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Pang B, Li L, Liu X, Cao Z, Pang T, Wang Q, Wei J. Association between serum vitamin D level and Graves' disease: a systematic review and meta-analysis. Nutr J 2024; 23:60. [PMID: 38849834 PMCID: PMC11157715 DOI: 10.1186/s12937-024-00960-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 05/17/2024] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVE This meta-analysis aims to analyze the relationship between serum vitamin D (VD) levels and Graves' disease (GD). METHODS We conducted a search for publications on VD and GD in the English language. Our search encompassed databases such as PubMed, Embase, Web of Science, and the Cochrane Library, covering publications available through August 2023. A meta-analysis was performed using Cochrane RevMan 5.4 software. The standardized mean difference (SMD) and 95% confidence interval (CI) were used for outcome calculation. We used R software to test for publication bias. RESULTS Twelve studies were selected, comprising 937 (22.4%) cases with GD and 3254 (77.6%) controls. The overall meta-analysis revealed that patients with GD are significantly more likely to have low VD levels (SMD = - 0.66; 95% CI: -1.05, - 0.27; p = 0.001) than those in the control group. Egger's test results indicated no publication bias (p = 0.0791). These studies exhibited a high degree of heterogeneity (chi-square = 205.86, p < 0.00001; I2 = 95%). Subgroup analysis was conducted based on assay method, geographic location, and mean age of the case group to explore the heterogeneity sources. Assay methods and geographic locations were identified as potential heterogeneity sources. Based on the mean age, there were no statistically significant differences found in the subgroup analysis of the included studies. CONCLUSION There is promising evidence that low serum VD levels may increase the risk of GD. Further rigorous and long-term trials are needed to explore the role of VD in the onset and treatment of GD.
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Affiliation(s)
- Boxian Pang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate school, Beijing University of Chinese Medicine, Beijing, China
| | - Leyang Li
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xin Liu
- Bioscience Department, University of Nottingham, Nottingham, UK
| | - Zhengmin Cao
- Infections Disease Section, Guang'anmen Hospital, China Academy of Chinese Medicine Sciences, Beijing, China
| | - Tieliang Pang
- Beijing Anding hospital, Capital Medical University, Beijing, China.
| | - Qiuhong Wang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Junping Wei
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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2
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Gorini F, Tonacci A. Vitamin D: An Essential Nutrient in the Dual Relationship between Autoimmune Thyroid Diseases and Celiac Disease-A Comprehensive Review. Nutrients 2024; 16:1762. [PMID: 38892695 PMCID: PMC11174782 DOI: 10.3390/nu16111762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
Autoimmune thyroid diseases (AITD) are among the most frequent autoimmune disorders, with a multifactorial etiology in which both genetic and environmental determinants are probably involved. Celiac disease (CeD) also represents a public concern, given its increasing prevalence due to the recent improvement of screening programs, leading to the detection of silent subtypes. The two conditions may be closely associated due to common risk factors, including genetic setting, changes in the composition and diversity of the gut microbiota, and deficiency of nutrients like vitamin D. This comprehensive review discussed the current evidence on the pivotal role of vitamin D in modulating both gut microbiota dysbiosis and immune system dysfunction, shedding light on the possible relevance of an adequate intake of this nutrient in the primary prevention of AITD and CeD. While future technology-based strategies for proper vitamin D supplementation could be attractive in the context of personalized medicine, several issues remain to be defined, including standardized assays for vitamin D determination, timely recommendations on vitamin D intake for immune system functioning, and longitudinal studies and randomized controlled trials to definitely establish a causal relationship between serum vitamin D levels and the onset of AITD and CeD.
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Affiliation(s)
- Francesca Gorini
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy;
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3
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Mikulska-Sauermann AA, Resztak M, Karaźniewicz-Łada M, Filipowicz D, Ruchała M, Główka FK. Assessment of Vitamin Concentrations in Patients with Hashimoto's Thyroiditis and Their Relationships with Thyroid Function, Biochemical Status, and Anthropometric Parameters-A Preliminary Study. Nutrients 2024; 16:1694. [PMID: 38892627 PMCID: PMC11174579 DOI: 10.3390/nu16111694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/04/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Hashimoto's thyroiditis (HT) is the leading cause of hypothyroidism, affecting mainly the female population. Many patients with HT have metabolic disorders and nutritional deficiencies. The aim of this study was to evaluate vitamin D, A, E, B2, and B6 concentrations, thyroid function, metabolic profile, and anthropometric parameters of patients with Hashimoto's thyroiditis. In 81 female patients with HT (study group), vitamin A and B2 concentrations were significantly lower than in 34 healthy women (control group). No differences were noted in vitamin D, E, and B6 concentrations between groups. Moreover, HT patients had similar anthropometric parameters, lipid profiles, and glucose and insulin concentrations compared to controls. This study showed some relationships between vitamin concentrations and anthropometric or biochemical profiles in HT patients. Among others, in the HT group, the concentration of vitamin D was positively correlated with the level of HDL and negatively correlated with BMI, total fat mass, and insulin level, which influence cardiovascular risk. The results indicate that patients with HT should be routinely tested for vitamin concentrations to prevent nutritional deficiencies. Further studies are also needed on the role of vitamins in the development and progression of HT and the presence of metabolic complications in this population.
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Affiliation(s)
- Aniceta Ada Mikulska-Sauermann
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (M.R.); (M.K.-Ł.); (F.K.G.)
- Doctoral School, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
| | - Matylda Resztak
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (M.R.); (M.K.-Ł.); (F.K.G.)
| | - Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (M.R.); (M.K.-Ł.); (F.K.G.)
| | - Dorota Filipowicz
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland; (D.F.); (M.R.)
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland; (D.F.); (M.R.)
| | - Franciszek K. Główka
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (M.R.); (M.K.-Ł.); (F.K.G.)
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Cabalar I, Le TH, Silber A, O'Hara M, Abdallah B, Parikh M, Busch R. The role of blood testing in prevention, diagnosis, and management of chronic diseases: A review. Am J Med Sci 2024:S0002-9629(24)01169-8. [PMID: 38636653 DOI: 10.1016/j.amjms.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/06/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
Blood tests are vital to prevention, diagnosis, and management of chronic diseases. Despite this, it can be challenging to construct a comprehensive view of the clinical importance of blood testing because relevant literature is typically fragmented across different disease areas and patient populations. This lack of collated evidence can also make it difficult for primary care providers to adhere to best practices for blood testing across different diseases and guidelines. Thus, this review article synthesizes the recommendations for, and importance of, blood testing across several common chronic conditions encountered in primary care and internal medicine, including cardiovascular diseases, diabetes mellitus, chronic kidney disease, vitamin D deficiency, iron deficiency, and rheumatoid arthritis. Future research is needed to continue improving chronic disease management through clearer dissemination and awareness of clinical guidelines among providers, and better access to blood testing for patients (e.g., via pre-visit laboratory testing).
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Affiliation(s)
- Imelda Cabalar
- Division of Rheumatology, Department of Medicine, Adventist HealthCare Fort Washington Medical Center, Fort Washington, MD, USA
| | - Thu H Le
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | | | | | | | | | - Robert Busch
- Division of Community Endocrinology, Department of Medicine, Albany Medical Center, Albany, NY, USA.
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Islam MA, Ahmed S, Sultana S, Alam SS, Hossan T, Gouda W, Alsaqabi F, Hassan R, Kotyla PJ. Vitamin D Status in Patients with Primary Antiphospholipid Syndrome (PAPS): A Systematic Review and Meta-Analysis. Antibodies (Basel) 2024; 13:22. [PMID: 38534213 DOI: 10.3390/antib13010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/24/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
Primary antiphospholipid syndrome (PAPS) is a systemic autoimmune disorder, characterised by consistently high levels of antiphospholipid antibodies, thrombosis, and/or pregnancy morbidity. Due to various suspected causes, deficient or insufficient levels of vitamin D in the serum have been reported in patients with PAPS; however, the reports have been sporadic and inconclusive. This systematic review and meta-analysis aimed to comprehensively evaluate the serum vitamin D levels in patients with PAPS compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42019132128) and a systematic literature search was conducted through Google Scholar, PubMed, Web of Science, Scopus, and ScienceDirect databases without restricting language and year. Pooled prevalence, mean difference (MD), and odds ratio (OR) along with 95% confidence intervals (CI) were determined by using a random effects model. Study quality was assessed by the Joana Brigg's Institute (JBI) protocol and publication bias was evaluated by a trim and fill funnel plot, Begg's, and Egger's tests. The pooled prevalence of vitamin D deficiency and insufficiency was found to be 32.2% [95% CI: 16.3-48.2] and 61.5% [95% CI: 40.2-82.8], respectively. Serum levels of vitamin D were considerably lower in the PAPS patients compared to controls (MD: -5.75, 95% CI: -9.73 to -1.77; p = 0.005). Multiple sensitivity analyses showed that the results remained statistically significant, demonstrating the robustness of this meta-analysis. No significant publication bias was detected in determining the MD of serum vitamin D levels in PAPS and controls. In conclusion, PAPS patients had greater rates of vitamin D deficiency or insufficiency, higher frequency of thrombosis, and lower serum vitamin D levels than healthy individuals.
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Affiliation(s)
- Md Asiful Islam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Saleh Ahmed
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Shabiha Sultana
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Sayeda Sadia Alam
- Department of Biochemistry & Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Tareq Hossan
- Department of Biochemistry & Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
- Department of Internal Medicine, Division of Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA
| | - Wesam Gouda
- Department of Rheumatology, Al-Azhar University Hospital, Assiut 71524, Egypt
- Department of Rheumatology, Al-Sabah Hospital, Kuwait City P.O. Box 4078, Kuwait
| | - Faisal Alsaqabi
- Department of Rheumatology, Al-Sabah Hospital, Kuwait City P.O. Box 4078, Kuwait
| | - Rosline Hassan
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Przemysław J Kotyla
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Faculty in Katowice, Medical University of Silesia, 40-635 Katowice, Poland
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Zhang J, Song Z, Yuan H, Cai ZH. The effects of metabolic indicators and immune biomarkers on pregnancy outcomes in women with recurrent spontaneous abortion: a retrospective study. Front Endocrinol (Lausanne) 2024; 14:1297902. [PMID: 38298186 PMCID: PMC10827934 DOI: 10.3389/fendo.2023.1297902] [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: 09/20/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
Background The etiology of recurrent spontaneous abortion (RSA) remains elusive despite specific investigations affirming the association between RSA and thyroid autoimmunity (TAI). This study explores the immunological and metabolic profiles of RSA patients exhibiting positive thyroid antibodies and their connection with the rates of first-trimester miscarriage and live births. The aim is to provide further guidance for clinical interventions. Methods A retrospective analysis included 478 women with RSA. Thyroid profile, thyroid peroxidase antibodies, and anti-thyroglobulin antibodies were measured in all participants. The clinical characteristics and pregnancy outcomes of RSA women were compared between thyroid autoimmunity (TAI)-positive and TAI-negative patients. Significant factors associated with adverse pregnancy outcomes and risk prediction models were explored in TAI-positive patients. Correlation analysis was used to identify specific metabolic or immune biomarkers associated with thyroid autoantibodies. Results The prevalence of TAI was 18.6%. Compared with women without TAI, the thyroid-stimulating hormone (TSH) concentration of TAI-positive RSA was significantly higher (2.80 ± 2.98 vs 1.89 ± 1.17, p=0.006). After 28 weeks, the live birth rate of the TAI-positive group was lower than that of the TAI-negative group, with statistical significance (p<0.05). The immune biomarkers that differed between RSA women with live births and those with first-trimester miscarriages were complement C4 and interleukin-6, respectively, in TAI-negative and TAI-positive women. Then, a risk prediction model for first-trimester miscarriage was constructed for TAI-positive women with an AUC of 0.81. Finally, some factors related to thyroid peroxidase antibody (TPO-Ab) levels were explored, and it was found that TPO-Ab levels were positively correlated with free thyroxine and negatively correlated with 25 hydroxyvitamin D, interleukin-4, and fasting blood glucose in RSA patients. Conclusion TAI-positive RSA patients have higher first-trimester miscarriage rates and a lower live birth rate, which may be related to metabolic immune shifts in TAI-positive RSA patients.
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Affiliation(s)
- Jie Zhang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhan Song
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hui Yuan
- Key Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co., Ltd., Hangzhou, Zhejiang, China
| | - Zhu-Hua Cai
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Grygorieva N, Tronko M, Kovalenko V, Komisarenko S, Tatarchuk T, Dedukh N, Veliky M, Strafun S, Komisarenko Y, Kalashnikov A, Orlenko V, Pankiv V, Shvets O, Gogunska I, Regeda S. Ukrainian Consensus on Diagnosis and Management of Vitamin D Deficiency in Adults. Nutrients 2024; 16:270. [PMID: 38257163 PMCID: PMC10820145 DOI: 10.3390/nu16020270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Vitamin D deficiency (VDD) is a global problem, however, there were no Ukrainian guidelines devoted to its screening, prevention, and treatment, which became the reason for the Consensus creation. This article aimed to present the Consensus of Ukrainian experts devoted to VDD management. Following the creation of the multidisciplinary Consensus group, consent on the formation process, drafting and fine-tuning of key recommendations, and two rounds of voting, 14 final recommendations were successfully voted upon. Despite a recent decrease in VDD prevalence in Ukraine, we recommend raising awareness regarding VDD's importance and improving the strategies for its decline. We recommend screening the serum 25-hydroxyvitamin D (25(OH)D) level in risk groups while maintaining a target concentration of 75-125 nmol/L (30-50 ng/mL). We recommend prophylactic cholecalciferol supplementation (800-2000 IU/d for youthful healthy subjects, and 3000-5000 IU/d for subjects from the risk groups). For a VDD treatment, we recommend a short-term administration of increased doses of cholecalciferol (4000-10,000 IU/d) with 25(OH)D levels monitored after 4-12 weeks of treatment, followed by the use of maintenance doses. Additionally, we recommend assessing serum 25(OH)D levels before antiosteoporotic treatment and providing vitamin D and calcium supplementation throughout the full course of the antiosteoporotic therapy.
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Affiliation(s)
- Nataliia Grygorieva
- D.F. Chebotarev Institute of Gerontology, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Mykola Tronko
- V.P. Komisarenko Institute of Endocrinology and Metabolism, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Volodymir Kovalenko
- National Scientific Center «The M.D. Strazhesko Institute of Cardiology», Clinical and Regenerative Medicine, The National Academy of Medical Sciences of Ukraine, 03151 Kyiv, Ukraine
| | - Serhiy Komisarenko
- Palladin Institute of Biochemistry, The National Academy of Sciences of Ukraine, 02000 Kyiv, Ukraine
| | - Tetiana Tatarchuk
- Institute of Pediatrics, Obstetrics and Gynecology Named after Academician O.M. Lukyanova, The National Academy of Medical Sciences of Ukraine, 04050 Kyiv, Ukraine
| | - Ninel Dedukh
- D.F. Chebotarev Institute of Gerontology, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Mykola Veliky
- Palladin Institute of Biochemistry, The National Academy of Sciences of Ukraine, 02000 Kyiv, Ukraine
| | - Serhiy Strafun
- Institute of Traumatology and Orthopedics, The National Academy of Medical Sciences of Ukraine, 01601 Kyiv, Ukraine
| | - Yulia Komisarenko
- Department of Endocrinology, O.O. Bogomolets National Medical University, 01601 Kyiv, Ukraine
| | - Andrii Kalashnikov
- Institute of Traumatology and Orthopedics, The National Academy of Medical Sciences of Ukraine, 01601 Kyiv, Ukraine
| | - Valeria Orlenko
- V.P. Komisarenko Institute of Endocrinology and Metabolism, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Volodymyr Pankiv
- Ukrainian Scientific and Practical Centre for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues, Health Ministry of Ukraine, 01021 Kyiv, Ukraine
| | - Oleg Shvets
- Department of Public Health and Nutrition, National University of Life and Environmental Sciences of Ukraine, 03041 Kyiv, Ukraine
| | - Inna Gogunska
- O.S. Kolomiychenko Institute of Otolaryngology, The National Academy of Medical Sciences of Ukraine, 03057 Kyiv, Ukraine
| | - Svitlana Regeda
- Center of Innovative Medical Technologies, The National Academy of Sciences of Ukraine, 04053 Kyiv, Ukraine
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8
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Liu S, Tan B, Zhou J, Xiao L, Li M, Yin J. Vitamin D status and the risk of neuromyelitis optica spectrum disorders: A systematic review and meta-analysis. J Clin Neurosci 2024; 119:185-192. [PMID: 38113581 DOI: 10.1016/j.jocn.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Previous studies have linked vitamin D deficiency with autoimmune diseases, and recent research has found low vitamin D levels in neuromyelitis optica spectrum disorder (NMOSD) patients. We aimed to determine the variances in serum 25(OH)D levels between NMOSD patients and healthy controls. METHODS We searched English and Chinese databases (PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, WanFang Med, VIP) for observational studies related to serum 25(OH)D levels in NMOSD patients published up to August 24, 2023. We included studies with healthy controls and compared serum 25(OH)D levels between NMOSD patients and controls. We computed the mean difference (MD) and 95% confidence interval (CI) for continuous variables to evaluate serum 25(OH)D levels and combined odds ratios (ORs) and 95% CIs for dichotomized 25(OH)D data. RESULTS Six papers were selected for meta-analysis, including 794 participants (347 in the NMOSD group and 447 in the healthy control group). Meta-analysis showed significantly lower serum 25(OH)D levels in the NMOSD group (MD: -7.83, 95 % CI: -10.99 to -4.68). The risk of 25(OH)D deficiency was 23.36 times higher in the NMOSD group (OR: 23.36, 95 % CI: 0.85 to 640.76, p = 0.06>0.05), with a 94 % occurrence rate. There was no significant difference in the risk of having sufficient 25(OH)D between the groups (p = 0.12>0.05). CONCLUSION NMOSD patients have lower serum 25(OH)D levels than healthy controls. However, the current research results do not provide evidence for a causal relationship between serum 25(OH)D levels and the onset of NMOSD. Routine vitamin D supplementation may be advantageous for patients with NMOSD.
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Affiliation(s)
- Shuangxi Liu
- Department of Neurology, Hunan University of Medicine General Hospital, Hunan 418000, PR China
| | - Bichun Tan
- Department of Neurology, People's Hospital of Mayang Miao Autonomous County, Hunan 419400, PR China
| | - Jun Zhou
- Department of Neurology, Hunan University of Medicine General Hospital, Hunan 418000, PR China
| | - Liqian Xiao
- Department of Health Management Center, Hunan University of Medicine General Hospital, Hunan 418000, PR China
| | - Minxia Li
- Department of Neurology, Hunan University of Medicine General Hospital, Hunan 418000, PR China
| | - Junjie Yin
- Department of Neurology, Hunan University of Medicine General Hospital, Hunan 418000, PR China.
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Osowiecka K, Skrypnik D, Myszkowska-Ryciak J. Assessment of the Impact of Nutritional Intervention with the Probiotic Lactiplantibacillus plantarum 299v on Nutritional Status and Quality of Life of Hashimoto's Thyroiditis Patients-A Randomized Double-Blind Study Protocol. J Pers Med 2023; 13:1659. [PMID: 38138886 PMCID: PMC10744439 DOI: 10.3390/jpm13121659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/01/2023] [Accepted: 11/08/2023] [Indexed: 12/24/2023] Open
Abstract
The current treatment for the autoimmune disease of hypothyroidism (AIDH) is based on pharmacotherapy with levothyroxine. A non-pharmacological supplementary element of therapy could be the implementation of an individualized balanced diet and probiotics. Lactiplantibacillus plantarum 299v (Lp299v), with its anti-inflammatory effects, may also support the therapy. However, the number of studies on personalized dietary interventions with probiotics in AIDH is limited, and no clear conclusions can be drawn from the results so far. Therefore, this trial will analyze the effect of Lp299v supplementation in conjunction with nutrition education on the quality of life and nutritional status of patients with Hashimoto's. Methods: This double-blind, 12-week intervention study will include 100 female patients with AIDH. They will be divided into two groups: (1) individual personalized nutrition education + Lp299v and (2) individual personalized nutrition education + placebo. Before and after the education intervention, selected elements in the diet, eating behavior, quality of life, nutritional status (anthropometric parameters, body composition), blood pressure, and anti-TPO (antibodies against thyroid peroxidase) titer will be assessed. Hypothesis: It is expected that this study will provide deeper knowledge on the validity of using proper nutritional principles and Lp299v in AIDH. Specifically, the impact on the subjective assessment of the quality of life, selected elements in the diet, and the state of nutrition and health will be assessed.
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Affiliation(s)
- Karolina Osowiecka
- Doctoral School, Warsaw University of Life Sciences (WULS), 02-787 Warsaw, Poland
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 02-776 Warsaw, Poland
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 60-569 Poznan, Poland
| | - Joanna Myszkowska-Ryciak
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 02-776 Warsaw, Poland
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10
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Johnson CR, Thacher TD. Vitamin D: immune function, inflammation, infections and auto-immunity. Paediatr Int Child Health 2023; 43:29-39. [PMID: 36857810 DOI: 10.1080/20469047.2023.2171759] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/12/2022] [Indexed: 03/03/2023]
Abstract
Vitamin D plays an active role beyond mineral metabolism and skeletal health, including regulation of the immune system. Vitamin D deficiency is widely prevalent, and observational studies link low vitamin D status to a risk of infections and auto-immune disorders. Reports indicate an inverse relationship between vitamin D status and such conditions. This review details vitamin D signalling interactions with the immune system and provides experimental and clinical evidence evaluating vitamin D status, vitamin D supplementation and host susceptibility to infections, inflammation and auto-immunity. The published literature including related reviews, systematic reviews, meta-analyses, randomised controlled trials (RCTs), observational studies and basic science reports have been synthesised. Meta-analyses of observational studies have demonstrated a link between low vitamin D status and risk of acute respiratory infections, COVID-19 disorders, multiple sclerosis, type 1 diabetes (T1DM), inflammatory bowel disease (IBD), systemic lupus erythematosus and other auto-immune disorders. Observational studies suggest that vitamin D supplementation may protect against several infectious and auto-immune conditions. Meta-analyses of RCTs had mixed results, demonstrating a small protective role for vitamin D supplementation against acute respiratory infections, especially in those with vitamin D deficiency and children, and providing modest benefits for the management of T1DM and IBD. Vitamin D status is inversely associated with the incidence of several infectious and auto-immune conditions. Supplementation is recommended for those with vitamin D deficiency or at high risk of deficiency, and it might provide additional benefit in acute respiratory infections and certain auto-immune conditions.
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Affiliation(s)
- Casey R Johnson
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Tom D Thacher
- Department of Family Medicine, Mayo Clinic, Rochester, New York, USA
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11
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Ruggeri RM, Barbalace MC, Croce L, Malaguti M, Campennì A, Rotondi M, Cannavò S, Hrelia S. Autoimmune Thyroid Disorders: The Mediterranean Diet as a Protective Choice. Nutrients 2023; 15:3953. [PMID: 37764737 PMCID: PMC10535745 DOI: 10.3390/nu15183953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Autoimmune thyroid diseases are on the rise worldwide, and such a rapid increase is mainly driven by environmental factors related to changed lifestyles in "modern" societies. In this context, diet seems to play a crucial role. An unhealthy high-energy diet, rich in animal fat and proteins, salt and refined sugars (the so-called "Western diet") negatively influences the risk of autoimmunity by altering the immune balance and the gut microbiota composition, enhancing oxidative stress and promoting inflammation. In contrast, the Mediterranean diet represents a unique model of healthy eating, characterized by a high intake of food from vegetable sources, a low consumption of saturated fats in favor of unsaturated fats (mainly, olive oil), a moderate consumption of fish (typically, the small oily fishes) and dairy products, as well as a moderate consumption of wine at meals, and a low intake of meat. Thanks to its nutritional components, the Mediterranean Diet positively influences immune system function, gut microbiota composition, and redox homeostasis, exerting anti-oxidants, anti-inflammatory, and immunomodulatory effects. The present review was aimed at exploring the existing knowledge on the correlations between dietary habits and thyroid autoimmunity, to evaluate the role of the Mediterranean diet as a protective model.
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Affiliation(s)
- Rosaria Maddalena Ruggeri
- Department of Human Pathology of Adulthood and Childhood DETEV “G. Barresi”, Endocrinology Unit, University of Messina, 98125 Messina, Italy;
| | - Maria Cristina Barbalace
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (M.C.B.); (S.H.)
| | - Laura Croce
- Department of Internal Medicine and Therapeutics, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) University of Pavia, 27100 Pavia, Italy; (L.C.); (M.R.)
| | - Marco Malaguti
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (M.C.B.); (S.H.)
| | - Alfredo Campennì
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Unit of Nuclear Medicine, University of Messina, 98125 Messina, Italy;
| | - Mario Rotondi
- Department of Internal Medicine and Therapeutics, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) University of Pavia, 27100 Pavia, Italy; (L.C.); (M.R.)
| | - Salvatore Cannavò
- Department of Human Pathology of Adulthood and Childhood DETEV “G. Barresi”, Endocrinology Unit, University of Messina, 98125 Messina, Italy;
| | - Silvana Hrelia
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (M.C.B.); (S.H.)
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12
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Zhou L, Wang Y, Su J, An Y, Liu J, Wang G. Vitamin D Deficiency Is Associated with Impaired Sensitivity to Thyroid Hormones in Euthyroid Adults. Nutrients 2023; 15:3697. [PMID: 37686729 PMCID: PMC10490158 DOI: 10.3390/nu15173697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
The relationship between vitamin D deficiency and sensitivity to thyroid hormones was unclear. We aimed to explore the association of 25-hydroxyvitamin D (25(OH)D) levels with thyroid hormone sensitivity in euthyroid adults. A total of 3143 subjects were included. The serum 25(OH)D, free thyroxine (FT3), free thyrotropin (FT4), thyroid-stimulating hormone (TSH), and other clinical variables were measured. Vitamin D deficiency was defined as 25(OH)D < 20 ng/mL. Thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI), thyroid-stimulating hormone index (TSHI), thyrotrophic thyroxine resistance index (TT4RI), and FT3/FT4 were calculated to assess thyroid hormone sensitivity. Results showed that 58.8% of the participants had vitamin D deficiency. They had significantly higher levels of triglyceride, insulin, FT3, FT4, TSH, TFQI, PTFQI, TSHI, and TT4RI and lower levels of high-density lipoprotein cholesterol than those with sufficient vitamin D (all p < 0.05). Logistic regression analysis showed that the risk of impaired sensitivity to thyroid hormones evaluated by TFIQ, PTFQI, TSHI, and TT4RI increased by 68% (OR: 1.68; 95%CI: 1.45-1.95; and p < 0.001), 70% (OR: 1.70; 95%CI: 1.46-1.97; and p < 0.001), 66% (OR: 1.66; 95%CI: 1.43-1.92; and p < 0.001), and 50% (OR: 1.50; 95%CI: 1.30-1.74; and p < 0.001), respectively, in participants with vitamin D deficiency compared with those with sufficient vitamin D after adjusting for multiple confounders. In conclusion, in euthyroid populations, vitamin D deficiency was associated with impaired sensitivity to thyroid hormones.
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Affiliation(s)
- Liyuan Zhou
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; (L.Z.); (J.S.); (Y.A.); (J.L.)
| | - Ying Wang
- Medical Examination Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China;
| | - Jingru Su
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; (L.Z.); (J.S.); (Y.A.); (J.L.)
| | - Yu An
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; (L.Z.); (J.S.); (Y.A.); (J.L.)
| | - Jia Liu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; (L.Z.); (J.S.); (Y.A.); (J.L.)
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; (L.Z.); (J.S.); (Y.A.); (J.L.)
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13
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Berisha-Muharremi V, Tahirbegolli B, Phypers R, Hanna R. Efficacy of Combined Photobiomodulation Therapy with Supplements versus Supplements alone in Restoring Thyroid Gland Homeostasis in Hashimoto Thyroiditis: A Clinical Feasibility Parallel Trial with 6-Months Follow-Up. J Pers Med 2023; 13:1274. [PMID: 37623524 PMCID: PMC10455109 DOI: 10.3390/jpm13081274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
Hashimoto thyroiditis (HT) is a thyroid-specific autoimmune disorder, triggering hypothyroidism in a population with an adequate dietary intake. Despite the current conventional treatment focuses on the permanent replacement of levothyroxine (LT4) deficiency, it appears that thyroid autoimmunity remains the cause of persistent symptoms in patients with HT, even when they achieve to be euthyroid from a biochemical standpoint. Photobiomodulation (PBM) showed to be an effective therapy in the management of autoimmune diseases, but with limited evidence. Hence, our study was conducted to appraise the efficacy of PBM therapy with supplements in restoring thyroid gland homeostasis in patients with HT compared with supplements alone. Seventy-four female subjects aged between 20 and 50 years old were recruited and divided equally into two groups: PBM and supplements group (group 1); and supplements alone group (group 2). The PBM dosimetry and treatment protocols were as follows: wavelength, 820 nm; power output, 200 mW; continuous emission mode; irradiating time, 20 s per point; fluence, 32 J/cm2 per point; treatment frequency, twice a week (excluding weekends); and treatment duration, three consecutive weeks. Whereas, the supplements protocol for both groups was the same, as follows: subjects with a serum level of vitamin D3 <40 ng/dL, who received replacement according to their serum levels, and all the subjects had a daily intake of 100 µg of oral selenium. The biochemical (FT3, FT4, antiTPO and antiTG) and anthropometric measurements were evaluated. Our findings showed significant improvement in group 1 parameters (PBM+ supplements) compared with group 2 (supplements only) in terms of weight loss and reduction in the following parameters: BMI, hip and waist circumference, waist/hip ratio, TSH, antiTPO, antiTG and treatment dose of LT4 (p < 0.05). Our results, for the first time, demonstrated an efficacy of PBM delivered at a lower fluence with supplements in restoring thyroid function, anthropometric parameters and lifestyle factors in patients with HT. Hence, extensive studies with a longer follow-up period are warranted.
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Affiliation(s)
- Venera Berisha-Muharremi
- Faculty of Medicine, University of Prishtina, Bulevardi i Dëshmorëve nn, 10000 Prishtina, Kosovo;
- Poliklinika Endomedica, Muharrem Fejza Str. Nr. 84, 10000 Prishtina, Kosovo
| | - Bernard Tahirbegolli
- Department of Management of Health Institution and Services, Heimerer College, 10000 Prishtina, Kosovo;
- National Sports Medicine Centre, Lagjia e Spitalit nn, 10000 Prishtina, Kosovo
| | - Ruth Phypers
- Laser Medicine Centre, 10 Harley Street, London W1G 9PF, UK;
| | - Reem Hanna
- Department of Oral Surgery, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 16132 Genoa, Italy
- Department of Restorative Dental Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, Rockefeller, University College London, London WC1E 6DE, UK
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14
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Zirilli A, Ruggeri RM, Barbalace MC, Hrelia S, Giovanella L, Campennì A, Cannavò S, Alibrandi A. The Influence of Food Regimes on Oxidative Stress: A Permutation-Based Approach Using the NPC Test. Healthcare (Basel) 2023; 11:2263. [PMID: 37628461 PMCID: PMC10454221 DOI: 10.3390/healthcare11162263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/01/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: This paper aims to assess the existence of significant differences between two dietary regimes (omnivorous vs. semi-vegetarian) with reference to some oxidative stress markers (SOD, GPx, TRxR, GR, AGEs, and AOPPs) using non-parametric combination methodology based on a permutation test. (2) Methods: At the endocrinology unit of Messina University Hospital, two hundred subjects were asked to fill out a questionnaire about their dietary habits. None were under any pharmacological treatment. Using the NPC test, all comparisons were performed stratifying patients according to gender, age (≤40 or >40 years), BMI (normal weight vs. overweight), physical activity (sedentary vs. active lifestyle), TSH, FT4 levels in quartiles, and diagnosis of Hashimoto's thyroiditis. We evaluated differences in oxidative stress parameters in relation to two examined dietary regimes (omnivorous vs. semi-vegetarian). (3) Results: The antioxidant parameters GPx and TRxR were significantly lower in subjects with an omnivorous diet than in semi-vegetarians, particularly in females, both age groups, subjects with normal weight, those not affected by Hashimoto's thyroiditis, and both the sedentary and active lifestyle groups. Finally, the AGE and AOPP markers were significantly lower in semi-vegetarians. (4) Conclusion: Thanks to the NPC methodology, we can state that dietary patterns exert a significant influence on some oxidative stress parameters.
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Affiliation(s)
- Agata Zirilli
- Department of Economics, University of Messina, 98122 Messina, Italy;
| | - Rosaria Maddalena Ruggeri
- Department of Human Pathology of Adults and Developmental Age “G. Barresi”, University of Messina, 98125 Messina, Italy; (R.M.R.); (S.C.)
| | - Maria Cristina Barbalace
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (M.C.B.); (S.H.)
| | - Silvana Hrelia
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (M.C.B.); (S.H.)
| | - Luca Giovanella
- Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland;
- Clinic for Nuclear Medicine, University Hospital of Zürich, 8091 Zürich, Switzerland
| | - Alfredo Campennì
- Unit of Nuclear Medicine, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy;
| | - Salvatore Cannavò
- Department of Human Pathology of Adults and Developmental Age “G. Barresi”, University of Messina, 98125 Messina, Italy; (R.M.R.); (S.C.)
| | - Angela Alibrandi
- Department of Economics, University of Messina, 98122 Messina, Italy;
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15
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Lebiedziński F, Lisowska KA. Impact of Vitamin D on Immunopathology of Hashimoto's Thyroiditis: From Theory to Practice. Nutrients 2023; 15:3174. [PMID: 37513592 PMCID: PMC10385100 DOI: 10.3390/nu15143174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Hashimoto's thyroiditis (HT) is a common autoimmune disease affecting the thyroid gland, characterized by lymphocytic infiltration, damage to thyroid cells, and hypothyroidism, and often requires lifetime treatment with levothyroxine. The disease has a complex etiology, with genetic and environmental factors contributing to its development. Vitamin D deficiency has been linked to a higher prevalence of thyroid autoimmunity in certain populations, including children, adolescents, and obese individuals. Moreover, vitamin D supplementation has shown promise in reducing antithyroid antibody levels, improving thyroid function, and improving other markers of autoimmunity, such as cytokines, e.g., IP10, TNF-α, and IL-10, and the ratio of T-cell subsets, such as Th17 and Tr1. Studies suggest that by impacting various immunological mechanisms, vitamin D may help control autoimmunity and improve thyroid function and, potentially, clinical outcomes of HT patients. The article discusses the potential impact of vitamin D on various immune pathways in HT. Overall, current evidence supports the potential role of vitamin D in the prevention and management of HT, although further studies are needed to fully understand its mechanisms of action and potential therapeutic benefits.
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Affiliation(s)
- Filip Lebiedziński
- Department of Physiopathology, Medical University of Gdańsk, 80-211 Gdansk, Poland
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16
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Rattanamusik N, Uitrakul S, Charoenpiriya A. Vitamin D Levels in Patients with Active and Remission Graves' Disease. MEDICINES (BASEL, SWITZERLAND) 2023; 10:41. [PMID: 37505062 PMCID: PMC10383553 DOI: 10.3390/medicines10070041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND The association between Graves' disease (GD) and serum vitamin D levels has been studied for decades although the results were controversial. Moreover, the difference in vitamin D levels between the different stages of GD is not well studied. Therefore, this study aimed to compare the vitamin D levels between active and remission GD and to investigate the factors affecting vitamin D levels in GD patients. METHODS This cross-sectional study was performed between 1 January to 31 December 2021. The eligible patients were in either the active or remission stage of GD. The demographic and clinical data of the patients willing to participate in the study were collected, as well as their vitamin D levels. Comparisons of continuous parameters between the active and remission groups were performed using the Mann-Whitney U test, while categorical parameters were performed using the Chi-square test. RESULTS 75 patients were diagnosed with GD, with 54.7% in the active stage. The mean vitamin D level was lower in the active GD group than in the remission GD group (28.23 vs. 31.58 ng/mL, respectively, p-value 0.079). The prevalence of vitamin D deficiency (i.e., serum vitamin D level < 20 ng/mL) in the active GD group was 14.6%, and in the remission GD group was 0% (p-value 0.02). Moreover, there was a significant negative correlation between the serum vitamin D level and serum free T4 level (p-value 0.03). CONCLUSIONS In spite of non-significance, patients with active GD had lower mean vitamin D levels compared to those with remission GD. The prevalence of vitamin D deficiency was significantly higher in the active GD patients. Additionally, a negative correlation between serum vitamin D levels and serum free T4 levels was observed in this study.
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Affiliation(s)
- Natapon Rattanamusik
- Department of Medicine, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat 80000, Thailand
| | - Suriyon Uitrakul
- Department of Pharmaceutical Care, School of Pharmacy, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Atchara Charoenpiriya
- Department of Medicine, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat 80000, Thailand
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17
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Hands JM, Corr PG, Frame LA. Clarifying the Heterogeneity in Response to Vitamin D in the Development, Prevention, and Treatment of Type 2 Diabetes Mellitus: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6187. [PMID: 37372772 DOI: 10.3390/ijerph20126187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023]
Abstract
In this review, we explore the potential drivers of heterogeneity in response to Vitamin D (VitD) therapy, such as bioavailability, sex-specific response, and autoimmune pathology, in those at risk for and diagnosed with T2DM. In addition, we propose distinct populations for future interventions with VitD. The literature concerning VitD supplementation in the prevention, treatment, and remission of type 2 diabetes mellitus (T2DM) spans decades, is complex, and is often contradictory with mixed findings upon intervention. By association, VitD status is powerfully predictive with deficient subjects reporting greater risk for T2DM, conversion to T2DM from prediabetes, and enhanced response to VitD therapy. Preclinical models strongly favor intervention with VitD owing to the pleiotropic influence of VitD on multiple systems. Additional research is crucial as there remain many questions unanswered that are related to VitD status and conditions such as T2DM. Future research must be conducted to better understand the potentially spurious relationships between VitD status, supplementation, sun exposure, health behaviors, and the diagnosis and management of T2DM. Public health practice can greatly benefit from a better understanding of the mechanisms by which we can reliably increase VitD status and how this can be used to develop education and improve health behaviors.
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Affiliation(s)
- Jacob M Hands
- The George Washington University School of Medicine & Health Sciences, Washington, DC 20037, USA
| | - Patrick G Corr
- The George Washington University School of Medicine & Health Sciences, Washington, DC 20037, USA
| | - Leigh A Frame
- The George Washington University School of Medicine & Health Sciences, Washington, DC 20037, USA
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18
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Piovani D, Brunetta E, Bonovas S. UV radiation and air pollution as drivers of major autoimmune conditions. ENVIRONMENTAL RESEARCH 2023; 224:115449. [PMID: 36764434 DOI: 10.1016/j.envres.2023.115449] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/18/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Autoimmune diseases comprise a very heterogeneous group of disorders characterized by disruptive immune responses against self-antigens, chronic morbidity and increased mortality. The incidence and prevalence of major autoimmune conditions are particularly high in the western world, at northern latitudes, and in industrialized countries. This study will mainly focus on five major autoimmune conditions, namely type 1 diabetes, multiple sclerosis, inflammatory bowel diseases, rheumatoid arthritis, and autoimmune thyroid disorders. Epidemiological and experimental evidence suggests a protective role of sunlight exposure on the etiology of major autoimmune conditions mediated by the endogenous production of vitamin D and nitric oxide. A historical perspective shows how the rise of anthropogenic air pollutants is temporally associated with dramatic increases in incidence of these conditions. The scattering caused by ambient particulate matter and the presence of tropospheric ozone can reduce the endogenous production of vitamin D and nitric oxide, which are implicated in maintaining the immune homeostasis. Air pollutants have direct detrimental effects on the human body and are deemed responsible of an increasingly higher portion of the annual burden of human morbidity and mortality. Air pollution contributes in systemic inflammation, activates oxidative pathways, induces epigenetic alterations, and modulates the function and phenotype of dendritic cells, Tregs, and T-cells. In this review, we provide epidemiological and mechanistic insights regarding the role of UV-mediated effects in immunity and how anthropic-derived air pollution may affect major autoimmune conditions through direct and indirect mechanisms.
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Affiliation(s)
- Daniele Piovani
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, 20089, Rozzano, Milan, Italy.
| | - Enrico Brunetta
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, 20089, Rozzano, Milan, Italy
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, 20089, Rozzano, Milan, Italy
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19
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Pinto S, Croce L, Carlier L, Cosson E, Rotondi M. Thyroid dysfunction during gestation and gestational diabetes mellitus: a complex relationship. J Endocrinol Invest 2023:10.1007/s40618-023-02079-3. [PMID: 37024642 PMCID: PMC10372128 DOI: 10.1007/s40618-023-02079-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE Gestational diabetes mellitus (GDM) and thyroid dysfunction during gestation (GTD) are the two most prevalent endocrinopathies during pregnancy. The aim of the present review is to provide an overview of the peculiar aspects of GDM and GTD, to highlight the potential interactions and clinical consequences of these two frequent clinical conditions. METHODS A literature review regarding GDM and GTD was carried out with particular interest on meta-analyses and human studies dealing with the (i) shared risk factors between GDM and GTD, (ii) the epidemiological link between GTD and GDM, (iii) physiopathologic link between GTD and GDM, (iv) clinical consequences of GDM and GTD, and (v) post-partum implications of GDM and GTD. RESULTS The association between GDM and GTD is common and may be explained by the insulin-resistance state due to maternal GTD, to alterations in the placentation process or to the many shared risk factors. Discrepant results of epidemiologic studies can be explained, at least in part, by the changes in diagnostic criteria and screening strategies throughout the years for both conditions. GDM and GTD impact pregnancy outcome and have post-partum long-term consequences, but more studies are needed to prove an additional adverse effect. CONCLUSIONS Based on the epidemiological and physio-pathological link between GDM and GTD, it could be suggested that a diagnosis of GTD could lead to screen GDM and the other way round.
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Affiliation(s)
- S Pinto
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- AP-HP, Ambulatory Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
| | - L Croce
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Pavia, PV, Italy
- Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, PA, Italy
| | - L Carlier
- AP-HP, Ambulatory Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
| | - E Cosson
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- UMR U1153 INSERM/U11125 INRA/CNAM/Université Paris 13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - M Rotondi
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Pavia, PV, Italy.
- Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy.
- NBFC, National Biodiversity Future Center, 90133, Palermo, PA, Italy.
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20
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Molecular Mechanisms in Autoimmune Thyroid Disease. Cells 2023; 12:cells12060918. [PMID: 36980259 PMCID: PMC10047067 DOI: 10.3390/cells12060918] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
The most common cause of acquired thyroid dysfunction is autoimmune thyroid disease, which is an organ-specific autoimmune disease with two presentation phenotypes: hyperthyroidism (Graves-Basedow disease) and hypothyroidism (Hashimoto’s thyroiditis). Hashimoto’s thyroiditis is distinguished by the presence of autoantibodies against thyroid peroxidase and thyroglobulin. Meanwhile, autoantibodies against the TSH receptor have been found in Graves-Basedow disease. Numerous susceptibility genes, as well as epigenetic and environmental factors, contribute to the pathogenesis of both diseases. This review summarizes the most common genetic, epigenetic, and environmental mechanisms involved in autoimmune thyroid disease.
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21
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Corsello A, Spolidoro GCI, Milani GP, Agostoni C. Vitamin D in pediatric age: Current evidence, recommendations, and misunderstandings. Front Med (Lausanne) 2023; 10:1107855. [PMID: 37007781 PMCID: PMC10060648 DOI: 10.3389/fmed.2023.1107855] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
In recent years vitamin D has been in the spotlight of many researchers for its possible role in various disorders, including autoimmune and infectious diseases. Even if vitamin D deficiency remains a major public health problem, its symptomatic manifestations are less and less common in clinical practice, and pediatric age represents a “gray area” where vitamin D supplementation is often administered in the absence of an effective evaluation of its status. Moreover, a poor knowledge about different definitions of “deficiency,” “insufficiency,” and similar terms is spread among clinicians, while guidelines are not univocal, especially after the first year of life. The aim of this brief opinion paper is to sum up recent evidence about vitamin D status and its supplementation in pediatrics, in order to better clarify a common definition of its deficiency. The aim of this opinion article is to raise awareness on this topic among clinicians and encourage a discussion on the real need for routine 25-hydroxycholecalciferol serum evaluation and its supplementation.
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Affiliation(s)
- Antonio Corsello
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Gregorio P. Milani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- *Correspondence: Gregorio P. Milani,
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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The Influence of Nutritional Intervention in the Treatment of Hashimoto's Thyroiditis-A Systematic Review. Nutrients 2023; 15:nu15041041. [PMID: 36839399 PMCID: PMC9962371 DOI: 10.3390/nu15041041] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Diet can be a complementary treatment for Hashimoto's disease by affecting thyroid function and anti-inflammatory properties. It is still unclear which dietary strategy would be the most beneficial. The aim of this systematic review is to examine all the data currently available in the literature on the effects of nutritional intervention on biochemical parameters (anti-thyroid antibody and thyroid hormones levels) and characteristic symptoms in the course of Hashimoto's thyroiditis. This systematic review was prepared based on PRISMA guidelines. Articles in PubMed and Scopus databases published up to November 2022 were searched. As a result of the selection, out of 1350 publications, 9 were included for further analysis. The nutritional interventions included the following: elimination of gluten (3 articles) or lactose (1 article), energy restriction with or without excluding selected foods (n = 2), consumption of Nigella sativa (n = 2), or dietary iodine restriction (n = 1). The intervention duration ranged from 21 days to 12 months and included individuals with various thyroid function. Of the nine studies, three studies were female only. An improvement was observed during an energy deficit and after the elimination of selected ingredients (e.g., gluten, lactose, or goitrogens), as well as after the intervention of Nigella sativa. These interventions improved antibody levels against peroxidase (anti-TPO), (thyrotropin) TSH, and free thyroxine (fT4). No improvement was seen on the iodine-restricted diet. Varied outcomes of analyzed dietary interventions may be due to the heterogeneous thyroid condition, high variability between patients, and differences in habitual intake of critical nutrients (e.g., iodine, selenium, and iron) in different populations. Therefore, there is a great need for further experimental studies to determine whether any nutritional interventions are beneficial in Hashimoto's disease.
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The Role of Vitamin D in Autoimmune Thyroid Diseases: A Narrative Review. J Clin Med 2023; 12:jcm12041452. [PMID: 36835987 PMCID: PMC9966459 DOI: 10.3390/jcm12041452] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
Vitamin D (VitD) deficiency has garnered significant attention in contemporary medical research. Although the canonical biological activity of VitD manifests itself mainly in the regulation of calcium-phosphorus metabolism, recent studies show that, thanks to the presence of numerous receptors, VitD may also play an important role in regulating the immune system. VitD deficiency has been demonstrated to impact autoimmune disease, coeliac disease, infections (including respiratory/COVID-19), and patients with cancer. Recent studies also show that VitD plays a significant role in autoimmune thyroid diseases (AITDs). Many studies have shown a correlation between low VitD levels and chronic autoimmune thyroiditis - Hashimoto thyroiditis (HT), Graves' disease (GD), and postpartum thyroiditis (PPT). This review article, therefore, describes the current state of knowledge on the role of VitD in AITDs, including HT, GD, and PTT.
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Cai B, Zhou M, Xiao Q, Zou H, Zhu X. L-shaped association between serum 25-hydroxyvitamin D and all-cause mortality of individuals with rheumatoid arthritis. Rheumatology (Oxford) 2023; 62:575-582. [PMID: 35689616 DOI: 10.1093/rheumatology/keac341] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE We aimed to examine the relationship between serum 25-hydroxyvitamin D and all-cause, cause-specific mortality of patients with RA. METHODS This cohort study included 1466 patients with RA from The National Health and Nutrition Examination Survey (NHANES) 2001-14. Mortality status was obtained according to death certificate records from the National Death Index. Cox proportional risk models were used to estimate hazard ratios (HR) and 95% CI for mortality. A generalized additive model, smooth curve fitting and 2-piecewise Cox proportional hazards models were established to address the nonlinearity between serum 25-hydroxyvitamin D and mortality. RESULTS A total of 1466 patients [mean (s.d.) 59.89 (14.14) years old; 58.94% female] were enrolled. The weighted mean level of 25-hydroxyvitamin D was 59.26 (24.99) nmol/l and 38.95% were found with deficient (or severe deficient) vitamin D (<50.00 nmol/l). During 10453 person-years of follow-up, 268 patients were documented for all-cause death, including 52 cardiovascular disease (CVD)deaths and 48 cancer deaths. Compared with patients with serum 25-hydroxyvitamin D <25.00 nmol/l, patients with higher serum 25-hydroxyvitamin D were more likely to have lower rate of all-cause mortality. Nonlinear and L-shaped association between serum 25-hydroxyvitamin D and all-cause mortality was found, and decreased serum 25-hydroxyvitamin D was significantly associated with increased risk of all-cause mortality in patients with serum 25-hydroxyvitamin D <37.30 nmol/l [HR 0.95 (0.92, 0.98); P < 0.01]. CONCLUSION An L-shaped association between serum 25-hydroxyvitamin D and all-cause mortality was found among patients with RA, indicating that serum 25-hydroxyvitamin D should be improved to a certain level for the prevention of premature death.
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Affiliation(s)
- Bin Cai
- Department of Rheumatology, Huashan Hospital, Fudan University.,Department of Rheumatology and Immunology, Renji Hospital, Shanghai Jiaotong University School of Medicine
| | - Mengmeng Zhou
- Department of Rheumatology, Huashan Hospital, Fudan University
| | - Qingqing Xiao
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hejian Zou
- Department of Rheumatology, Huashan Hospital, Fudan University
| | - Xiaoxia Zhu
- Department of Rheumatology, Huashan Hospital, Fudan University
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Czubek E, Alcer K, Varjacic M, Romaniuk P. The importance and effectiveness of nutritional counselling in patients with autoimmune thyroid diseases in Poland. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2022; 20:63. [PMID: 36471304 PMCID: PMC9721046 DOI: 10.1186/s12962-022-00397-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/30/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Autoimmune thyroid diseases are the most common diseases in humans. Their pathogenesis is complex, pushing patients to search different ways of alleviating their effects, one of which is diet change. The aim of this study was to assess the role of medical personnel in shaping eating habits in patients with autoimmune thyroid disease based on experiences declared by patients. METHODS We examined 208 individuals, of which 205 were qualified for final investigation. We selected study participants using accidental sampling, based on their appearance in health care facilities, including the ones providing endocrinological advices. The relationships between the qualitative features were tested using the Chi-square test of independence, assuming the significance level of p < 0.05. In the case of the expected cardinality < 10, the Chi-square test with correction for Yates continuity was used, while for the cardinality < 5-the Fisher exact test. RESULTS People with thyroid disease are statistically more likely to use dietitian advice than people without thyroid disease. The highest percentage of respondents decided to modify their nutrition due to their own initiative. In addition, patients with autoimmune thyroid disease are statistically more likely to consider changing their diet to improve their well-being. The connection between the source of advice and modification of eating behaviour was also noted. CONCLUSION Thanks to the joint effort of medical staff, patients can receive reliable knowledge about their disease, treatment and nutrition adapted to their needs. Trial registration approved by the Bioethics Committee of Medical University of Silesia in Katowice (opinion no.: PCN/0022/KB1/80/2).
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Affiliation(s)
- Ewa Czubek
- grid.411728.90000 0001 2198 0923Department of Health Policy, Medical University of Silesia, Katowice, Poland
| | - Klaudia Alcer
- grid.411728.90000 0001 2198 0923Doctoral School, Faculty of Health Sciences, Department of Health Policy, Medical University of Silesia, Katowice, Poland
| | - Mirjana Varjacic
- grid.413004.20000 0000 8615 0106Department of Fertility Pathology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Piotr Romaniuk
- grid.411728.90000 0001 2198 0923Department of Health Policy, Medical University of Silesia, Katowice, Poland
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Abstract
RATIONALE Pancytopenia and epilepsia are rare complications of Graves' disease (GD). Muscle weakness is a physical sign of GD. It is extremely rare for GD patients to present 3 symptoms at the same time. PATIENT CONCERNS A 35-year-old female was admitted to hospital for dizziness for 1 day. The results of laboratory examination on admission showed pancytopenia and hypothyroidism. Her clinical manifestations include pancytopenia, epilepsy, and muscle weakness. DIAGNOSIS Graves' hyperthyroidism. INTERVENTIONS She received endotracheal intubation, ventilator, antithyroid drugs, and hormone therapy. OUTCOME The patient was discharged after treatment. LESSON Severe complications caused by GD are rare and require antithyroid therapy. Although glucocorticoid is not recommended by the guidelines, it can effectively improve thrombocytopenia.
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Affiliation(s)
- Bao Fu
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Dinghong He
- Department of Critical Care Medicine of Jinsha County People’s Hospital, Bijie City, Guizhou Province, China
| | - Zhengguang Geng
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Xiaoyun Fu
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
- * Correspondence: Xiaoyun Fu, Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi City 563003, Guizhou Province, China (e-mail: )
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Sherchand O, Niraula A, Mishra B, Subedi M, Maskey R. Autoimmune Thyroid Disease in Patients with Hypovitaminosis D in Department of Biochemistry of a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:600-603. [PMID: 36705201 PMCID: PMC9297365 DOI: 10.31729/jnma.7493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/25/2022] [Indexed: 02/03/2023] Open
Abstract
Introduction Autoimmune thyroid disease is characterised by the generation of autoantibodies against self-antigens such as thyroid peroxidase, thyroglobulin, and thyroid-stimulating hormone receptor. Recent studies have implicated the role of hypovitaminosis D to immune dysfunction, failure of self-tolerance and generation of autoantibodies. This study aimed to find out the prevalence of autoimmune thyroid disease among hypovitaminosis D patients in a tertiary care centre. Methods A descriptive cross-sectional study was conducted among participants between the ages of 18 years to 65 years who visited the Department of Biochemistry of a tertiary care centre between the periods of July 2018 to December 2019. The study was initiated after receiving ethical approval from the Institutional Review Committee (Reference number: 42,8/074/075-IRC). Data was collected using a self-administered questionnaire followed by anthropometric measurement and blood collection. Thyroid hormone, thyroid peroxidase antibody and 25-hydroxy vitamin D were measured by chemiluminescence technique. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results Among 83 patients, 39 (46.98%) (42.32-51.63, 95% Confidence Interval) had autoimmune thyroid disease. Conclusions The prevalence of autoimmune thyroid disease among patients with hypovitaminosis D was similar to studies conducted in comparable settings. Keywords autoimmune diseases; prevalence; thyroid; vitamin D.
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Affiliation(s)
- Ojaswee Sherchand
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal,Correspondence: Dr Ojaswee Sherchand, Department of Biochemistry, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal. , Phone: +977-9841423736
| | - Apeksha Niraula
- Department of Biochemistry, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Bijaya Mishra
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Manish Subedi
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Robin Maskey
- Department of Internal Medicine, Mechi Zonal Hospital, Bhadrapur, Jhapa, Nepal
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Attard CC, Sze WCC, Vella S. Predictors of autoimmune thyroid disease. Proc AMIA Symp 2022; 35:608-614. [DOI: 10.1080/08998280.2022.2087038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Carol Cardona Attard
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta
- Department of Medicine, University of Malta Medical School, Msida, Malta
| | - W. C. Candy Sze
- Department of Endocrinology, St. Bartholomew’s Hospital, London, UK
- Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Sandro Vella
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta
- Department of Medicine, University of Malta Medical School, Msida, Malta
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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: 30] [Impact Index Per Article: 15.0] [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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Khozam SA, Sumaili AM, Alflan MA, Shawabkeh RAS. Association Between Vitamin D Deficiency and Autoimmune Thyroid Disorder: A Systematic Review. Cureus 2022; 14:e25869. [PMID: 35836431 PMCID: PMC9275446 DOI: 10.7759/cureus.25869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 12/15/2022] Open
Abstract
Despite recent evidence that low serum 25-hydroxyvitamin D (25(OH)D) levels and deflects may influence the emergence of autoimmune thyroid disorders (AITD), the relationship between vitamin D deficiency and Graves’ disease (GD) and Hashimoto's thyroiditis (HT), which comprise AITD, remains unclear. We retrieved studies that described vitamin D association with HT and GD from PubMed/Medline, Google Scholar, and the Cochrane Library. We included research studies that compared vitamin D levels and deficiency or sufficiency between AITD cases such as HT and GD cases and control subjects. The final assessment comprised 11 studies that recruited 1952 AITD cases (HT and GD) that were published between 2011 and 2021; these were included in the final review. All the included studies were observational, and more precisely, case-control studies that recruited healthy subjects as well as controls. The majority of the studies reviewed indicated that HT and GD patients have a greater prevalence of vitamin D deficiency or low serum 25 (OH)-D levels. Two studies failed to establish an association between vitamin D deficiency and HT and GD disease. In conclusion, vitamin D deficiency or insufficiency can increase the rate of autoimmune diseases such as HT and GD. Randomized controlled trials with a longer follow-up period are needed to confirm the causal relationship between autoimmune thyroid disorder and vitamin D and to provide more reliable insights into the relevance of treatment effects of vitamin D therapy or supplementation.
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31
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Vitamin D, the Vitamin D Receptor, Calcitriol Analogues and Their Link with Ocular Diseases. Nutrients 2022; 14:nu14112353. [PMID: 35684153 PMCID: PMC9183042 DOI: 10.3390/nu14112353] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 11/21/2022] Open
Abstract
The global prevalence of eye diseases continues to grow, bringing with it a reduction in the activity levels and quality of life of patients, and partial or complete blindness if left untreated. As such, there is considerable interest in identifying more effective therapeutic options and preventive agents. One such agent is vitamin D, known to have a range of anti-cancer, anti-angiogenic, anti-inflammatory and anti-oxidative properties, and whose deficiency is linked to the pathogenesis of a range of cardiovascular, cancer, and inflammatory diseases. This review presents the current stage of knowledge concerning the link between vitamin D and its receptor and the occurrence of eye disease, as well as the influence of analogues of calcitriol, an active metabolite of vitamin D. Generally, patients affected by various ocular disorders have vitamin D deficiency. In addition, previous findings suggest that vitamin D modulates the course of eye diseases and may serve as a marker, and that its supplementation could mitigate some disorders. However, as these studies have some limitations, we recommend further randomized trials to clarify the link between vitamin D and its activity with eye disease.
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32
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Alfaifi J, Elzain W, Alshahrani S, Soliman K, Korairi H, Abouelyazid A. Association between vitamin D status and subclinical hypothyroidism. CARDIOMETRY 2022. [DOI: 10.18137/cardiometry.2022.22.168172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract Aims and Objectives: The purpose of this study is to investigate the relation between Vitamin D levels and sub-clinical hypothyroidism and the effect of Vitamin D supplementation on treatment outcome. Design: A retrospective cohort file-based study. Method: In this study, the relation between Vitamin D level and subclinical hypothyroidism and the effect of Vitamin D supplementation on patients with subclinical hypothyroidism were evaluated where 30 patients were diagnosed with subclinical hypothyroidism followed up in Armed forces hospital southern region, KSA was included through electronic files revision. Results: The mean age was 41.6 +/- 12.4 years among the study group. Twenty-seven patients (90%) had their thyroid function test normalized after Vitamin D correction, while the rest had their TSH level improved from the baseline level. The presence of thyroid peroxidase antibodies (TPO) antibodies was found to be inversely related to TSH level after correction of Vitamin D level, and all patients who were negative for TPO 19 (100%) had their Thyroid Stimulating Hormone (TSH) level normalized after Vitamin D correction. In comparison, 3 (27.3%) of TPO-positive patients had subclinical hypothyroidism despite vitamin D correction. Conclusion: Vitamin D deficiency is inversely related to TSH, and TPO status and correction of Vitamin D deficiency in patients with subclinical hypothyroidism can normalize the thyroid function. Further studies are needed to establish the relationship between Vitamin D deficiency and subclinical hypothyroidism.
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Yang C, Yu L, Xiao Y, Ouyang L, Huang X. Discussion on the Transoral Vestibular Approach Endoscopy for TC Patients and the Significance of Serum 25-Hydroxyvitamin D Classification. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:3425225. [PMID: 35449845 PMCID: PMC9018171 DOI: 10.1155/2022/3425225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/24/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022]
Abstract
In order to discuss the transoral vestibular approach endoscopy through oral vestibular approach in TC and the efficacy of 25(OH)D classification, a total of 110 TC patients from January 2020 to June 2021 are selected. The endoscopic group and the control group are respectively established according to different surgical approaches, with 55 cases in each group. The control group received conventional TC resection, while the endoscopic group received endoscopic assisted TC resection through oral vestibular approach. The differences of intraoperative and postoperative indicators, clinical efficacy, incidence of adverse complications, VAS score, and total satisfaction are observed. TC resection assisted by endoscopy through oral vestibular approach can effectively improve all intraoperative indicators and reduce postoperative pain and has high safety in clinical application. In addition, this study conducted in-depth analysis and classification of serum 25(OH)D index level in postoperative TC patients, indicating that the serum 25(OH)D index level is closely related to prognosis, providing a basis for follow-up clinical monitoring of TC patients' signs and optimization of diagnosis and treatment plans.
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Affiliation(s)
- Chunjiang Yang
- Department of Head and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Leitao Yu
- Department of Head and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Yong Xiao
- Department of Head and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Longhong Ouyang
- Department of Surgery, Yongfeng People's Hospital, Jian 331500, China
| | - Xiaohua Huang
- Department of Surgery, Yongfeng People's Hospital, Jian 331500, China
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Fletcher J, Bishop EL, Harrison SR, Swift A, Cooper SC, Dimeloe SK, Raza K, Hewison M. Autoimmune disease and interconnections with vitamin D. Endocr Connect 2022; 11:EC-21-0554. [PMID: 35196255 PMCID: PMC9010814 DOI: 10.1530/ec-21-0554] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022]
Abstract
Vitamin D has well-documented effects on calcium homeostasis and bone metabolism but recent studies suggest a much broader role for this secosteroid in human health. Key components of the vitamin D system, notably the vitamin D receptor (VDR) and the vitamin D-activating enzyme (1α-hydroxylase), are present in a wide array of tissues, notably macrophages, dendritic cells and T lymphocytes (T cells) from the immune system. Thus, serum 25-hydroxyvitamin D (25D) can be converted to hormonal 1,25-dihydroxyvitamin D (1,25D) within immune cells, and then interact with VDR and promote transcriptional and epigenomic responses in the same or neighbouring cells. These intracrine and paracrine effects of 1,25D have been shown to drive antibacterial or antiviral innate responses, as well as to attenuate inflammatory T cell adaptive immunity. Beyond these mechanistic observations, association studies have reported the correlation between low serum 25D levels and the risk and severity of human immune disorders including autoimmune diseases such as inflammatory bowel disease, multiple sclerosis, type 1 diabetes and rheumatoid arthritis. The proposed explanation for this is that decreased availability of 25D compromises immune cell synthesis of 1,25D leading to impaired innate immunity and over-exuberant inflammatory adaptive immunity. The aim of the current review is to explore the mechanistic basis for immunomodulatory effects of 25D and 1,25D in greater detail with specific emphasis on how vitamin D-deficiency (low serum levels of 25D) may lead to dysregulation of macrophage, dendritic cell and T cell function and increase the risk of inflammatory autoimmune disease.
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Affiliation(s)
- Jane Fletcher
- Nutrition Nurses, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK
- School of Nursing, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Emma L Bishop
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Stephanie R Harrison
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, Leeds, UK
| | - Amelia Swift
- School of Nursing, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Sheldon C Cooper
- Gastroenterology Department, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK
| | - Sarah K Dimeloe
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Karim Raza
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Martin Hewison
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Correspondence should be addressed to M Hewison:
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35
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Lebădă IC, Ristea R, Metiu M. Vitamin D deficiency in thyroid autoimmune diseases. Arch Clin Cases 2022; 9:34-40. [PMID: 35529097 PMCID: PMC9066582 DOI: 10.22551/2022.34.0901.10201] [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] [Indexed: 11/25/2022] Open
Abstract
The role of vitamin D in the human body is a complex one, proven by the many studies performed related to this aspect. Data from the literature on the correlation between vitamin D deficiency and thyroid autoimmune pathology, although present and increasing in the last 10 years, have failed to establish exactly whether or not there is a link between them. The aim of the study was to assess the status of vitamin D in patients with autoimmune thyroid disease; and to determine if there is a correlation between parameters such as: thyroid stimulating hormone (TSH), free thyroxine (FT4), ATPO; and vitamin D levels. Therefore, we performed a retrospective study in which we included 60 patients, 32 with autoimmune thyroid pathology and 28 patients with negative antithyroid antibodies. The average age of those in the case group was 58 years old and 52 years old for the control group. Female sex was predominant in both groups of patients, 97% in the study group and 71% in the control group. Vitamin D values in patients with thyroid autoimmune pathology in our study were on average higher than those obtained in the control group (patients with negative thyroid antibodies), without finding a statistically significant difference between the values of the two groups of patients (p = 0.197). The study shows a high prevalence of vitamin D deficiency in both groups of patients (with or without autoimmune thyroid disease), the highest rate being observed among patients without autoimmune pathology, but without a statistically significant difference between values.
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Serum Vitamin D as a Biomarker in Autoimmune, Psychiatric and Neurodegenerative Diseases. Diagnostics (Basel) 2022; 12:diagnostics12010130. [PMID: 35054296 PMCID: PMC8774449 DOI: 10.3390/diagnostics12010130] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 02/05/2023] Open
Abstract
Vitamin D is a steroid hormone regulating calcium-phosphorus homeostasis, immune response and brain function. In the past thirty years, an increasing number of cohort studies, meta-analyses and randomized controlled trials (RTCs) evaluated the serum levels of 25-hydroxyvitamin D [25(OH)D], which is considered the Vitamin D status biomarker, in patients affected by neurological, psychiatric and autoimmune diseases. Although an association between low 25(OH)D serum levels and the prevalence of these diseases has been found, it is still unclear whether the serum 25(OH)D measurement can be clinically useful as a biomarker for diagnosis, prognosis and predicting treatment response in neurodegeneration, mental illness and immune-mediated disorders. The lack of standardized data, as well as discrepancies among the studies (in the analytical methods, cut-offs, endpoints and study sets), weakened the findings achieved, hindered pooling data, and, consequently, hampered drawing conclusions. This narrative review summarizes the main findings from the studies performed on serum 25(OH)D in neurological, psychiatric and autoimmune diseases, and clarifies whether or not serum 25(OH)D can be used as a reliable biomarker in these diseases.
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Jiang H, Chen X, Qian X, Shao S. Effects of vitamin D treatment on thyroid function and autoimmunity markers in patients with Hashimoto's thyroiditis-A meta-analysis of randomized controlled trials. J Clin Pharm Ther 2022; 47:767-775. [PMID: 34981556 PMCID: PMC9302126 DOI: 10.1111/jcpt.13605] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 12/23/2022]
Abstract
Introduction Recent evidence suggested that vitamin D deficiency was associated with Hashimoto's thyroiditis (HT) pathogenesis and thyroid hypofunction. This study aimed to investigate whether vitamin D supplementation would be effective in the prevention and progression of hypothyroidism in patients with HT. Methods PubMed, Embase and the Cochrane library were searched for randomized controlled trials (RCTs) and prospective cohort studies published from inception to August 2021. Results A total of 7 cohorts of patients from six clinical trials with 258 patients with HT were included. Significant difference was found (WMD = 19.00, 95% CI: 12.43, 25.58, p < 0.001; I2 = 90.0%, pheterogeneity < 0.001) between the vitamin D group and control group in serum 25‐hydroxyvitamin D level. And the combined results indicated vitamin D supplementation significantly reduced the level of thyroid peroxidase antibodies (TPO‐Ab) compared to the control group (WMD = −158.18, 95% CI: −301.92, −14.45, p = 0.031; I2 = 68.8%, pheterogeneity = 0.007). Whereas no significant differences were found on the levels of thyroid‐stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) compared to the control group (p > 0.05). What is New and Conclusion Our study demonstrated that vitamin D treatment might significantly increase the serum 25(OH)D levels and produce changes in TPO‐Ab titres. No significant association was found between serum vitamin D treatment and the levels of TG‐Ab, TSH, FT3 and FT4, suggesting that vitamin D is not associated with the function of the thyroid in patients with HT.
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Affiliation(s)
- Hui Jiang
- Department of Endocrinology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, China.,School of Medicine, Jiangsu University, Zhenjiang, China
| | - Xiaoluo Chen
- Department of Endocrinology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, China
| | - Xiaoqin Qian
- Department of Ultrasound, Affiliated People's Hospital of Jiangsu University, Zhenjiang, China
| | - Shihe Shao
- School of Medicine, Jiangsu University, Zhenjiang, China
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Kaan Demircioglu M, Gul Demircioglu Z, Aygun N, Yilmaz Ozguven B, Ethem Akgun I, Uludag M. Is Vitamin D Deficiency Associated with Chronic Lymphocytic Thyroiditis? SISLI ETFAL HASTANESI TIP BULTENI 2021; 55:510-515. [PMID: 35317375 PMCID: PMC8907690 DOI: 10.14744/semb.2021.45202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/20/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Vitamin D deficiency is a very common global health problem. Evidence from recent studies focuses on the extraskeletal effects of vitamin D (Vit D) deficiency. Chronic lymphocytic thyroiditis (or Hashimoto's thyroiditis) is an autoimmune disease of the thyroid. Although there are many studies reporting that autoimmune thyroid diseases may be associated with Vitamin D deficiency, this is still a controversial issue that has not yet been proven. In this study, we aimed to appraise whether there is a relationship between lymphocytic thyroiditis diagnosed by histopathological evaluation and Vitamin D deficiency. METHODS Data of 256 patients whom were operated by a single surgeon in a single center between 2012 and 2017 and whose preoperative vitamin D tests and thyroid pathologies have been collected, were retrospectively evaluated. Due to the pathological examination, two groups were formed considering the presence of lymphocytic thyroiditis (Group 1), and the absence of lymphocytic thyroiditis (Group 2). Vitamin D deficiency was defined as the level <20 ng/mL (50 nmol/L) and Vitamin D insufficiency was defined as the level 21-29 ng/mL (525-725 nmol/L). RESULTS There were 108 (92F/16M) patients in Group 1, and 148 (116F/32M) patients in Group 2, and the mean age was lower in Group 1 (p=0.053). The mean vitamin D levels (16.6±15.2 vs. 14±10, p=0.409) and vitamin D deficiency rates (67.6% vs. 72.3%, p=0.416) were found similar between the Groups 1 and 2. No positive significant correlation was found between lymphocytic thyroiditis and vitamin D level or vitamin D deficiency rates. There was a positive correlation between lymphocytic thyroiditis and age, preoperative thyroid-stimulating hormone level, preoperative anti-thyroglobulin ,and anti-thyroid peroxidase levels, but no significant relationship was found with Vitamin D level. CONCLUSION According to our results, lymphocytic thyroiditis was not associated with either Vitamin D deficiency or Vitamin D level.
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Affiliation(s)
| | | | - Nurcihan Aygun
- Department of General Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Banu Yilmaz Ozguven
- Department of Pathology, İstanbul Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Ismail Ethem Akgun
- Department of General Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Uludag
- Department of General Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Liu D, Meng X, Tian Q, Cao W, Fan X, Wu L, Song M, Meng Q, Wang W, Wang Y. Vitamin D and Multiple Health Outcomes: An Umbrella Review of Observational Studies, Randomized Controlled Trials, and Mendelian Randomization Studies. Adv Nutr 2021; 13:1044-1062. [PMID: 34999745 PMCID: PMC9340982 DOI: 10.1093/advances/nmab142] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/29/2020] [Accepted: 11/19/2021] [Indexed: 12/18/2022] Open
Abstract
Observational studies, randomized controlled trials (RCTs), and Mendelian randomization (MR) studies have yielded inconsistent results on the associations of vitamin D concentrations with multiple health outcomes. In the present umbrella review we aimed to evaluate the effects of low vitamin D concentrations and vitamin D supplementation on multiple health outcomes. We summarized current evidence obtained from meta-analyses of observational studies that examined associations between vitamin D concentrations and multiple health outcomes, meta-analyses of RCTs that investigated the effect of vitamin D supplementation on multiple health outcomes, and MR studies that explored the causal associations of vitamin D concentrations with various diseases (international prospective register of systematic reviews PROSPERO registration number CRD42018091434). A total of 296 meta-analyses of observational studies comprising 111 unique outcomes, 139 meta-analyses of RCTs comprising 46 unique outcomes, and 73 MR studies comprising 43 unique outcomes were included in the present umbrella review. Twenty-eight disease outcomes were identified by both meta-analyses of observational studies and MR studies. Seventeen of these reported disease outcomes had consistent results, demonstrating that lower concentrations of vitamin D were associated with a higher risk for all-cause mortality, Alzheimer's disease, hypertension, schizophrenia, and type 2 diabetes. The combinations of consistent evidence obtained by meta-analyses of observational studies and MR studies together with meta-analyses of RCTs showed that vitamin D supplementation was associated with a decreased risk for all-cause mortality but not associated with the risk for Alzheimer's disease, hypertension, schizophrenia, or type 2 diabetes. The results indicated that vitamin D supplementation is a promising strategy with long-term preventive effects on multiple chronic diseases and thus has the potential to decrease all-cause mortality. However, the current vitamin D supplementation strategy might not be an efficient intervention approach for these diseases, suggesting that new strategies are highly needed to improve the intervention outcomes.
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Affiliation(s)
- Di Liu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China,Centre for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Xiaoni Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Weijie Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Xin Fan
- School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Manshu Song
- Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Qun Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China,Centre for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia,School of Public Health, Shandong First Medical University and Shandong Academy of Medical Science, Tai'an, Shandong, 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: 11] [Impact Index Per Article: 3.7] [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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Association between Serum 25-Hydroxyvitamin D Level and Stroke Risk: An Analysis Based on the National Health and Nutrition Examination Survey. Behav Neurol 2021; 2021:5457881. [PMID: 34745384 PMCID: PMC8570893 DOI: 10.1155/2021/5457881] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background To analyze the association between serum 25-hydroxyvitamin D level (25(OH)D) and stroke risk based on the National Health and Nutrition Examination Survey (NHANES). Methods Between 2007 and 2018, the baseline information of participants from NHNES was collected. Univariate analysis was used to identify the covariates. Multivariate logistic regression model was used to analyze the association between serum 25(OH)D level and the stroke risk. Results Of the 8,523 participants, there were 310 participants with stroke and 8,213 participants without stroke. The multivariate logistic analysis showed that serum 25(OH)D deficiency (odds ratio (OR): 1.993, 95% confidence intervals (CI): 1.141-3.481, and P = 0.012) was the significant risk factors for stroke. Subgroup analysis showed that non-Hispanic whites with serum 25(OH)D deficiency (OR: 2.501, 95% CI: 1.094-5.720, and P = 0.001) and insufficiency (OR: 1.853, 95% CI: 1.170-2.934, and P = 0.006) were associated with a higher risk of stroke than those with normal 25(OH)D levels. Conclusions Serum 25(OH)D deficiency may be associated with an increased risk of stroke.
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Vassalle C, Parlanti A, Pingitore A, Berti S, Iervasi G, Sabatino L. Vitamin D, Thyroid Hormones and Cardiovascular Risk: Exploring the Components of This Novel Disease Triangle. Front Physiol 2021; 12:722912. [PMID: 34603080 PMCID: PMC8481379 DOI: 10.3389/fphys.2021.722912] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/18/2021] [Indexed: 12/26/2022] Open
Abstract
The role of thyroid hormones (THs) in the cardiovascular (CV) system, through several direct and indirect effects is recognized. Even very small modification in TH levels (as those observed in subclinical hypothyroidism or hyperthyroidism, and low triiodothyronine syndrome) may adversely affect the CV system, whereas thyroid hormones benefit the CV system and improve the prognosis. There is also evidence of vitamin D effects on cardiometabolic disease (e.g., through modulation of endothelial and smooth muscle cell activity, renin-angiotensin-aldosterone system, nitric oxide, oxidative stress, and inflammatory response), as well as an association between vitamin D [25(OH)D] deficiency and autoimmune thyroid diseases or cancer, and a relationship between vitamin D concentration and titers of antibodies and thyroid autoimmunity replacement. Interestingly, experimental data indicate a direct effect of vitamin D on Type 2 deiodinase expression causing subsequential peripheral conversion of T4 into T3. However, the functional links among THs, vitamin D and the cardiovascular system, and clinical effects of coexisting abnormalities in this new troublesome triad, have not yet been reviewed. The main aim of this review is to discuss pathophysiology of this relationship, proposing new mechanistic insights involving vitamin D in the modulation of cardiometabolic disease and thyroid profile.
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Affiliation(s)
| | | | | | - Sergio Berti
- Fondazione CNR-Regione Toscana Gabriele Monasterio, Pisa, Italy
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Hanna HWZ, Rizzo C, Abdel Halim RM, El Haddad HE, Salam R, El-Sayed Abou-Youssef H. Vitamin D status in Hashimoto's thyroiditis and its association with vitamin D receptor genetic variants. J Steroid Biochem Mol Biol 2021; 212:105922. [PMID: 34015387 DOI: 10.1016/j.jsbmb.2021.105922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/06/2021] [Accepted: 05/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hashimoto's thyroiditis (HT) is considered the predominant cause of hypothyroidism in iodine sufficient countries. The deficiency of 25-OH-vitamin D3 serum level and the variation of vitamin D receptor (VDR) gene were implicated in a number of autoimmune disorders. This study aimed to test the hypothesis linking between VDR FokI and BsmI variants and HT, in addition to explain their impact on 25-OH-vitamin D3 serum level. MATERIALS AND METHODS Cross sectional study included 160 hypothyroid subjects, 112 patients with HT and 48 hypothyroid non-HT controls. They were diagnosed based on anti-TPO Ab and or anti-TG Ab results. All cases were subjected to full history taking, thyroid ultrasound examination and a panel of assays (TSH, f.T3, f.T4, anti-TPO Ab, anti-TG Ab, calcium, alkaline phosphatase and phosphate). Serum 25-OH-vitamin D3 was assayed using HPLC-UV method. VDR variants (FokI and BsmI) were genotyped using real-time PCR. RESULTS FokI AA genotype was statistically higher in HT patients than control group (P value = 0.02) with subsequently higher serum 25-OH-vitamin D3 level in comparison to all other genotypes (P value = 0.039). Serum 25-OH-vitamin D3 level was statistically indifferent between HT and control group (P value = 0.223). A statistically significant increase in total thyroid volume was observed in HT group (P value = 0.002). CONCLUSION FokI AA genotype is more associated with HT in Egyptian patients compared to hypothyroid non-HT controls. Moreover, patients with FokI AA genotype have statistically higher levels of 25-OH-vitamin D3 suggesting VDR dysfunction even in patients expressing normal level of vitamin D.
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Affiliation(s)
- Hany William Z Hanna
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Cristiano Rizzo
- Clinical Division and Research Unit of Metabolic Diseases, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | | | | | - Randa Salam
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Chrgondi M, Billa RD, Chacham S, Gurnurkar S. Unusual Etiology of Hypercalcemia in an Adolescent With Acute Gastroenteritis. Cureus 2021; 13:e16483. [PMID: 34430099 PMCID: PMC8372673 DOI: 10.7759/cureus.16483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 11/05/2022] Open
Abstract
We present the report of an adolescent female who presented with acute gastroenteritis, weight loss, and hypercalcemia. Further evaluation revealed hyperthyroidism to be the cause of hypercalcemia. Treatment of hyperthyroidism successfully corrected the hypercalcemia in our index case.
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Affiliation(s)
- Madhuradhar Chrgondi
- Pediatrics/Critical Care Medicine, Carver College of Medicine, University of Iowa, Iowa City, USA
| | | | - Swathi Chacham
- Pediatrics, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Shilpa Gurnurkar
- Pediatric Endocrinology, Nemours Children's Hospital, Orlando, USA
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Fang F, Chai Y, Wei H, Wang K, Tan L, Zhang W, Fan Y, Li F, Shan Z, Zhu M. Vitamin D deficiency is associated with thyroid autoimmunity: results from an epidemiological survey in Tianjin, China. Endocrine 2021; 73:447-454. [PMID: 33759075 DOI: 10.1007/s12020-021-02688-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The pathogenesis of Hashimoto's thyroiditis (HT) is unclear, although some studies have identified an association between vitamin D deficiency and thyroid autoantibody positivity. This study aimed to investigate vitamin D status, and its relationships with thyroid autoantibody positivity and HT, via a large epidemiological survey. METHODS The epidemiological survey was conducted in Tianjin, China. All participants underwent testing for serum 25-hydroxyvitamin D (25OHD), thyroid function, and thyroid autoantibodies, and some participants underwent testing to evaluate CD4+ T-cell differentiation and concentrations of related cytokines. RESULTS The study included 1812 participants and revealed prevalences of 13.1% for thyroid peroxidase antibodies (i-TPOAb) and 14.0% for thyroglobulin antibodies (i-TgAb). Logistic regression analysis revealed that thyroid autoantibody positivity was associated with sex, age, and 25OHD classification. An increased likelihood of i-TPOAb positivity was associated with 25OHD deficiency (odds ratio [OR]: 2.428, 95% confidence interval [CI]: 1.383-4.261) and 25OHD inadequacy (OR: 1.198, 95% CO: 0.828-1.733; p = 0.008). An increased likelihood of i-TgAb positivity was associated with 25OHD deficiency (OR: 2.366, 95% CI: 1.366-4.099) and 25OHD inadequacy (OR: 1.263, 95% CI: 0.883-1.807; p = 0.009). Relative to healthy subjects, patients with HT had significantly higher proportions of Th1 and Th17 cells, as well as higher concentrations of related cytokines. CONCLUSIONS This study revealed that vitamin D deficiency was associated with thyroid autoantibody positivity, and that vitamin D deficiency seems to be involved in the pathological mechanism underlying HT. Large randomized controlled trials are needed to investigate the effects of vitamin D supplementation on HT.
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Affiliation(s)
- Fang Fang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Yun Chai
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Hongyan Wei
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Kunling Wang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Yuxin Fan
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Fengao Li
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China.
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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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Babić Leko M, Gunjača I, Pleić N, Zemunik T. Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels. Int J Mol Sci 2021; 22:6521. [PMID: 34204586 PMCID: PMC8234807 DOI: 10.3390/ijms22126521] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/09/2023] Open
Abstract
Thyroid hormones are necessary for the normal functioning of physiological systems. Therefore, knowledge of any factor (whether genetic, environmental or intrinsic) that alters the levels of thyroid-stimulating hormone (TSH) and thyroid hormones is crucial. Genetic factors contribute up to 65% of interindividual variations in TSH and thyroid hormone levels, but many environmental factors can also affect thyroid function. This review discusses studies that have analyzed the impact of environmental factors on TSH and thyroid hormone levels in healthy adults. We included lifestyle factors (smoking, alcohol consumption, diet and exercise) and pollutants (chemicals and heavy metals). Many inconsistencies in the results have been observed between studies, making it difficult to draw a general conclusion about how a particular environmental factor influences TSH and thyroid hormone levels. However, lifestyle factors that showed the clearest association with TSH and thyroid hormones were smoking, body mass index (BMI) and iodine (micronutrient taken from the diet). Smoking mainly led to a decrease in TSH levels and an increase in triiodothyronine (T3) and thyroxine (T4) levels, while BMI levels were positively correlated with TSH and free T3 levels. Excess iodine led to an increase in TSH levels and a decrease in thyroid hormone levels. Among the pollutants analyzed, most studies observed a decrease in thyroid hormone levels after exposure to perchlorate. Future studies should continue to analyze the impact of environmental factors on thyroid function as they could contribute to understanding the complex background of gene-environment interactions underlying the pathology of thyroid diseases.
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Affiliation(s)
| | | | | | - Tatijana Zemunik
- Department of Medical Biology, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia; (M.B.L.); (I.G.); (N.P.)
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Nikooyeh B, Shariatzadeh N, Rismanchi M, Hollis BW, Neyestani TR. Daily intake of yogurt drink fortified either with vitamin D alone or in combination with added calcium causes a thyroid-independent increase of resting metabolic rate in adults with type 2 diabetes: a randomized double blind clinical trial. Appl Physiol Nutr Metab 2021; 46:1363-1369. [PMID: 34077684 DOI: 10.1139/apnm-2021-0248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We investigated the effect of daily intake of yogurt drink fortified with either vitamin D alone or with added calcium on resting metabolic rate (RMR), thyroid hormones and homeostatic model assessment for insulin resistance (HOMA-IR) in subjects with type 2 diabetes (T2D). A total of 75 adult subjects with T2D were randomly assigned to one of the three groups to receive either D-fortified yogurt drink (DY; 1000 IU vitamin D/d), Ca-D-fortified yogurt drink (CDY; 1000 IU vitamin D plus 500 mg calcium), or plain yogurt drink (PY) for 12 weeks. All assessments were done at the baseline and after the intervention. The concentrations of anti-thyroid peroxidase antibody (anti-TPO-Ab), intact parathyroid hormone (iPTH) and thyroid stimulating hormone (TSH) had significant decline compared with baseline values only in CDY group. The mean RMR increased in both DY and CDY groups (p<0.001 for both). Also, changes of serum concentrations of 25(OH)D (B= 2.96, 95%CI= 1.3- 4.6, p=0.001) and iPTH (B= -2.41, 95%CI= -4.5- -0.31, p=0.025) remained significant predictors of RMR changes even after adjustment for changes of serum concentrations of TSH (B= -18.2, 95%CI= -61.7- 25.2, p=0.406). Daily intake of vitamin D together with calcium at physiological doses has attenuating effect on anti-TPO-Ab and TSH. Also, vitamin D with or without added calcium causes a significant thyroid-independent increase in RMR in euthyroid subjects with T2D. Registered at clinicaltrials.gov as NCT01229891. Novelty: Daily intake of vitamin D with calcium at physiological doses has attenuating effect on anti-TPO-Ab and TSH. Vitamin D with or without added calcium causes a thyroid-independent increase in RMR in euthyroid subjects with T2D.
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Affiliation(s)
- Bahareh Nikooyeh
- National Nutrition and Food Technology Research Institute, 226734, Laboratory of Nutrition Research, Tehran, Tehran, Iran (the Islamic Republic of);
| | - Nastaran Shariatzadeh
- National Nutrition and Food Technology Research Institute, 226734, Laboratory of Nutrition Research, Tehran, Tehran, Iran (the Islamic Republic of);
| | - Marjan Rismanchi
- National Nutrition and Food Technology Research Institute, 226734, Tehran, Tehran, Iran (the Islamic Republic of);
| | - Bruce W Hollis
- Medical University of South Carolina, 2345, Department of Pediatrics, Charleston, United States;
| | - Tirang R Neyestani
- Shahid Beheshti University of Medical Sciences, 556492, Tehran, Iran (the Islamic Republic of), 19839-63113;
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Application of Dried Blood Spots and Serum Samples for the Determination of Vitamin D Metabolites in the Group of Healthy Women and with Hashimoto’s Thyroiditis. Chromatographia 2021. [DOI: 10.1007/s10337-021-04047-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Purpose
The relationship between Hashimoto's thyroiditis and vitamin D concentration was already presented in many studies. The aim of this study was to analyze the differences in the concentration of vitamin D metabolites between healthy women and women with Hashimoto's thyroiditis (HT).
Methods
The quantitative analysis of five vitamin D metabolites was carried out using liquid chromatography coupled with tandem mass spectrometry. The analyzed materials were serum and dried blood spots (DBS). The results obtained for the two materials were also compared.
Results
No statistically significant differences were found in the mean concentration of the 25(OH)D3, 25(OH)D2, 24,25(OH)2D3, 1,25(OH)2D3 metabolites between the test and the control groups. However, a strong correlation was found between the 25(OH)D3 and 24,25(OH)2D3 metabolites.
Conclusion
The study showed that healthy women and women with Hashimoto's disease had similar concentration of vitamin D metabolites. Research also proved that DBS is a good alternative to serum. The differences in 25(OH)D concentration were not statistically significant (17.0 and 15.5 ng mL−1 for serum and DBS, respectively). DBS can be successfully used in research on a large group of people, since the process of material collection, as well as sample preparation, is fast and simple. It is also easy to transport and store, and requires small volume of blood.
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Krysiak R, Szkróbka W, Okopień B. Dehydroepiandrosterone potentiates the effect of vitamin D on thyroid autoimmunity in euthyroid women with autoimmune thyroiditis: A pilot study. Clin Exp Pharmacol Physiol 2021; 48:195-202. [PMID: 33007106 DOI: 10.1111/1440-1681.13410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022]
Abstract
The impact of androgens on the thyroid in women is poorly understood. The aim of the present study was to investigate whether vitamin D/dehydroepiandrosterone (DHEA) combination therapy is superior to vitamin D alone in affecting thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in young women with autoimmune thyroid disease. The study included 35 euthyroid women with untreated Hashimoto's thyroiditis and reduced sexual drive, allocated to one of two treatment groups. The first group (n = 19) received both vitamin D and DHEA, while the second (n = 16) was treated with only vitamin D. Serum thyroid antibody titres and concentrations of thyrotropin, free thyroid hormones, dehydroepiandrosterone-sulphate (DHEA-S), 25-hydroxyvitamin D, testosterone and estradiol were measured at baseline and 6 months later. Vitamin D administered alone or in combination with DHEA decreased serum titres of thyroid peroxidase and thyroglobulin antibodies, which correlated with baseline antibody titres, baseline 25-hydroxyvitamin D levels and treatment-induced increase in 25-hydroxyvitamin D levels. Apart from a stronger effect on antibody titres, vitamin D/DHEA combination therapy slightly decreased thyrotropin levels, as well as increased DHEA-S and testosterone levels. In this group of women, treatment-induced changes in antibody titres and thyrotropin levels correlated with the impact on DHEA-S and testosterone. The obtained results suggest that vitamin D/DHEA combination therapy may be a better treatment option for euthyroid women with Hashimoto's thyroiditis than vitamin D alone.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Witold Szkróbka
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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