The Study On Relationship Between Serum25-hydroxyvitamin D₃Concentration And Hashimoto’s Thyroiditis

Background:Hashimoto’s thyroiditis（HT）， sometimes called Hashimoto’sdisease（HD）,also known as Chronic lymphocytic thyroiditis is one of autoimmunedisease.According to recent datas,the incidencs of this diease have a tendency toincrease and tend to be younger，thus it cause wide attention.The pathogenesis of HThave not yet been elucidated,but have a Closely associated with many factors,Mostscholars believe that Immune factors take play the most important role in thepathogenesis of HT.1,25-Dihydroxyvitamin D₃is the active form of vitamin D, which not onlyplays an important role in body calcium metabolism and cell growth,differentiation,but a rencent study also found that has effects on immune regulation.1,25（OH）₂D₃is a secosteroid hormone that binds to the vitamin D receptor（VDR）,The identification of vitamin D receptor in cells involved in the immuneresponse and the discovery that activated dendritic cells produce vitamin D hormonesuggested that vitamin D could exert immunoregulatory effects. In addition to directeffects on T cell activation，1,25-Dihydroxyvitamin D——3also modulates the phenotypeand function of antigen presenting cells and in particular of dendritic cells throughmultiple mechanisms. The awareness on Immune regulation mechanism of1,25-Dihydroxyvitamin D₃reveals that have a wide range of applications in thetreatment of autoimmune diseases．Research in recent years found that the deficiencyof vitamin D₃can induce the occurence of various autoimmune disease,in themeanwhile，the supplement of vitamin D₃can prevent and treat the emergence ofautoimmune disease.However, the reports that the connection between1,25（OH）₂D-3and hashimoto thyroiditis are not so much, this article will study in this area. Objective: To observe the serum25-Dihydroxyvitamin D₃level of the patients with Hashimoto’s hhpothyroidism and the relationship between serum25-Dihydroxyvitamin D₃level and thyroperoxidase antibodies、thyroglobulin antidody，and also explore wether it Has an impact on thyroperoxidase antibodies、thyroglobulin antidody、free triiodothyronine、free thyroxine and thyroid-Stimulating hormone when replenishing the1alpha25-dihydroxyvitamin D₃in the collaborative treatment of HT.Methods:40cases of patients with Hashimoto’s hhpothyroidism were collected between Jun2012and dec2012from Endocrinology outpatient and ward in the China-Japan hospital of JiLin university,at the same time we choose twenty healthy people as normal group. the serum concentrations of25-DihydroxyvitaminD₃,thyroglobulin antidody,thyroperoxidase antibodies,free triiodothyronine,free thyeoxin and thyroid-Stimulating hormone （TSH） were assayed in All selected objects.Seclect patients with serum25-Dihydroxyvitamin D₃below the lowerlimit of normal,and then divided into two groups A and B. Group A have a simple application of the levothyroxine treatment.Group B put into use calcitriolsoft capsule on the basis of the application of levothyroxine therapy. Observedthe Serum levels of25-OHD₃, FT3, FT4, TSH, TGAb, TPOAb in before andafter treatment After3months of continuous administration.Resultst: Compare with normal group,the serum concentrations of25-Dihydroxyvitamin D₃in Hashimoto’s hhpothyroidism group were remarkably decrease.（P<0.01）。 According to relevant analysis: in the Hashimoto’s hypothyroidism group,the concentration of25-Dihydroxyvitamin D₃was negatively associated with the TPO-Ab（r=-0.642，P<0.01）、TGAb（r=-0.516，P<0.01）、TSH（r=-0.059，P<0.01）and was pisitively associated with与FT3（r=0.387，P<0.05）、FT4（r=0.175，P<0.05）. In A and B group,the serum TPO-Ab、TGAb Concentration were all decrsase significantly after therapy（P<0.05,P<0.01）,and group B decreased more than group A（P<0.05）.â‘£After treatment,the thyroid function of patients form A and B group was improved significantly than before（P<0.01）,and the thyroid function had no diffenerce in the two groups（P>0.05）。 Conclusion: The patients with HT had25-Dihydroxyvitamin D₃deficiency,whith had connection with humoral immune disorders,and indicated25-Dihydroxyvitamin D₃deficiency played an important role in the development of thyroid autoimmune. When using levothyroxine to treat people with Hashimoto’s hypothyroidism,we can give supplementary active vitamin D₃to help treat HT by reducing the serum thyroid autoantibody leves.