| Objectives:To explore and verify the correlation between vitamin D deficiency and Hashimoto’s thyroiditis(HT).To explore whether vitamin D supplementation can effectively improve the condition of HT patients and the possible mechanism.To provide theoretical basis for the treatment of HT patients with vitamin D deficiency in clinical work.Methods:From June 2020 to Jan 2021,the patients who were treated at the Physical Examination Center,Department of Endocrinology and Metabolism,Qujing Hospital Affiliated to Kunming Medical University,who were first diagnosed with Hashimoto’s thyroid,and the normal control population matched with general data were selected as subjects based on inclusion and exclusion criteria.The serum 250HD,TSH,FT4,FT3 and TT3,TT4,TPO-Ab,TG-Ab,Th17 and RORyt mRNA levels were detected,to analyze the differences of the above indicators in the research objects.HT patients were randomly divided into the treated group and the untreated group.The subjects were followed up 3 months later,and the above indicators were detected again to analyze the differences between the treated group and the untreated group.SPSS26.0 statistical analysis software was used for statistical analysis.Results:1.The differences of gender[80(50/30)vs 21(14/7),p=0.724],age(44.1±10.33 vs 42.48±9.14,p=0.514),BMI(22.71 ±0.85 vs 22.8±0.98,p=0.659),sun exposure(17.31±9.24 vs 19.05±10.91,p=0.463),physical activity(34.13±22.76 vs 41.43±20.07),p=0.184)between HT group and healthy control group had no statistical significance(p>0.05).The differences of gender[12(7/5)vs 15(8/7)],p=1.000],age(48.75±7.69 vs 45.93±8.91,p=0.395),BMI(23.03±0.90 vs 22.73±0.84,p=0.383),sun exposure(18.75±10.25 vs 19.00±8.285,p=0.945),and physical activity(32.50±23.79 vs 34.00±25.01,p=0.876)between HT treated group and untreated groups had no statistical significance(p>0.05).2.The differences of TPO-Ab[379.8(113.48,611.35)vs 178.1(125.2,897.0),p=0.591]、TG-Ab[12.14(1.84,173.77)vs 29.3(0.1,195.9),p=0.884]、250HD(17.44±5.86 vs 17.08±5.37,p=0.870)、IL-17[26.07(17.51,39.88)vs 20.40(18.16,20.64),p=0.133]、RORγtmRNA 2-ΔΔCt[2.21(1.68,3.85)vs 1.64(1.26,2.44),p=0.114]between HT treated group and untreated group at the time of enrollment had no statistical significance(p>0.05).3.The 250HD level in HT group was lower than that in healthy control group(13.86±6.13 vs 23.87±6.53,p=0.000),and the difference was statistically significant(p<0.01).However,there was no linear correlation between vitamin D level and ATPO-Ab or ATG-Ab titers(r=0.119,P=0.352 vs r=0.063,p=0.626)in HT patients(p>0.05).In HT patients,the differences of TPO-Ab[254.95(43.70,625.83)vs 259.90(144.35,487.60)vs 405.71(143.10,659.83),p=0.488],TG-Ab[16.70(4.60,130.30)vs 22.35(2.68,130.80)vs 41.79(1.47,138.98),p=0.985]between 250HD severe deficiency group,25OHD deficiency group and 250HD insufficient group were no statistical significance(p>0.05).4.The level of IL-17 in HT group was higher than that in healthy control group[19.98(11.07,23.30)vs 12.98(9.66,16.33),p=0.037],and the difference was statistically significant(p<0.05).The 2-ΔΔCt value of RORyt mRNA in HT group was higher than that in healthy control group[1.75(1.17,2.73)vs 1.32(0.71,1.83),p=0.013],and the difference was statistically significant(p<0.05).5.In HT treated group,the titers of TPO-Ab[379.8(113.48,611.35)vs 119.4(54.42,513.21),p=0.002]and TG-Ab[12.14(1.84,173.77)vs 3.15(1.79,136.88),p=0.023]were significantly lower than before in the 3-month follow-up with vitamin D supplementation,with statistically significant differences(p<0.05).In untreated group,the differences of the titer of TPO-Ab[178.1(125.2,897.0)vs 167.3(121.7,827.6),p=0.097]between before and after 3 months of follow-up had no statistical significance(p>0.05),but the differences of the titer of TG-Ab[29.3(0.1,195.9)vs 23.0(0,143.0),p=0.003]had statistical significance(p<0.05).The differences of the difference value of TPO-Ab before and after 3 months of follow-up(185.24±161.46 vs 11.77±25.59,p=0.000)between HT treated and untreated group had statistical significance(p<0.05).But the differences of the difference value of TG-Ab before and after 3 months of follow-up[5.83(0.06,36.89)vs 4.3(0,15.4),p=0.883]between HT treated and untreated group had no statistical significance(p>0.05).6.In HT group,IL-17(27.64±13.01 vs 23.56±15.65,p=0.029)decreased after 3 months of vitamin D supplementation,and the difference was statistically significant(p<0.05).But,there was no significant difference in the 2-ΔΔCt value of RORyt mRNA[2.21(1.68,3.85)vs 2.26(1.56,2.97),p=0.239](p>0.05).However,there was no significant difference in IL-17[20.40(18.16,20.64)vs 18.46(13.45,22.46),p=0.363]and the 2-ΔΔCt value of RORγt mRNA(1.82±0.76 vs 1.87±0.76,p=0.91)in HT untreated group before and after 3 months follow-up(p>0.05).The differences of the difference value of IL-17[3.18(1.44,6.12)vs 1.10(-1.60,5.17),p=0.114]and the difference 2-ΔCt value of RORyt mRNA[0.43(=1.00,2.11)vs-0.23(-0.64,0.90),p=0.435]before and after 3 months of follow-up between HT treated and untreated group had no statistical significance(p>0.05).Conclusion:1.Compared with healthy controls,HT patients had lower serum 25OHD levels.However,there was no obvious linear correlation has been found between 25OHD level and the titer of thyroid autoantibodies TPO-Ab and TG-Ab.2.The expression of IL-17 and RORγt mRNA in peripheral blood of HT patients was higher than that of healthy control group.It suggested that the expression of Th 17 cells and RORyt mRNA was increased in HT patients3.Vitamin D supplementation is beneficial to decrease the titer of TPO-Ab in peripheral blood of HT patients.It is beneficial to the remission of HT patients.4.There was no significant decrease of IL-17 and RORy mRNA in HT group treated with vitamin D supplementation.We considered that these results may be related to the low number of patients followed up,or to the fact that vitamin D supplementation in HT patients has not yet reached adequate levels. |
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