To Preliminarily Explore The Relationship Between The Liver Damage Associated With Graves’ Disease And 25 (OH) Vitamin D

Objective: To explore the changes of serum 25(OH)vitamin D levels and the relationship between the two in patients with Graves hyperthyroidism complicated with liver damage,and to provide evidence for clinical application of vitamin D to treat such patients.Methods : The sample was selected from 130 new Graves hyperthyroid patients admitted to our hospital from January 2016 to December 2018.According to the two indexes of hyperthyroidism and liver function,they were divided into three groups,which were Graves disease hyperthyroid liver damage group.Graves disease group with normal liver function,and healthy patients who did not have blood relationship at the same period as the health control group were specifically divided into 64 patients with Graves disease and liver damage(group A,n = 64),including 14 males,50 females,with an average age of(47.07 ± 1.10)years;66 patients with normal liver function in Graves disease(group B,n = 76),including 23 males and 43 females,with an average age of(51.65 ± 2.35)Years;healthy control group of 60 cases(group C,n = 60),including 17 males and 43 females,with an average age of(51.63 ± 2.15)years.The ELISA method was used to measure the 25(OH)D content in patients’ blood samples.The 25(OH)VD content was divided from high to low: normal(50-149.9nmol/l),insufficient(30-50nmol/l),and lack(<30nmol/l).Compare the three groups of samples to see if there is a difference,and if so,analyze the cause of the difference;then use Spearman correlation method to analyze the correlation between serum 25(OH)vitamin D and other laboratory test data.Results :According to the statistics of experimental data,there were 78 cases of serum 25-hydroxyvitamin D in the A + B group lower than normal.The total proportion of 60% in Graves disease patients was much higher than 40% in the normal control group.(P <0.05).The comparison between group A and group B revealed that the number of serum 25(OH)VD levels lower than normal was 53 and25 respectively,and the difference was statistically significant(P <0.05).The content of 25(OH)D in group A was 38.95±12.33nmol/l,which was significantly lower than that in group C,50.60±25.30nmol/l,and the difference was statistically significant,that is,P <0.05.The content of 25(OH)D in group B was46.76±18.21nmol/l,which was lower than the content in group C 50.60±25.30nmol/l,the difference was statistically significant,that is,P <0.05.The content of 25(OH)D in group of Graves disease patients was 44.44±16.44nmol/l,which was significantly lower than that in group C,50.60±25.30nmol/l,and the difference was statistically significant,The Spearman method was used to find that contents of 25(OH)D and FT3(r =-0.708,P<0.05),FT4(r =-0.622,P <0.05),TRAb(r =-0.724,P <0.05),TBIL in patients with hyperthyroid liver damage(r =-0.577,P <0.05),etc.were all negatively correlated;positively correlated with TSH(r = 0.871,P <0.05).Conclusion :This study found that serum 25(OH)vitamin D levels in patients with Graves hyperthyroidism and liver damage were lower than those in normal people and lower than those with normal liver function in Graves disease.The reason for the lower than normal levels in patients with impaired and normal liver function may be that the decline in 25(OH)VD content is the mechanism that causes Graves disease,or it may be the decline in 25(OH)VD caused by Graves disease.That is,if the causality cannot be determined only by observing the content of 25(OH)VD,this study continues to analyze the correlation between 25(OH)VD and the detection indicators of hyperthyroidism and liver damage.Combined with the Spearman study method,the serum 25(OH)VD content in Graves disease with liver damage was negatively correlated with FT3,FT4,and TRAb,and positively correlated with TSH,which indirectly proved that serum 25(OH)VD content is related to the onset of Graves disease.Combined with the Spearman research method,the serum 25(OH)VD content of Graves disease with liver damage was negatively correlated with TBIL;that is,the higher the TBIL,the lower the 25(OH)VD content.It is reasonable to speculate that the 25(OH)VD may be Graves disease is one of the causes,but Graves disease with liver damage is one of the reasons for the further decline in 25(OH)VD content.Vitamin D levels are related to calcium and phosphorus metabolism,which in turn affects body bone density(BMD).The clinical significance is that 25(OH)VD index should be observed at any time after Graves disease patients with liver damage to prevent complications such as bone density decline and subsequent fractures.In summary,25(OH)VD is related to the onset of Gravesdisease.Clinical monitoring of 25(OH)VD content in real time,vitamin D supplementation is helpful for treatment,and it has the effect of preventing liver damage.Vitamin D should also be added in time,which has a certain effect on preventing complications such as jaundice and fractures.