Correlation between Vitamin D Status and Antithyroid Antibody Levels in Patients with Newly Diagnosed Hashimoto Thyroiditis: Case-Control Study in Tlemcen (Algeria)
Article Sidebar
Downloads
Submit your own article
Register as an author to reserve your spot in the next issue of the Medical Research Archives.
Author RegistrationJoin the Society
The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.
Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.
MembershipMain Article Content
Abstract
Introduction: Hashimoto thyroiditis (HT) is characterized by the presence of antithyroid antibodies with lymphocyte infiltration of the thyroid gland. Its etiology results from the interaction between environmental factors and genetic susceptibility traits. One of the factors most recently involved in autoimmunity is vitamin D. The principal aim of our study was to investigate a possible relationship between vitamin D status and antithyroid antibody levels in patients with newly diagnosed Hashimoto diseases, from Tlemcen.
Materials and methods: Cross-sectional case-control study, including 310 subjects, divided into two groups: a group of cases (n = 155) with newly diagnosed HT and a group of apparently healthy controls (n = 155). The 02 groups were matched by sex, age ± 02 years, body mass index (BMI) and the same season (blood collection period). All subjects benefited from hormonal assays, anti-thyroid antibodies and biochemical parameters (Thyroid Stimulating Hormone (TSH), Free Thyroxine (FT4), anti-peroxydase antibody (anti-TPO), anti-thyroglobulin antibody (anti-Tg), 25 hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), calcemia, phosphoremia, albuminemia and alkaline phosphatases).
Results: High prevalence of hypovitaminosis D in our study population: 98% at the threshold of 25(OH)D < 30 ng/mL, 89% at the threshold < 20 ng/mL. The most significant risk factors associated with low levels of 25(OH)D are lack of sun exposure, season, skin color and lack of physical activity. The 25(OH)D deficit is more pronounced in the HT group than in the control group with a significant difference (11.45 ± 5.16 vs 13.02 ± 7.45; p = 0.03). In the HT group, the correlation between the status of 25(OH)D and the anti-TPO is inverse and significant (r = - 0.185; p = 0.02), relationship confirmed by multivariate analysis by linear regression where the 02 variables statistically related to anti-TPO are Vit D and TSH. Moreover, no correlation between 25(OH)D and anti-Tg and not between 25(OH)D and the degree of depth of biological hypothyroidism.
Conclusion: There is an inverse and significant statistical relationship between serum levels of 25(OH)D and anti-TPO in the case group, however the exact involvement of vitamin D in the immunopathogenesis of Hashimoto’s diseases remains to be substantiated.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Holick MF. Vitamin D deficiency. The New England journal of medicine. Jul 19, 2007; 357 (3): 266-281. Doi: 10.1056/NEJMra070553
3. Zhou C, Assem M, Tay JC, et al. Steroid and xenobiotic receptor and vitamin D receptor crosstalk mediates CYP24 expression and drug-induced osteomalacia. The Journal of clinical investigation. Jun 2006; 116 (6): 1703-1712. Doi: 10.1172/JCI27793
4. Kivity S, Agmon-Levin N, Zisappl M, and al. Vitamin D and autoimmune thyroid diseases. Cellular & molecular immunology. May 2011; 8 (3) :243-247. Doi: 10.1038/cmi.2010.73
5. Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto's thyroiditis. Thyroid. Aug 2011;21(8):891-896. Doi: 10.1089/thy.2009.0200
6. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of clinicalendocrinology and metabolism. Jul 2011;96(7):1911-1930. Doi: 10.1210/jc.2011-0385
7. Agmon-Levin N, Theodor E, Segal RM, Shoenfeld Y. Vitamin D in systemic and organ-specific autoimmune diseases. Clinical reviews in allergy & immunology. Oct 2013;45(2):256-266. Doi: 10.1007/s12016-012-8342-y
8. Haussler MR, Haussler CA, Whitfield GK, et al. The nuclear vitamin D receptor controls the expression of genes encoding factors which feed the "Fountain of Youth" to mediate healthful aging. The Journal of steroid biochemistry and molecular biology. Jul 2010;121(1-2):88-97. Doi: 10.10 16/ j.jsbmb. 2010.03.019
9. Van Halteren AG, Tysma OM, van Etten E, Mathieu C, Roep BO. 1alpha,25-dihydroxyvitamin D3 or analogue treated dendritic cells modulate human autoreactive T cells via the selective induction of apoptosis. Journal of autoimmunity. Nov 2004;23(3):233-239. Doi: 10.1016/j.jaut.2004.06.004
10. Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. The New England journal of medicine. Jul 11, 1996;335(2):99-107. Doi: 10.1056/NEJM199607113350206
11. Orgiazzi J. The spectrum of autoimmune thyroid diseases (AITD). Annales de medecine interne. Jun 1999;150(4):294-300. Doi: AMI-08-1999-150-4-0003-410X-101019-ART71
12. Mazokopakis EE, Chatzipavlidou V. Hashimoto's thyroiditis and the role of selenium. Current concepts. Hellenic journal of nuclear medicine. Jan-Apr 2007;10(1):6-8. PMID: 17450242
13. Kotsa K, Watson PF, Weetman AP. A CTLA-4 gene polymorphism is associated with both Graves disease and autoimmune hypothyroidism. Clinical endocrinology. May 1997;46(5):551-554. Doi: 10.1046/j.1365-2265.1997.1710996.x
14. Lacka K, Maciejewski A. [Vitamin D in the etiopathogenesis of autoimmune thyroiditis]. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. May 2013 ; 34 (203) :281-285. PMID: 23894780
15. Bozkurt NC, Karbek B, Ucan B, et al. The association between severity of vitamin D deficiency and Hashimoto's thyroiditis. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. May-Jun 2013;19(3):479-484. Doi: 10.4158/EP12376.OR
16. Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmunity reviews. Apr-May 2014;13(4-5):391-397. Doi: 10.1016/j.autrev.2014.01.007
17. Vondra K, Starka L, Hampl R. Vitamin D and thyroid diseases. Physiological research. 2015;64 Suppl 2:S95-S100. Doi : 10.33549/physiolres.933083
18. Bizzaro G, Shoenfeld Y. Vitamin D and autoimmune thyroid diseases: facts and unresolved questions. Immunologic research. Feb 2015;61(1-2):46-52. Doi: 10.1007/s12026-014-8579-z
19. Wiersinga WM. Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease. Endocrinology and metabolism. Jun 2016;31(2):213-222. Doi: 10.3803/EnM.2016.31.2.213
20. Bozkurt NC, Karbek B, Ucan B, et al. The association between severity of vitamin D deficiency and Hashimoto's thyroiditis. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. May-Jun 2013; 19 (3): 479-484. Doi: 10.4158/EP12376.OR
21. Kim D. The Role of Vitamin D in Thyroid Diseases. International journal of molecular sciences. Sep 12 2017;18(9). Doi: 10.3390/ijms18091949
22. Shin DY, Kim KJ, Kim D, Hwang S, Lee EJ. Low serum vitamin D is associated with anti-thyroid peroxidase antibody in autoimmune thyroiditis. Yonsei medical journal. Mar 2014;55(2):476-481. Doi: 10.3349/ymj.2014.55.2.476
23. Goswami R, Marwaha RK, Gupta N, et al. Prevalence of vitamin D deficiency and its relationship with thyroid autoimmunity in Asian Indians: a community-based survey. The British journal of nutrition. Aug 2009;102(3):382-386. Doi: 10.1017/S0007114509220824
24. Muscogiuri G, Mari D, Prolo S, et al. 25 Hydroxyvitamin D Deficiency and Its Relationship to Autoimmune Thyroid Disease in the Elderly. International journal of environmental research and public health. Aug 26 2016;13(9). Doi: 10.3390/ijerph13090850
25. Mazokopakis EE, Papadomanolaki MG, Tsekouras KC, Evangelopoulos AD, Kotsiris DA, Tzortzinis AA. Is vitamin D related to pathogenesis and treatment of Hashimoto's thyroiditis? Hellenic journal of nuclear medicine. Sep-Dec 2015;18(3):222-227.PMID: 26637501
26. Meddeb N, Sahli H, Chahed M, et al. Vitamin D deficiency in Tunisia. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. Feb 2005;16(2):180-183. Doi: 10.1007/s00198-004-1658-6
27. Jean- Claude Souberbielle. Epidemiology of vitamin D deficiency. Journal of Nutrition and Dietetics.2014;49(6):252-259. Doi: 10.1684/pnv.2016.0589
28. Kabylie Ldd. Andemique goitre http://www.algerielle.com/sante/sante-pratique/175-le-goitre-endemique.html. January 2011.
29. Tlemcen latitude and longitude Distance Calculatorhttps://www.distancede.comTlemcen latitude.