jsmc-10221

VITAMIN D DEFICIENCY AND ITS ASSOCIATION WITH HYPOTHYROIDISM

Taha Othman Mahwi a and Neveen Nawzad Mahmood b

a Department of Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

b University of Sulaimani, Kurdistan Region, Iraq.

Submitted: 4/8/2019; Accepted: 29/10/2019; Published: 21/12/2019

DOI Link: https://doi.org/10.17656/jsmc.10221

ABSTRACT

Background

Vitamin D has a major role in autoimmune diseases, the vitamin D receptor (VDR) is expressed in a variety of body tissues including thyrocytes, it’s suggested that there is a potential role of vitamin D in the development of Hashimoto’s thyroiditis and its progression to hypothyroidism. Vitamin D deficiency is a worldwide problem that has health consequences.

Objectives

To evaluate the association of vitamin D deficiency in hypothyroid patients in Sulaimani Governorate.

Methods

In this study 200 participants were included; consisted of 100 diagnosed hypothyroid patients and 100 healthy controls; age range was matched. All subjects (n = 200) were evaluated for 25(OH) vitamin D. Thyroid autoantibody [anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG)] levels with thyroid-stimulating hormone (TSH) and free thyroxine (T4) were measured in group 1.

Results

Serum 25(OH) vitamin D level was significantly lower in hypothyroid patients (13.6 ± 11.4ng/ml) than in controls (24.1 ± 20.7ng/ml), (P < 0.001). 83% of hypothyroid cases were vitamin D deficient, which is significantly more than control 54% (P< 0.001). (100) hypothyroid cases were correlated to anti-TPO and anti-Tg; (83) case had vitamin D deficiency, (66) and (46) cases of vitamin D deficient group were anti-TPO, anti-Tg positive respectively (P-value =0.42, P-value =0.13).

Conclusions

Our findings indicate that patients with hypothyroidism present with lower vitamin D levels than healthy controls; deficiency of vitamin D was linked to the presence of antithyroid antibodies.

KEYWORDS

Vitamin D deficiency, Hypothyroidism, Autoimmune disease.

References

1. Holick MF. Vitamin D Deficiency. N Engl J Med. 2007 Jul 19;357(3):266–81.

2. Michael Holick TC. Vitamin D deficiency- A worldwide problem (2008).pdf. Am J Clin Nutr. 2008;87(87):1080–6.

3. Sahota O. Understanding vitamin D deficiency. Age Ageing. 2014 Sep;43(5):589–91.

4. Silva MC, Furlanetto TW. Intestinal absorption of vitamin D: a systematic review. Nutr Rev. 2018 Jan 1;76(1):60–76.

5. Jones BJ, Twomey PJ. Issues with vitamin D in routine clinical practice. Rheumatology. 2008 Apr 4;47(9):1267–8.

6. Lips P, Eekhoff M, van Schoor N, Oosterwerff M, de Jongh R, Krul-Poel Y, et al. Vitamin D and type 2 diabetes. J Steroid Biochem Mol Biol. 2017 Oct 1;173:280–5.

7. Mustafa M, Iftikhar HM, Sharifa AM, Nang MK. Clinical advancement in Rheumatoid Arthritis Clinical advancement in Rheumatoid Arthritis. IOSR J Dent Med Sci. 2018;17(2):55–61.

8. Limketkai BN, Bechtold ML, Nguyen DL. Vitamin D and the Pathogenesis of Inflammatory Bowel Disease. Curr Gastroenterol Rep. 2016 Oct 18;18(10):52.

9. Ascherio A, Munger KL, Simon KC. Vitamin D and multiple sclerosis. Lancet Neurol. 2010;9(6):599–612.

10. Cantorna MT, Mahon BD. Mounting evidence for vitamin D as an environmental factor affecting autoimmune disease prevalence. Exp Biol Med (Maywood). 2004 Dec;229(11):1136–42.

11. Szodoray P, Nakken B, Gaal J, Jonsson R, Szegedi A, Zold E, et al. The Complex Role of Vitamin D in Autoimmune Diseases. Scand J Immunol. 2008 Sep 1;68(3):261–9.

12. Stechschulte SA, Kirsner RS, Federman DG. Vitamin D: Bone and Beyond, Rationale and Recommendations for Supplementation. Am J Med. 2009;122(9):793–802.

13. Braunstein MD G. Clinical THYROIDOLOGY FOR THE PUBLIC. Am Thyroid Assoc. 2018;7(4):17.

14. Kostic I, Curcio F. Causes of Hypothyroidism. In: Springer D, editor. Hypothyroidism - Influences and Treatments. 8th ed. Italy: InTech; 2012. p. 152–62.

15. Halawani MS, Nughays RO, Altemani AF, Mubarak N, Hussien M, Alghamdi NM, et al. Causes , Diagnosis , and Management of Hypothyroidism. Egypt J Hosp Med. 2018;71(April):2250–2.

16. Bozkurt N, Karbek B, Ucan B, Sahin M, Cakal E, Ozbek M, et al. The Association Between Severity of Vitamin D Deficiency and Hashimoto’s Thyroiditis. Endocr Pract. 2013 May;19(3):479–84.

17. Mansournia N, Mansournia MA, Saeedi S, Dehghan J. The association between serum 25OHD levels and hypothyroid Hashimoto’s thyroiditis. J Endocrinol Invest. 2014 May 18;37(5):473–6.

18. Robien K, Oppeneer SJ, Kelly JA, Hamilton-Reeves JM. Drug-vitamin D interactions: a systematic review of the literature. Nutr Clin Pract. 2013 Apr;28(2):194–208.

19. Mahwi T, Raouf RM. PREVALENCE OF VITAMIN D DEFICIENCY IN DIABETIC PATIENTS. J Sulaimani Med Coll. 2018 Oct 15;8(3):175–80.

20. DELUCA HF, CANTORNA MT. Vitamin D: its role and uses in immunology. FASEB J. 2002 Dec;15(14):2579–85.

21. Zmijewski MA. Vitamin D and Human Health. Int J Mol Sci. 2019;20(1):145.

22. Zhang J, Lazar MA. The Mechanism of Action of Thyroid Hormones. Annu Rev Physiol. 2000 Mar;62(1):439–66.

23. Bischoff-Ferrari HA. Optimal Serum 25-Hydroxyvitamin D Levels for Multiple Health Outcomes. 9th ed. Reichrath J, editor. Vol. 624, ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY. New York, NY: Springer New York; 2008. 55–71 p.

24. Penna G, Adorini L. 1 ,25-Dihydroxyvitamin D3 Inhibits Differentiation, Maturation, Activation, and Survival of Dendritic Cells Leading to Impaired Alloreactive T Cell Activation. J Immunol. 2000;164(5):2405–11.

25. Taher YA, van Esch BCAM, Hofman GA, Henricks PAJ, van Oosterhout AJM. 1 ,25-Dihydroxyvitamin D3 Potentiates the Beneficial Effects of Allergen Immunotherapy in a Mouse Model of Allergic Asthma: Role for IL-10 and TGF-. J Immunol. 2008 Apr 15;180(8):5211–21.

26. Correale J, Ysrraelit MC, Gaitán MI. Vitamin D-mediated immune regulation in Multiple Sclerosis. J Neurol Sci. 2011 Dec 15;311(1–2):23–31.

27. Kenneth L.Becker KL(ed). Principles and Practice of Endocrinology and Metabolism 3rd edition.Lippincott Williams &Wilkins,Philadelphia. 2002. 456–459 p.

28. Mazokopakis EE, Kotsiris DA. Hashimoto’s autoimmune thyroiditis and vitamin D deficiency. Current aspects. Hell J Nucl Med. 2014;17(1):37–40.

29. Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc. 2011 Jan;86(1):50–60.

30. Cowan A, Pugh R, Mccaughey A. Treatment of Vitamin D Deficiency in Adults. National health system. 2017. p. 4–9.

31. Wang J, Lv S, Chen G, Gao C, He J, Zhong H, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients. 2015 Apr 3;7(4):2485–98.

32. Kivity S, Agmon-Levin N, Zisappl M, Shapira Y, Nagy E V, Dankó K, et al. Vitamin D and autoimmune thyroid diseases. Cell Mol Immunol. 2011 May 31;8(3):243–7.

33. Wang X, Zynat J, Guo Y, Osiman R, Tuhuti A, Zhao H, et al. Low Serum Vitamin D Is Associated with Anti-Thyroid-Globulin Antibody in Female Individuals. Int J Endocrinol. 2015;2015:285–90.

34. Kim D. Low vitamin D status is associated with hypothyroid Hashimoto’s thyroiditis. Hormones. 2016 Jul 9;15(3):385–93.

35. Muscogiuri G, Mari D, Prolo S, Fatti L, Cantone M, Garagnani P, et al. 25 Hydroxyvitamin D Deficiency and Its Relationship to Autoimmune Thyroid Disease in the Elderly. Int J Environ Res Public Health. 2016 Aug 26;13(9):850.

36. Yasmeh J, Farpour F, Rizzo V, Kheradnam S, Sachmechi I. HASHIMOTO THYROIDITIS NOT ASSOCIATED WITH VITAMIN D DEFICIENCY. Endocr Pract. 2016 Jul;22(7):809–13.

Full Text

This work is licensed under a Creative Commons Attribution 4.0 International License.