AITD患者血清25（OH）D水平与甲状腺激素和自身抗体的相关性

摘要

目的：探讨25-羟维生素D[25（OH）D]水平对自身免疫性甲状腺疾病（AITD）患者甲状腺激素及自身抗体的影响。方法 AITD患者48例，其中Graves病17例（GD组），桥本甲状腺炎（HT）31例（HT组）。另选择健康者19例为对照组。检测血清25（OH） D、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）及促甲状腺素受体抗体（TRAb）水平。分析AITD患者25（OH）D水平与FT3、FT4、TT3、TT4、TSH、TPOAb、TRAb水平的相关性。结果与对照组比较，GD组、HT组患者25（OH）D水平明显降低，差异有统计学意义（P<0.05）。GD组血清中25（OH）D水平与TPOAb（r=-0.9261，P<0.01）水平呈显著负相关，与FT3、FT4、TT3、TT4、TSH、TRAb水平无明显相关性。HT组血清中25（OH）D水平与FT4（r=-0.8632，P<0.01）、TPOAb（r=-0.4222，P<0.05）、TRAb（r=-0.9561，P<0.01）水平呈显著负相关，与FT3、TT3、TT4、TSH水平无明显相关性。结论 AITD患者25（OH）D水平不足，其可能在甲状腺自身免疫反应的发生发展中起着重要作用。%ObjectiveTo explore the effect of serum 25-hydroxyvitamin D[25(OH)D]level on thyroid hormones and its auto-antibody in patients with autoimmune thyroid disease(AITD)and study the correlation among them.Methods 48 cases AITD outpatients(GD group and HT group)and 19 cases healthy subjects(control group)were selected from Aug. 2011 to Feb 2013. The levels of serum 25(OH)D,free triiodothyronine(FT3),free thyroxine(FT4),total triiodothyronine(TT3),total thyroxine(TT4),thyroid-stimulating hormone(TSH), thyroid peroxidase antibody(TPOAb),thyrotrophin receptor antibody(TRAb)were detected in GD group and HT group as well as control group.The correlation between serum 25(OH)D levels and the levels of FT3,FT4,TT3,TT4,TSH,TPOAb,TRAb were analyzed.Results Compared with the control group,the levels of 25(OH)D in GD group and HT group were decreased,there were statistically significant difference(P<0.05). In GD group,the levels of 25(OH)D and TPOAb(r=-0.9261,P<0.01)were negatively related,but the levels of 25(OH)D and FT3,FT4,TT3,TT4, TSH,TRAb had no obvious relation. In HT group,the levels of 25(OH)D and FT4(r=-0.8632,P<0.01),TPOAb(r=-0.4222,P<0.05),TRAb (r=-0.9561,P<0.01)were negatively related,and the levels of 25(OH)D and FT3,TT3,TT4,TSH had no obvious relation.Conclusion Vitamin D deficiency universally exists in AITD patients,and it may play an important role in the pathogenesis of AITD.