomization Analysis for Vitamin D and Thyroid Peroxidase Antibody. Int J Endocrinol 2022; 2022:2260388. [PMID: 35399300 PMCID: PMC8993571 DOI: 10.1155/2022/2260388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Whether Vitamin D deficiency or insufficiency is associated with thyroid autoimmunity was debated for long time. This study was still to explore the causal relationship of 25 (OH) D with a thyroid peroxidase antibody (TPOAb). METHODS The data were obtained from a cross-sectional study, SPECT-China study, which was performed in 23 sites in East China during 2014 to 2016. 10636 participants were finally included in this study. Genotyped four 25 (OH) D-related and four TPOAb-associated single nucleotide polymorphisms (SNPs) created their genetic risk scores (GRS). Bidirectional mendelian randomization (MR) analysis was used in this study. RESULTS 25 (OH) D GRS was significantly associated with 25 (OH) D (B -0.093, 95% CI -0.111, -0.074) and TPOAb level (B 0.067, 95% CI 0.002 to 0.132). TPOAb GRS was significantly associated with TPOAb concentration (B 0.345, 95% CI 0.135 to 0.556), but not 25 (OH) D (B -0.030, 95% CI -0.091 to 0.030). Using 25 (OH) D_GRS as instrumental variable in the MR analysis, a causal relationship of genetically determined 25 (OH) D with increased TPOAb concentration (B -0.720, 95% CI -1.429 to -0.012). No relation was found between genetically instrumented TPOAb and 25 (OH) D. CONCLUSION A higher VD_GRS was associated with higher risk of increased TPOAb concentration, which supports a causal association between decreased vitamin D and increased concentration of TPOAb in an eastern Chinese population.
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Affiliation(s)
- Yingchao Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Bing Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chunfang Zhu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Appunni S, Rubens M, Ramamoorthy V, Saxena A, Tonse R, Veledar E, McGranaghan P. Association between vitamin D deficiency and hypothyroidism: results from the National Health and Nutrition Examination Survey (NHANES) 2007-2012. BMC Endocr Disord 2021; 21:224. [PMID: 34772378 PMCID: PMC8590325 DOI: 10.1186/s12902-021-00897-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 11/05/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Many smaller studies have previously shown a significant association between thyroid autoantibody induced hypothyroidism and lower serum vitamin D levels. However, these finding have not been confirmed by large-scale studies. In this study, we evaluated the relationship between hypothyroidism and vitamin D levels using a large population-based data. METHODS For this study, we used National Health and Nutrition Examination Survey (NHANES) during the years 2007-2012. We categorized participants into three clinically relevant categories based on vitamin D levels: optimal, intermediate and deficient. Participants were also split into hypothyroid and hyperthyroid. Weighted multivariable logistic regression analyses were used to calculate the odds of being hypothyroid based on vitamin D status. RESULTS A total of 7943 participants were included in this study, of which 614 (7.7%) were having hypothyroidism. Nearly 25.6% of hypothyroid patients had vitamin D deficiency, compared to 20.6% among normal controls. Adjusted logistic regression analyses showed that the odds of developing hypothyroidism were significantly higher among patients with intermediate (adjusted odds ratio [aOR], 1.7, 95% CI: 1.5-1.8) and deficient levels of vitamin D (aOR, 1.6, 95% CI: 1.4-1.9). CONCLUSION Low vitamin D levels are associated with autoimmune hypothyroidism. Healthcare initiatives such as mass vitamin D deficiency screening among at-risk population could significantly decrease the risk for hypothyroidism in the long-term.
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Affiliation(s)
- Sandeep Appunni
- Department of Biochemistry, Government Medical College, Kozhikode, Kerala, India
| | | | | | | | | | - Emir Veledar
- Baptist Health South Florida, Miami, Florida, USA
- Department of Biostatistics, Florida International University, Miami, FL, USA
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Peter McGranaghan
- Miami Cancer Institute, Miami, Florida, USA.
- Baptist Health South Florida, Miami, Florida, USA.
- Department of Internal Medicine and Cardiology, Charité - Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
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Taheriniya S, Arab A, Hadi A, Fadel A, Askari G. Vitamin D and thyroid disorders: a systematic review and Meta-analysis of observational studies. BMC Endocr Disord 2021; 21:171. [PMID: 34425794 PMCID: PMC8381493 DOI: 10.1186/s12902-021-00831-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 07/30/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The contribution of vitamin D to thyroid disorders has received paramount attention; however, results are mixed. Hence, we designed a systematic review and meta-analysis to obtain a definitive conclusion. METHODS The search included PubMed, ISI Web of Science, Scopus, and Google Scholar databases up to March 2021 to collect available papers reporting the relationship between serum levels of vitamin D and thyroid disorders. The pooled effect was reported as weighted mean difference (WMD) and 95% confidence interval (CI). RESULTS Out of 6123 datasets, 42 were eligible to get into this systematic review and meta-analysis. Serum vitamin D was markedly lower in autoimmune thyroid diseases (AITD) (WMD - 3.1 ng/dl; 95% CI, - 5.57 to - 0.66; P = 0.013; I2 = 99.9%), Hashimoto's thyroiditis (HT) (WMD - 6.05 ng/dl; 95% CI, - 8.35 to - 3.75; P < 0.001; I2 = 91.0%) and hypothyroidism patients (WMD - 13.43 ng/dl; 95% CI, - 26.04 to - 0.81; P = 0.03; I2 = 99.5%), but not in subjects with Graves' disease (GD) (WMD - 4.14 ng/dl; 95% CI, - 8.46 to 0.17; P = 0.06; I2 = 97.5%). CONCLUSIONS Our findings suggested lower vitamin D levels in patients with hypothyroidism, AITD, and HT compared to healthy subjects. However, the link between serum vitamin D and GD was only significant among subjects ≥40 years old.
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Affiliation(s)
- Sorour Taheriniya
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdulmannan Fadel
- School of Sport and Exercise Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, UK
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Vitamin D and Hashimoto's Thyroiditis: Observations from CROHT Biobank. Nutrients 2021; 13:nu13082793. [PMID: 34444953 PMCID: PMC8401592 DOI: 10.3390/nu13082793] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022] Open
Abstract
The aims of this study were to evaluate: (1) associations of vitamin D with the presence/severity of Hashimoto’s thyroiditis (HT) and (2) correlations of vitamin D with thyroid-related phenotypes. Total 25(OH)D (vitamin D in the text) was measured from stored serum samples of 461 HT patients and 176 controls from a Croatian Biobank of HT patients (CROHT). (1) Vitamin D levels, and proportions of vitamin D deficiency, were compared between HT cases and controls. HT patients were additionally divided into two groups (MILD and OVERT) to take into account HT severity. (2) Correlations between vitamin D and 10 clinical phenotypes in all HT patients and two subgroups of HT patients were tested using the Spearman correlation test. Our analyses were adjusted for age, gender, BMI, smoking status and seasonality of blood sampling. (1) No significant differences in vitamin D levels, or proportions of vitamin D deficiency, were detected between HT patients of all disease stages and controls. However, a nominally significant difference in vitamin D levels between MILD and OVERT subgroups (OR = 1.038, p = 0.023) was observed. Proportions of individuals with vitamin D deficiency during winter–spring were high: all HT cases (64.69%), MILD (60.64%), OVERT (68.7%), controls (60.79%). (2) A nominally significant negative correlation between vitamin D and TSH in all HT patients (r = −0.113, p = 0.029) and a positive correlation between vitamin D and systolic blood pressure in OVERT HT patients (r = 0.205, p = 0.025) were identified. Our study indicates that there is no association between vitamin D and HT; however, there may be a subtle decrease in vitamin D levels associated with overt hypothyroidism.
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Abed MN, Alassaf FA, Qazzaz ME, Alfahad M, Jasim MHM. Insights into the Perspective Correlation Between Vitamin D and Regulation of Hormones: Thyroid and Parathyroid Hormones. Clin Rev Bone Miner Metab 2021. [DOI: 10.1007/s12018-021-09279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Zeber-Lubecka N, Hennig EE. Genetic Susceptibility to Joint Occurrence of Polycystic Ovary Syndrome and Hashimoto's Thyroiditis: How Far Is Our Understanding? Front Immunol 2021; 12:606620. [PMID: 33746952 PMCID: PMC7968419 DOI: 10.3389/fimmu.2021.606620] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/07/2021] [Indexed: 12/15/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) and Hashimoto’s thyroiditis (HT) are endocrine disorders that commonly occur among young women. A higher prevalence of HT in women with PCOS, relative to healthy individuals, is observed consistently. Combined occurrence of both diseases is associated with a higher risk of severe metabolic and reproductive complications. Genetic factors strongly impact the pathogenesis of both PCOS and HT and several susceptibility loci associated with a higher risk of both disorders have been identified. Furthermore, some candidate gene polymorphisms are thought to be functionally relevant; however, few genetic variants are proposed to be causally associated with the incidence of both disorders together.
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Affiliation(s)
- Natalia Zeber-Lubecka
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Ewa E Hennig
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Genetics, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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16
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Turashvili N, Javashvili L, Giorgadze E. "Vitamin D Deficiency Is More Common in Women with Autoimmune Thyroiditis: A Retrospective Study". Int J Endocrinol 2021; 2021:4465563. [PMID: 34457000 PMCID: PMC8387174 DOI: 10.1155/2021/4465563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/19/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Vitamin D is a hormone that is mainly produced in the skin upon ultraviolet B radiation exposure and has important influence on various organs. In recent years, data have been collected that vitamin D deficiency plays an important role in the development of various nonskeletal diseases, including autoimmune diseases. Chronic autoimmune thyroiditis (Hashimoto's thyroiditis) is one of the most common organ-specific autoimmune endocrine diseases. It is characterized by increased level of antithyroid peroxidase and/or antithyroglobulin antibodies in blood, which often leads to thyroid dysfunction and structural changes of the gland. There is an opinion that vitamin D deficiency may be considered as an important risk factor for development of chronic autoimmune thyroiditis, but data of various small studies are controversial. Despite the fact that Georgia is a sunny country, vitamin D deficiency is a widespread problem here. Thyroid diseases, including the chronic autoimmune thyroiditis, are also very common in Georgia. The aim of our research was to compare the level of vitamin D between the patients with chronic autoimmune thyroiditis and the healthy subjects. METHODS This retrospective study enrolled subjects, who were 18-70 years old and visited the clinics "Cortex" and "National Institute of Endocrinology" in 2018 or in 2019 from mid-spring to mid-summer. Data of thyroid-stimulating hormone, free thyroxine, antithyroid peroxidase antibodies, antithyroglobulin antibodies, thyroid ultrasonography, and 25(OH) vitamin D were retrospectively analysed based on medical history. In total, data of 1295 patients were collected. The statistical processing of data was performed through the SPSS 20 program. RESULTS The negative association between thyroid-stimulating hormone, antithyroid peroxidase antibodies, antithyroglobulin antibodies, heterogeneous parenchyma of thyroid gland, and vitamin D was found in women. Statistically significant association was not detected in men. CONCLUSIONS Serum vitamin D is lower in women with autoimmune thyroiditis and primary hypothyroidism. Further studies are needed to evaluate the influence of vitamin D supplementation on thyroid autoantibody positivity or primary hypothyroidism.
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Affiliation(s)
- Nino Turashvili
- Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | | | - Elene Giorgadze
- Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
- National Institute of Endocrinology, Tbilisi, Georgia
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El Othman R, Ephrem C, Touma E, Hallit S, El Othman R. A case report of thyroid-associated Orbitopathy with elevated TPO antibodies. BMC Endocr Disord 2020; 20:176. [PMID: 33246456 PMCID: PMC7693503 DOI: 10.1186/s12902-020-00658-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 11/22/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Thyroid associated orbitopathy (TAO) is defined as an immune mediated inflammatory process affecting the extraocular muscles, connective and adipose tissue of uncertain etiopathogenesis. TAO are classically described in Grave's disease (GD) however it may occur in euthyroid and hypothyroid patients. Those patients usually test positive for Thyroid Stimulating Hormone receptor antibodies (TRAb). For instance, only few cases of severe Hashimoto's thyroiditis (HT) associated orbitopathy with negative TRAb are reported to date. CASE PRESENTATION Herewith we report a rare case of a middle-aged female who presented with bilateral progressive upper and lower palpebral edema and a unilateral marked proptosis associated with asthenia, headache and decrease in visual acuity. Biological investigation was notable for high levels of anti-thyroid peroxidase antibodies (Anti-TPO) in an otherwise euthyroid patient with negative TRAb. Orbital Magnetic resonance imaging revealed edema of the extraocular muscles and inflammation of periorbital soft tissue. The patient received a treatment with intravenous methylprednisolone followed by oral treatment with prednisone. This regimen was both effective and safe with minimal metabolic side effects in our patient. CONCLUSION Minor ocular manifestations of HT are common; however, severe sight threatening ophtalmopathy in the absence of TRAb is rare. Multiple differential diagnosis should be considered and investigated before diagnosing this rare entity. Management of similar cases is currently based on reports and no clear guidelines have been elaborated, corticosteroids is the mainstream of treatment with a potential benefit of selenium supplementation in mild to moderate cases.
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Affiliation(s)
- Radwan El Othman
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Christelle Ephrem
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Department of Internal Medicine, University Hospital Center- Notre Dame des Secours, Byblos, Lebanon
| | - Elsie Touma
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
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Vitamin D and Autoimmune Thyroid Disease-Cause, Consequence, or a Vicious Cycle? Nutrients 2020; 12:nu12092791. [PMID: 32933065 PMCID: PMC7551884 DOI: 10.3390/nu12092791] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
Vitamin D is a steroid hormone traditionally connected to phosphocalcium metabolism. The discovery of pleiotropic expression of its receptor and of the enzymes involved in its metabolism has led to the exploration of the other roles of this vitamin. The influence of vitamin D on autoimmune disease—namely, on autoimmune thyroid disease—has been widely studied. Most of the existing data support a relationship between vitamin D deficiency and a greater tendency for development and/or higher titers of antibodies linked to Hashimoto’s thyroiditis, Graves’ disease, and/or postpartum thyroiditis. However, there have also been some reports contradicting such relationships, thus making it difficult to establish a unanimous conclusion. Even if the existence of an association between vitamin D and autoimmune thyroid disease is assumed, it is still unclear whether it reflects a pathological mechanism, a causal relationship, or a consequence of the autoimmune process. The relationship between vitamin D’s polymorphisms and this group of diseases has also been the subject of study, often with divergent results. This text presents a review of the recent literature on the relationship between vitamin D and autoimmune thyroid disease, providing an analysis of the likely involved mechanisms. Our thesis is that, due to its immunoregulatory role, vitamin D plays a minor role in conjunction with myriad other factors. In some cases, a vicious cycle is generated, thus contributing to the deficiency and aggravating the autoimmune process.
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19
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Behera KK, Saharia GK, Hota D, Sahoo DP, Sethy M, Srinivasan A. Effect of Vitamin D Supplementation on Thyroid Autoimmunity among Subjects of Autoimmune Thyroid Disease in a Coastal Province of India: A Randomized Open-label Trial. Niger Med J 2020; 61:237-240. [PMID: 33487845 PMCID: PMC7808291 DOI: 10.4103/nmj.nmj_200_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/25/2020] [Accepted: 09/04/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Hashimoto's thyroiditis (HT) is a variant of autoimmune thyroid disorders (AITD) which has been associated with vitamin D (vit-D) deficiency. However, whether vit-D supplementation is linked to reduction of thyroid autoantibodies and improvement of thyroid function is not well characterized. The present study was planned to evaluate the effect of vit-D supplementation on possible improvement of thyroid autoantibody titer and thyroid hormone profile in patients with AITD subjects. METHODS Twenty-three patients of HT were given weekly supplementation of 60,000 IU vit-D for 8 weeks followed by once a month for another 4 months. After 6 months of vit-D supplementation, thyroid autoantibody titer (TPO antibody) and thyroid hormone profile was rechecked. RESULTS Mean serum vit-D was increased significantly from 15.33 ± 5.71 to 41.22 ± 12.24 ng/mL (normal levels) after supplementation. There was significant increase in thyroid autoantibody titre (from 746.8 ± 332.2 to 954.1 ±4 59.8 IU/ml; P = 0.006) and TSH level (7.23 ± 3.16 to 3.04 ± 2.62 (mIU/L); P = 0.01) following 6 months of vit-D supplementation. CONCLUSION Vitamin-D levels were low in AITD patients in eastern India and, its supplementation in HT patients increased thyroid antibody titer and there was significant reduction in serum TSH and increased in free T4.
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Affiliation(s)
- Kishore Kumar Behera
- Department of Endocrinology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Gautom Kumar Saharia
- Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Debasish Hota
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Durgesh Prasad Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Madhusmita Sethy
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Anand Srinivasan
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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20
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Guo Y, Wu CY, Deng YH, Wu JL. <p>Associations Between Serum 25-Hydroxyvitamin D Levels and Thyroid Function Parameters in Previously Healthy Children Aged 6 to 24 Months</p>. Healthc Policy 2020; 13:1647-1653. [PMID: 33061698 PMCID: PMC7519340 DOI: 10.2147/rmhp.s269640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/27/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Vitamin D deficiency has been linked to overt thyroid diseases. Data on the effects of vitamin D status on thyroid function in children are less examined. The goal of the present study was to explore the association between serum 25-hydroxyvitamin D [25(OH)D] levels and thyroid function parameters in early childhood. Patients and Methods This was a cross-sectional study involving record-linkage of children’s data of routine health check-ups for promoting early childhood development at Guangdong Women and Children’s Hospital; 2869 children aged 6–24 months were included from January 2015 to May 2017. Serum 25(OH)D, thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels were measured using the electrochemiluminescence immunoassay. Results The study population had a mean serum 25(OH)D level of 79.7 ± 28.1 nmol/L and 12.5% vitamin D deficiency and 36.0% insufficiency rates. The rates of thyroid dysfunctions detected were 2.9% hypothyroidism, 4.2% subclinical hypothyroidism, 0.9% hyperthyroidism, and 1.7% subclinical hyperthyroidism among the previously healthy children aged 6 to 24 months. Serum 25(OH)D levels had no significant correlation with TSH (r = 0.022, P = 0.236), FT3 (r = 0.014, P = 0.440) and FT4 (r = −0.059, P = 0.056) levels. No significant difference in the levels of thyroid hormones was found between the different quartiles of 25(OH)D level. Vitamin D deficiency [25(OH)D < 50 nmol/L] was associated with hypothyroidism (adjusted odds ratio = 2.16, 95% confidence interval: 1.18–3.94) but not with subclinical hypothyroidism, hyperthyroidism, and subclinical hyperthyroidism. Conclusion Vitamin D deficiency is slightly associated with hypothyroidism. No associations were found between serum 25(OH)D levels and thyroid-related measures (TSH, FT3, and FT4) in previously healthy children aged 6–24 months.
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Affiliation(s)
- Yong Guo
- Department of Children’s Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou511400, People’s Republic of China
| | - Chun-Yan Wu
- Department of Children’s Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou511400, People’s Republic of China
| | - Yu-Hong Deng
- Department of Children’s Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou511400, People’s Republic of China
| | - Jie-Ling Wu
- Department of Children’s Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou511400, People’s Republic of China
- Correspondence: Jie-Ling Wu Department of Children’s Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University, Guangzhou511400, People’s Republic of ChinaTel +86 2039151521 Email
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21
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Pezeshki B, Ahmadi A, Karimi A. The Effect of Vitamin D Replacement on Patient with Subclinical Hypothyroidism: A Pilot Randomized Clinical Trial. Galen Med J 2020; 9:e1592. [PMID: 34466557 PMCID: PMC8343658 DOI: 10.31661/gmj.v9i0.1592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/13/2019] [Accepted: 03/22/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Subclinical hypothyroidism (SCH) is characterized by an elevated Thyroid Stimulating Hormone (TSH) with a normal T4. The prevalence of Vitamin D deficiency in patients SCH is high. Some studies suggested that Vitamin D supplements could be reduced serum concentration of TSH so improve SCH and prevent overt hypothyroidism. This study aims to explore the effect of vitamin D replacement on subclinical hypothyroidism. Materials and Methods: Fifty-nine patients, diagnosed with both subclinical hypothyroidism and Vitamin D deficiency by the Endocrinology outpatient clinics between January 2018 and March 2019, were included in this trial. The patients with overt hypothyroidism, cardiovascular risk factors, or positive TPO antibody, abnormal T4, and pregnant women were excluded from this study. The 40 subjects were investigated who received vitamin D supplements for two months. Analyses were conducted through paired-samples t-test and independent-samples t-test using SPSS 24 (Armonk, NY: IBM Corp). Results: The mean serum levels of TSH was decreased from 6.89 mIU/l in the pre-test to 3.34 mIU/l in the post-test, and the difference was found to be statistically significant at P<0.001. Conclusion: We found that the TSH mean level significantly dropped through the use of vitamin D supplements. Thus, it is recommended that all the patients with subclinical hypothyroidism be screened and treated with vitamin D supplements.
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Affiliation(s)
- Babak Pezeshki
- Noncommunicable Disease Research Center, Fasa University of Medical Science, Fasa, Iran
| | - Ali Ahmadi
- Noncommunicable Disease Research Center, Fasa University of Medical Science, Fasa, Iran
- Correspondence to: Ali Ahmadi, Noncommunicable Disease Research Center, Fasa University of Medical Science, Fasa, Iran Telephone Number: +989173520551 Email Address:
| | - Aliasghar Karimi
- Noncommunicable Disease Research Center, Fasa University of Medical Science, Fasa, Iran
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Mele C, Caputo M, Bisceglia A, Samà MT, Zavattaro M, Aimaretti G, Pagano L, Prodam F, Marzullo P. Immunomodulatory Effects of Vitamin D in Thyroid Diseases. Nutrients 2020; 12:nu12051444. [PMID: 32429416 PMCID: PMC7284826 DOI: 10.3390/nu12051444] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/24/2022] Open
Abstract
Vitamin D is a secosteroid with a pleiotropic role in multiple physiological processes. Besides the well-known activity on bone homeostasis, recent studies suggested a peculiar role of vitamin D in different non-skeletal pathways, including a key role in the modulation of immune responses. Recent evidences demonstrated that vitamin D acts on innate and adaptative immunity and seems to exert an immunomodulating action on autoimmune diseases and cancers. Several studies demonstrated a relationship between vitamin D deficiency, autoimmune thyroid disorders, and thyroid cancer. This review aims to summarize the evidences on the immunomodulatory effect of vitamin D on thyroid diseases.
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Affiliation(s)
- Chiara Mele
- Department of Translational Medicine, University of Piemonte Orientale UPO, 28100 Novara, Italy; (C.M.); (G.A.)
- Division of General Medicine, S. Giuseppe Hospital, I.R.C.C.S. Istituto Auxologico Italiano, 28824 Verbania, Italy
| | - Marina Caputo
- Department of Health Sciences, University of Piemonte Orientale UPO, 28100 Novara, Italy; (M.C.); (F.P.)
- Division of Endocrinology, University Hospital “Maggiore della Carità”, 28100 Novara, Italy; (M.T.S.); (M.Z.)
| | - Alessandro Bisceglia
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (A.B.); (L.P.)
| | - Maria Teresa Samà
- Division of Endocrinology, University Hospital “Maggiore della Carità”, 28100 Novara, Italy; (M.T.S.); (M.Z.)
| | - Marco Zavattaro
- Division of Endocrinology, University Hospital “Maggiore della Carità”, 28100 Novara, Italy; (M.T.S.); (M.Z.)
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (A.B.); (L.P.)
| | - Gianluca Aimaretti
- Department of Translational Medicine, University of Piemonte Orientale UPO, 28100 Novara, Italy; (C.M.); (G.A.)
- Division of Endocrinology, University Hospital “Maggiore della Carità”, 28100 Novara, Italy; (M.T.S.); (M.Z.)
| | - Loredana Pagano
- Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (A.B.); (L.P.)
| | - Flavia Prodam
- Department of Health Sciences, University of Piemonte Orientale UPO, 28100 Novara, Italy; (M.C.); (F.P.)
- Division of Endocrinology, University Hospital “Maggiore della Carità”, 28100 Novara, Italy; (M.T.S.); (M.Z.)
| | - Paolo Marzullo
- Department of Translational Medicine, University of Piemonte Orientale UPO, 28100 Novara, Italy; (C.M.); (G.A.)
- Division of General Medicine, S. Giuseppe Hospital, I.R.C.C.S. Istituto Auxologico Italiano, 28824 Verbania, Italy
- Correspondence: ; Tel.: +39-03-2351-4436
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Gallo D, Mortara L, Gariboldi MB, Cattaneo SAM, Rosetti S, Gentile L, Noonan DM, Premoli P, Cusini C, Tanda ML, Bartalena L, Piantanida E. Immunomodulatory effect of vitamin D and its potential role in the prevention and treatment of thyroid autoimmunity: a narrative review. J Endocrinol Invest 2020; 43:413-429. [PMID: 31584143 DOI: 10.1007/s40618-019-01123-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/18/2019] [Indexed: 02/06/2023]
Abstract
The main role of vitamin D is to control mineral homeostasis. However, recent studies suggested the existence of a number of extraskeletal effects. Among the latter, preclinical studies provided consistent data on the involvement of vitamin D in innate and adaptive immunity and autoimmunity. Molecular biology studies showed that both vitamin D receptor and vitamin D enzymatic complexes are expressed in a large number of cells and tissues unrelated to mineral homeostasis. In contrast, only a few randomized clinical trials in humans investigated the possible role of vitamin D in the prevention or treatment of immunological disorders. In this regard, low serum vitamin D levels have been reported in observational trials in human autoimmune disorders. The aim of the present paper was to review the potential implications of vitamin D in immune modulation, with special focus on thyroid autoimmune disorders.
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Affiliation(s)
- D Gallo
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale L. Borri, 57, 21100, Varese, Italy
| | - L Mortara
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - M B Gariboldi
- Department of Biotechnology and Life Sciences, University of Insubria, Busto Arsizio, Italy
| | - S A M Cattaneo
- Immunohematology and Transfusion Medicine Unit, ASST dei Sette Laghi, Varese, Italy
| | - S Rosetti
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale L. Borri, 57, 21100, Varese, Italy
| | - L Gentile
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale L. Borri, 57, 21100, Varese, Italy
| | - D M Noonan
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
- Vascular Biology and Angiogenesis Laboratory, Science and Technology Pole (PST), IRCCS Multimedica, Milan, Italy
| | - P Premoli
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale L. Borri, 57, 21100, Varese, Italy
| | - C Cusini
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale L. Borri, 57, 21100, Varese, Italy
| | - M L Tanda
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale L. Borri, 57, 21100, Varese, Italy
| | - L Bartalena
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale L. Borri, 57, 21100, Varese, Italy.
| | - E Piantanida
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale L. Borri, 57, 21100, Varese, Italy.
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Bellan M, Andreoli L, Mele C, Sainaghi PP, Rigamonti C, Piantoni S, De Benedittis C, Aimaretti G, Pirisi M, Marzullo P. Pathophysiological Role and Therapeutic Implications of Vitamin D in Autoimmunity: Focus on Chronic Autoimmune Diseases. Nutrients 2020; 12:E789. [PMID: 32192175 PMCID: PMC7146294 DOI: 10.3390/nu12030789] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 03/13/2020] [Indexed: 02/07/2023] Open
Abstract
Vitamin D is a pleiotropic secosteroid yielding multiple actions in human physiology. Besides the canonical regulatory activity on bone metabolism, several non-classical actions have been described and the ability of vitamin D to partake in the regulation of the immune system is particularly interesting, though far stronger and convincing evidence has been collected in in vitro as compared to in vivo studies. Whether vitamin D is able to regulate at physiological concentrations the human immune system remains unproven to date. Consequently, it is not established if vitamin D status is a factor involved in the pathogenesis of immune-mediated diseases and if cholecalciferol supplementation acts as an adjuvant for autoimmune diseases. The development of autoimmunity is a heterogeneous process, which may involve different organs and systems with a wide range of clinical implications. In the present paper, we reviewed the current evidences regarding vitamin D role in the pathogenesis and management of different autoimmune diseases.
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Affiliation(s)
- Mattia Bellan
- Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy; (M.B.); (C.M.); (P.P.S.); (C.R.); (C.D.B.); (G.A.); (M.P.)
- Division of Internal Medicine, “AOU Maggiore della Carità”, 28100 Novara, Italy
- CAAD, Centre for Autoimmune and Allergic Diseases, 28100 Novara, Italy
| | - Laura Andreoli
- Rheumatology and Clinical Immunology Unit and Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, 25128 Brescia, Italy; (L.A.); (S.P.)
| | - Chiara Mele
- Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy; (M.B.); (C.M.); (P.P.S.); (C.R.); (C.D.B.); (G.A.); (M.P.)
| | - Pier Paolo Sainaghi
- Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy; (M.B.); (C.M.); (P.P.S.); (C.R.); (C.D.B.); (G.A.); (M.P.)
- Division of Internal Medicine, “AOU Maggiore della Carità”, 28100 Novara, Italy
- CAAD, Centre for Autoimmune and Allergic Diseases, 28100 Novara, Italy
| | - Cristina Rigamonti
- Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy; (M.B.); (C.M.); (P.P.S.); (C.R.); (C.D.B.); (G.A.); (M.P.)
- Division of Internal Medicine, “AOU Maggiore della Carità”, 28100 Novara, Italy
- CAAD, Centre for Autoimmune and Allergic Diseases, 28100 Novara, Italy
| | - Silvia Piantoni
- Rheumatology and Clinical Immunology Unit and Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, 25128 Brescia, Italy; (L.A.); (S.P.)
| | - Carla De Benedittis
- Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy; (M.B.); (C.M.); (P.P.S.); (C.R.); (C.D.B.); (G.A.); (M.P.)
- Division of Internal Medicine, “AOU Maggiore della Carità”, 28100 Novara, Italy
- CAAD, Centre for Autoimmune and Allergic Diseases, 28100 Novara, Italy
| | - Gianluca Aimaretti
- Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy; (M.B.); (C.M.); (P.P.S.); (C.R.); (C.D.B.); (G.A.); (M.P.)
| | - Mario Pirisi
- Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy; (M.B.); (C.M.); (P.P.S.); (C.R.); (C.D.B.); (G.A.); (M.P.)
- Division of Internal Medicine, “AOU Maggiore della Carità”, 28100 Novara, Italy
- CAAD, Centre for Autoimmune and Allergic Diseases, 28100 Novara, Italy
| | - Paolo Marzullo
- Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy; (M.B.); (C.M.); (P.P.S.); (C.R.); (C.D.B.); (G.A.); (M.P.)
- Division of General Medicine, Ospedale S. Giuseppe, I.R.C.C.S. Istituto Auxologico Italiano, 28921 Verbania, Italy
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Li L, Liu S, Yu J. Autoimmune thyroid disease and type 1 diabetes mellitus: same pathogenesis; new perspective? Ther Adv Endocrinol Metab 2020; 11:2042018820958329. [PMID: 32973994 PMCID: PMC7493255 DOI: 10.1177/2042018820958329] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022] Open
Abstract
Autoimmune thyroid disease (AITD) and type 1 diabetes mellitus (T1DM) are two common autoimmune diseases that can occur concomitantly. In general, patients with diabetes have a high risk of AITD. It has been proposed that a complex genetic basis together with multiple nongenetic factors make a variable contribution to the pathogenesis of T1DM and AITD. In this paper, we summarize current knowledge in the field regarding potential pathogenic factors of T1DM and AITD, including human leukocyte antigen, autoimmune regulator, lymphoid protein tyrosine phosphatase, forkhead box protein P3, cytotoxic T lymphocyte-associated antigen, infection, vitamin D deficiency, and chemokine (C-X-C motif) ligand. These findings offer an insight into future immunotherapy for autoimmune diseases.
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Affiliation(s)
- Liyan Li
- Department of Endocrinology, First People’s Hospital of Jinan, Jinan, People’s Republic of China
| | - Shudong Liu
- Department of Endocrinology, Shandong Rongjun General Hospital, Jinan, People’s Republic of China
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Cyprian F, Lefkou E, Varoudi K, Girardi G. Immunomodulatory Effects of Vitamin D in Pregnancy and Beyond. Front Immunol 2019; 10:2739. [PMID: 31824513 PMCID: PMC6883724 DOI: 10.3389/fimmu.2019.02739] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 11/08/2019] [Indexed: 12/19/2022] Open
Abstract
In addition to its role in calcium homeostasis and bone formation, a modulatory role of the active form of vitamin D on cells of the immune system, particularly T lymphocytes, has been described. The effects of vitamin D on the production and action of several cytokines has been intensively investigated in recent years. In this connection, deficiency of vitamin D has been associated with several autoimmune diseases, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), Hashimoto Thyroiditis (HT), and multiple sclerosis (MS). In a successful pregnancy, the maternal immune response needs to adapt to accommodate the semiallogeneic fetus. Disturbances in maternal tolerance are implicated in infertility and pregnancy complications such as miscarriages (RM) and preeclampsia (PE). It is well-known that a subset of T lymphocytes, regulatory T cells (Tregs) exhibit potent suppressive activity, and have a crucial role in curtailing the destructive response of the immune system during pregnancy, and preventing autoimmune diseases. Interestingly, vitamin D deficiency is common in pregnant women, despite the widespread use of prenatal vitamins, and adverse pregnancy outcomes such as RM, PE, intrauterine growth restriction have been linked to hypovitaminosis D during pregnancy. Research has shown that autoimmune diseases have a significant prevalence within the female population, and women with autoimmune disorders are at higher risk for adverse pregnancy outcomes. Provocatively, dysregulation of T cells plays a crucial role in the pathogenesis of autoimmunity, and adverse pregnancy outcomes where these pathologies are also associated with vitamin D deficiency. This article reviews the immunomodulatory role of vitamin D in autoimmune diseases and pregnancy. In particular, we will describe the role of vitamin D from conception until delivery, including the health of the offspring. This review highlights an observational study where hypovitaminosis D was correlated with decreased fertility, increased disease activity, placental insufficiency, and preeclampsia in women with APS.
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Affiliation(s)
- Farhan Cyprian
- Department of Basic Medical Sciences, College of Medicine, Member of QU Health, Qatar University, Doha, Qatar
| | - Eleftheria Lefkou
- Institute of Obstetric Hematology, Perigenesis, Thessaloniki, Greece
| | - Katerina Varoudi
- Institute of Obstetric Hematology, Perigenesis, Thessaloniki, Greece
| | - Guillermina Girardi
- Department of Basic Medical Sciences, College of Medicine, Member of QU Health, Qatar University, Doha, Qatar
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Kim CY, Lee YJ, Choi JH, Lee SY, Lee HY, Jeong DH, Choi YJ. The Association between Low Vitamin D Status and Autoimmune Thyroid Disease in Korean Premenopausal Women: The 6th Korea National Health and Nutrition Examination Survey, 2013-2014. Korean J Fam Med 2019; 40:323-328. [PMID: 31476853 PMCID: PMC6768840 DOI: 10.4082/kjfm.18.0075] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND This study aimed to analyze the association of low vitamin D status with thyroid autoimmunity and dysfunction in the Korean population according to sex and menopausal status in women. METHODS This study was based on the data acquired from the 6th Korea National Health and Nutrition Examination Survey. We enrolled 4,356 subjects who had data of thyroid function, antithyroid peroxidase antibody (TPOAb), and serum 25-hydroxyvitamin D (25[OH]D) levels. We excluded subjects who were pregnant and who had a history of thyroid disease or thyroid cancer, and those with transient thyroid dysfunction who tested negative for TPOAb (TPOAb[-]). RESULTS TPOAb positivity (TPOAb[+]) with thyroid dysfunction (subclinical and overt hypothyroidism) was more prevalent in the vitamin D deficient group than in the vitamin D insufficient and sufficient groups including premenopausal (P=0.046) and postmenopausal women (P=0.032), although no significant differences were observed in men. The mean serum 25(OH)D level was significantly lower in the TPOAb(+) with thyroid dysfunction group than in the TPOAb(+) with euthyroidism and TPOAb(-) groups of premenopausal women (P=0.001), although no significant differences were observed in men and postmenopausal women. Multivariate binary logistic regression analysis, adjusted for age, body mass index, and current smoking status, showed that vitamin D insufficiency and deficiency were significantly associated with TPOAb(+) with thyroid dysfunction in premenopausal women (P<0.001), although no significant associations were observed in men and postmenopausal women. CONCLUSION Low vitamin D status was significantly associated with thyroid autoimmunity and dysfunction in the Korean population, especially in premenopausal women.
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Affiliation(s)
- Choon-Young Kim
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Yeon Ji Lee
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Ji-Ho Choi
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Soo Yeon Lee
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hye Young Lee
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Da Hye Jeong
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Yeon Jun Choi
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
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Dutta D, Sharma M, Aggarwal S, Mohindra R, Bhattacharya S, Kalra S. Vitamin D, Thyroid Autoimmunity and Cancer: An Interplay of Different Factors. Indian J Endocrinol Metab 2019; 23:507-513. [PMID: 31803589 PMCID: PMC6873262 DOI: 10.4103/ijem.ijem_526_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND AIMS In spite of large volume of data linking Vitamin D with cardiovascular morbidity, autoimmunity, cancer, and virtually every organ system, Vitamin D and thyroid is a lesser-known aspect of Vitamin D in clinical practice. This article intends to highlight the current literature on the impact of Vitamin D status and supplementation on thyroid autoimmunity and cancer. METHODS References for this review were identified through searches of PubMed for articles published to from 1950 to August 2019 using the terms "thyroid" [MeSH Terms] AND "Vitamin D" [MeSH Terms] OR "thyroid" [All Fields] AND "Vitamin D" [All Fields]. RESULTS Significant inverse correlation was documented between anti-thyroid peroxidase antibody (TPOAb) and serum 25-hydroxy-Vitamin D (25OHD). TPOAb positivity is more prevalent in Vitamin D deficient individuals. A large volume of medical literature is available from observational studies linking Vitamin D with thyroid autoimmunity. Data from interventional studies documenting beneficial effects of Vitamin D on thyroid autoimmunity is also available, but lesser than that from observational studies. Short-term high dose oral Vitamin D supplementation reduces TPOAb titers. Certain Vitamin D receptor (VDR) gene polymorphism have been linked to increased occurrence of autoimmune thyroid disorders (AITD). Vitamin D deficiency, decreased circulating calcitriol has been linked to increased thyroid cancer. Certain VDR gene polymorphisms have been linked with increased as well as decreased occurrence of thyroid cancer. Data is scant on use of Vitamin D and its analogues for treating thyroid cancer. CONCLUSION In spite of large volume of medical literature from observational studies linking Vitamin D with thyroid autoimmunity and cancer, meaningful concrete clinical data on impact of Vitamin D supplementation on hard clinical end points in these disorders is lacking, and should be the primary area of research in the next decade.
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Affiliation(s)
- Deep Dutta
- Department of Endocrinology, CEDAR Super-Specialty Clinics, Dwarka, Gujarat, India
| | - Meha Sharma
- Department of Rheumatology, CEDAR Super-Specialty Clinics, Dwarka, Gujarat, India
| | - Sameer Aggarwal
- Department of Endocrinology, Apex Super-Specialty Hospital, Rohtak, Haryana, India
| | | | | | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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Xiong S, Peng H, Ding X, Wang X, Wang L, Wu C, Wang S, Xu H, Liu Y. Circular RNA Expression Profiling and the Potential Role of hsa_circ_0089172 in Hashimoto's Thyroiditis via Sponging miR125a-3p. MOLECULAR THERAPY. NUCLEIC ACIDS 2019; 17:38-48. [PMID: 31207490 PMCID: PMC6579753 DOI: 10.1016/j.omtn.2019.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/05/2019] [Accepted: 05/05/2019] [Indexed: 12/11/2022]
Abstract
Circular RNA (circRNA) is a novel subclass of noncoding-RNA molecules that participate in development and progression of a variety of human diseases via sponging microRNAs (miRNAs), but the role of circRNAs in Hashimoto’s thyroiditis (HT) has not been defined. In this study, peripheral blood samples from five patients with HT and five healthy volunteers were investigated by Illumina HiSeq Sequencer. A total of 627 differentially expressed circRNAs including 370 upregulated and 257 downregulated ones were identified in HT patients. Four upregulated circRNAs indicated the same rising tendency toward sequencing results. The expression of hsa_circ_0089172 was upregulated and correlated positively with the serum level of the thyroid peroxidase antibody. Two perfectly matched binding sites of miR-125a-3p were found in hsa_circ_0089172 sequences with bioinformatics tools. The expression of miR-125a-3p was decreased in the HT patients and correlated inversely with an elevated level of hsa_circ_0089172. Moreover, knockdown of hsa_circ_0089172 resulted in an increase of the expression of miR-125a-3p in vitro. Receiver operating characteristic (ROC) curve analysis suggested that hsa_circ_0089172 had significant value in HT diagnosis. Taken together, these results demonstrate that hsa_circ_0089172 as a potential diagnostic biomarker of HT and may play a crucial role in the pathogenesis of HT via sponging miR-125a-3p.
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Affiliation(s)
- Si Xiong
- Department of Endocrinology, The Affiliated People's Hospital, Jiangsu University, Zhenjiang 212002, China
| | - Huiyong Peng
- Department of Laboratory Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang 212002, China
| | - Xiangmei Ding
- Department of Endocrinology, The Affiliated People's Hospital, Jiangsu University, Zhenjiang 212002, China
| | - Xuehua Wang
- Department of Endocrinology, The Affiliated People's Hospital, Jiangsu University, Zhenjiang 212002, China
| | - Li Wang
- Department of Endocrinology, The Affiliated People's Hospital, Jiangsu University, Zhenjiang 212002, China
| | - Chenguang Wu
- Department of Endocrinology, The Affiliated People's Hospital, Jiangsu University, Zhenjiang 212002, China
| | - Shengjun Wang
- Department of Laboratory Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang 212002, China
| | - Huaxi Xu
- Institute of Laboratory Medicine, Jiangsu Key Laboratory of Laboratory Medicine, Jiangsu University School of Medicine, Zhenjiang 212013, China
| | - Yingzhao Liu
- Department of Endocrinology, The Affiliated People's Hospital, Jiangsu University, Zhenjiang 212002, China.
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Serum 25-hydoxyvitamin D concentrations in relation to Hashimoto’s thyroiditis: a systematic review, meta-analysis and meta-regression of observational studies. Eur J Nutr 2019; 59:859-872. [DOI: 10.1007/s00394-019-01991-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/05/2019] [Indexed: 12/29/2022]
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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: 13] [Impact Index Per Article: 2.6] [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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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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Musa IR, Rayis DA, Ahmed MA, Khamis AH, Nasr AM, Adam I. Thyroid Function and 25 (OH) Vitamin D Level among Sudanese Women in Early Pregnancy. Open Access Maced J Med Sci 2018; 6:488-492. [PMID: 29610606 PMCID: PMC5874371 DOI: 10.3889/oamjms.2018.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/19/2017] [Accepted: 02/08/2018] [Indexed: 12/31/2022] Open
Abstract
AIM: A cross-sectional study was conducted at Saad Abualila Hospital (Khartoum, Sudan) to evaluate the vitamin D levels and thyroid function among pregnant Sudanese women (132) in early pregnancy. METHODS: A cross-sectional study was conducted at Saad Abualila hospital (Khartoum, Sudan) during the period from March to July 2015. Women who were in early pregnancy with a singleton pregnancy were approached to participate in the study after signing informed consent. A sample size of 132 participants was calculated guided by the normal interval of thyroid function in Sudanese women in the first trimester and not the level of 25(OH) vitamin D. The 25 - hydroxyvitamin D (25 (OH) vitamins levels were measured using an electrochemiluminescence immunoassay on an Elecsys 2010 Analyzer (Roche Diagnostics, Mannheim, Germany). RESULTS: The mean (SD) of age, gravidity and gestational age was 27.6 (5.5) years, 2.2 (1.6) and 10.4 (2.2) weeks, respectively. The mean (SD) of the body mass index (BMI) and haemoglobin was 27.1 (5.2) kg/m2 and 10.8 (1.1) g/dl, respectively. Median (interquartile) values of TSH, FT3, and FT4 were 1.164 IU/ml (0.079 -2.177 IU/ml), 4.639 nmol/l (3.843 - 6.562 nmol/l), and 16.86 pmol/l (13.02 - 31.48 pmol/l), respectively. There was no significant correlation between vitamin D levels and TSH, FT3 and FT4 CONCLUSION: There is no correlation between 25 (OH) vitamin D levels and thyroid function during early pregnancy among Sudanese pregnant women, despite prevalent vitamin D deficiency among these women.
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Affiliation(s)
- Imad R Musa
- King Abdu Aziz Armed Forces, Hospital at Air Base, Dhahran, Kingdom of Saudi Arabia
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Ammar H Khamis
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Abubakr M Nasr
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Yussif NM, El-Mahdi FM, Wagih R. Hypothyrodism as a risk factor of periodontitis and its relation with vitamin D deficiency: mini-review of literature and a case report. CLINICAL CASES IN MINERAL AND BONE METABOLISM 2018; 14:312-316. [PMID: 29354159 DOI: 10.11138/ccmbm/2017.14.3.312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective The purpose of this report is to investigate the role and efficiency of the intra-ligamentary injection of vitamin D and calcium in the treatment of chronic periodontitis associated with hypothyroidism. Design A 43-year-old female with suspected hypothyroidism who revealed severe chronic periodontitis with grade III mobility. Pre-operative periodontal and systemic control preceded the used intervention. After 3 months, intra-ligamentary injectable vitamin D with calcium was introduced. Results Clinical evaluation revealed great improvement of the injected sites. Marked reduction of mobility, pocket depth and bleeding were detected. Conclusions Injectabe vitamin D is an adjunctive treatment modality that needs to be discovered in another way. It may provide further solutions for the periodontal regeneration problem. Clinical studies with large sample sizes and long term follow up are needed.
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Affiliation(s)
- Nermin M Yussif
- Master Degree, Periodontology Department, Faculty of Dentistry, October University of Modern Sciences and Art (MSA), Giza, Egypt
| | - Fatema Mohammed El-Mahdi
- Master degree, Oral Diagnosis, Medicine & Periodontology Dept. Faculty of Dentistry, Sabha University, Egypt
| | - Rasha Wagih
- PhD Degree, Oral Diagnosis, Medicine & Periodontology Dept. Faculty of Oral & Dental Medicine Cairo University, Egypt
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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: 121] [Impact Index Per Article: 17.3] [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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Musa IR, Gasim GI, Khan S, Ibrahim IA, Abo-Alazm H, Adam I. No Association between 25 (OH) Vitamin D Level And Hypothyroidism among Females. Open Access Maced J Med Sci 2017; 5:126-130. [PMID: 28507615 PMCID: PMC5420761 DOI: 10.3889/oamjms.2017.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 01/16/2017] [Accepted: 02/09/2017] [Indexed: 01/22/2023] Open
Abstract
AIM: The aim was to investigate serum vitamin D (25-OH) level among females with hypothyroidism. MATERIALS AND METHODS: A case-control study (58 in each arm) was conducted in Arar Central Hospital, Kingdom Saudi Arabia. The cases were females with hypothyroidism, and healthy females were controls. TSH, thyroid hormones: Free T3 (FT3) and Free T4 (FT4) and haemoglobin levels were measured in all participants. Serum vitamin D (25-OH) level was measured using the spectrophotometry. RESULTS: While there was no significant difference in the age and haemoglobin level, body mass index (BMI) was significantly higher in the cases. Compared with the controls, cases had significantly higher TSH, had significantly lower T4, and there was no significant difference in FT3 and 25 (OH) vitamin D, [16.1 (8.8-26.7) vs. 14.0 (9.5-20.3 ng/ml; P = 0.577]. Linear regression showed no association between, age, BMI, haemoglobin, TSH, FT3, FT4 and the log of 25 (OH) vitamin D levels. CONCLUSION: There was no significant difference in vitamin D level among females with hypothyroidism and healthy controls.
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Affiliation(s)
- Imad R Musa
- Armed Forces Hospital at King Abdu Aziz Air Base, Dhahran, Saudi Arabia
| | - Gasim I Gasim
- Alneelain School of Medicine, Alneelain University, Khartoum, Sudan
| | | | | | - Hamdi Abo-Alazm
- Medical Laboratory Science, United Medical Laboratory, Saudi Arabia
| | - Ishag Adam
- Faculty of Medicine, Khartoum University, Khartoum, Sudan
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Abstract
Autoimmune thyroid diseases (AIT) are common in children and may present with a variety of signs and symptoms including: euthyroid goiter, hypothyroidism, or hyperthyroidism. The natural history of AIT may be different in children but in all age groups, there appear to be genetic risk factors and environmental triggers that initiate thyroid autoimmunity. Areas covered: In this review, we summarize recent studies that investigate the genetics and environmental triggers believed to be involved in thyroid autoimmunity. We also discuss the approach and controversies in the treatment of children with AIT. Expert commentary: Much has been learned about the major roles for genetics, cytokines, regulatory lymphocytes, and environmental triggers in CLT but controversies remain.
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Affiliation(s)
- Prasanthi Pasala
- a Pediatric Endocrinology and Metabolism, Department of Pediatrics , Children's Hospital of Richmond at Virginia Commonwealth University , Richmond , VA , USA
| | - Gary L Francis
- a Pediatric Endocrinology and Metabolism, Department of Pediatrics , Children's Hospital of Richmond at Virginia Commonwealth University , Richmond , VA , USA
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