The Insufficiency Levels Of 25-hydroxyvitamin D Is Beneficial For The Decrease Of TRAB In Patients With Graves' Disease

Objective:A retrospective review of the relationship between baseline 25-hydroxyvitamin D levels and the remission rate or darkening rate of thyrotropin receptor antibody(TRAB)during treatment in patients with newly diagnosed Graves' disease(GD)Methods:This study was a retrospective investigation included 171 newly diagnosed GD patients in March 2013 to April 2016 attending the Endocrinology Department of the First Affiliated Hospital of Fujian Medical University were collected,aged(41.00±11.48)years old and 122 females(71.35%).95 patients in our hospital diagnosis clear requirements turn local hospital nearby after treatment,76 patients with GD were followed up and treated in our hospital,age(41.50±11.22)years old,53 female(73.61%)patients,median follow-up time was 11.03(6-27)months,4 patients without complete follow-up data.The GD patients who completed the follow-up were divided into three groups according to baseline 25-hydroxyvitamin D level,25-hydroxyvitamin D<20ng/mL group(31,43.05%),20-29 ng /mL group(20,27.78%),or 30ng/mL group(20,29.17%).TRAB and thyroid hormone were measured every 2 months during the first 6 months after initiation of anti-thyroid drugs(ATD),and TRAB and thyroid hormone were measured every 6 months after 6 months.Compare TRAB remission rate or darkening rate during follow-up in each group.Results: 1.The newly diagnosed patients with Graves' disease had different TSH and TRAB between baseline in different 25-hydroxyvitamin D groups.2.Kaplan-Meier survival analysis shows: Compared with the 25-hydroxyvitamin D<20 ng/mL group,the TRAB remission rate and darkening rate in the 25-hydroxyvitamin D 20-29 ng/mL group had begun to show a statistically significant increase at 6 months follow-up,followed by 12 month,24 months,and at the end of the natural follow-up period,this increase still existed;25-hydroxyvitamin D?30 ng/mL group had no difference in TRAB remission rate and darkening rate during the entire follow-up period.Compared with the 25-hydroxyvitamin D 20-29 ng/mL group,the 25-hydroxyvitamin D ?30 ng/mL group showed a lower TRAB response rate from the follow-up period of 12 months until the end of the follow-up;During the follow-up of 24 months to the end of the follow-up,TRAB darkening rate was also low and the difference was statistically significant.3.COX regression analysis corrected for age,sex,season,and other factors.Compared with the 25-hydroxyvitamin D <20 ng/mL group,the 25-hydroxy vitamin D 20-29 ng/mL group was followed up at 6,12,and 24 months of follow-up and at the end of the natural follow-up,have higher remission rates [RR;95% CI: 7.505(1.401-40.201),8.975(2.759-29.196),6.853(2.206-21.285),7.299(2.362-22.552)] and darkening rate [RR;95 % CI: 7.835(1.468-41.804),7.189(1.393-37.092),8.122(1.621-40.688),8.157(1.632-40.776)].4.The level of 25(OH)d at the time of initial diagnosis was not associated with the return of normal FT3,FT4,or TSH after ATD treatment.Conclusion:The insufficiency 25-hydroxyvitamin D levels are beneficial for the reduction of TRAB in patients with Graves disease,and higher 25-hydroxyvitamin D levels do not increase the benefit.