Changes Of Serum 25(OH)D3 And IGF-1 Levels In Patients With Thyroid Nodules

Objective: Thyroid nodules is one of the common diseases of endocrine system,and the pathogenesis is complicated.Some studies suggest that insulin-like growth factor-1 and 25(OH)D3 are associated with the occurrence of thyroid nodules.Studies have shown that the IGF-1/ insulin axis is directly linked to vitamin D.Some of the growth effects of IGF-1 may be mediated by vitamin D.In this study,398 healthy subjects were collected to detect the serum 25(OH)D3 and IGF-1 levels and to further clarify the changes and interactions of vitamin D3 and IGF-1 in patients with thyroid nodules.Methods: This study was conducted in Health Examination Center of Hebei Province General Hospital.Eventually,289 subjects with thyroid nodules and 109 normal subjects were enrolled in the study.The general conditions of the subjects was recorded and the thyroid ultrasound was detected in parallel.Serum 25(OH)D3 and IGF-1 levels were measured.Besides,glucose,lipids,thyroid function and other indicators were detected.All statistical analyses were performed.All participants were given informed written consent.Results:1.The association of the baseline characteristics and thyroid nodulesCompared with the control group,the nodular group had lower serum 25(OH)D3,IGF-1 and TT3.The nodular group had higher levels of serum FBG,TC,WC,TT4 and history of hypertension than the control group.However,there was difference of alcoholic drinking between the two groups.2.The correlation of thyroid nodules and related metabolic factorsThe results showed that there was a negative association between thyroid nodules and 25(OH)D3,IGF-1,TT3 levels,and a positive association with FBG,TC,TT4 and hypertension.3.The association of serum 25(OH)D3 and IGF-1The results showed that serum 25(OH)D3 was positively associated with IGF-1.4.The association of serum 25(OH)D3 level with the prevalence of thyroid nodules.We divided all the participants into four groups across serum 25(OH)D3quartiles.From the lowest quartile to the highest quartile of serum total25(OH)D3 level,the prevalence of thyroid nodules were 84.8%,75.0%,72.3% and 58.2%,respectively.Compared with subjects in first quartile,a significant decrease of prevalence of thyroid nodules was observed in the third quartile and the highest quartile.Compared with quartile 1 of serum25(OH)D3,univariate Logistic regression analysis showed that serum25(OH)D3 in quartile 3 had a significant correlation with decreased odds of thyroid nodules.After further adjustment for FBG,TC,TT3,TT4,hypertension and IGF-1,the ORs of thyroid nodules for increasing serum25(OH)D3 quartiles was still decreased,and there were significant difference.Compared with quartile 1 of serum 25(OH)D3,univariate Logistic regression analysis showed that serum 25(OH)D3 in quartile 4 had a significant correlation with decreased odds of thyroid nodules.After further adjustment for FBG,TC,TT3,TT4,hypertension and IGF-1,the ORs of thyroid nodules for increasing serum 25(OH)D3 quartiles was still decreased,and there were significant difference.5.The association of serum IGF-1 level with the prevalence of thyroid nodules.We divided all the participants into four groups across serum IGF-1quartiles.From the lowest quartile to the highest quartile of serum total IGF-1level,the prevalence of thyroid nodules were 79.8%,85.0%,73.0% and 52.5%,respectively.Compared with subjects in first quartile,a significant decrease of prevalence of thyroid nodules was observed in the highest quartile.Compared with quartile 1 of serum IGF-1,univariate Logistic regression analysis showed that serum IGF-1 in quartile 4 had a significant correlation with decreasedodds of thyroid nodules.After further adjustment for FBG,TC,TT3,TT4,hypertension and 25(OH)D3,the ORs of thyroid nodules for increasing serum IGF-1 quartiles were also increased,but there were no significant difference.Conclusions:1.The incidence of thyroid nodules is relatively lower in a high level of serum 25(OH)D3 population,and serum 25(OH)D3 may be a direct protective factor for thyroid nodules.2.Serum IGF-1 may be one of the indirect protective factors of thyroid nodules,possibly through the 25(OH)D3 effect on the occurrence of thyroid nodules.