Effect Of Vitamin D On Serum Related Antibody Levels In Women With Autoimmune Thyroid Disease

Objective: autoimmune thyroid disease(autoimmune thyroid disease,AITD)is an organ-specific autoimmune disease caused by multiple factors,such as genetic and environmental factors.it is mediated by humoral and cellular immunity,and its incidence is about 5%.mainly including Graves disease(Graves' disease,GD)and Hashimoto's thyroiditis(Hashimoto's thyroiditis,HT).continuous in-depth studies of vitamin D(vitamin D,VD)have found that VD not only regulate calcium and phosphorus metabolism,but also have important relationships with the immune system,cell differentiation,and other endocrine glands.The correlation between VD level and AITD has attracted more and more attention.studies have pointed out that AITD patients' VD levels are generally low,and whether supplementary VD treatment benefits AITD patients is controversial.this study aims to analyze the effect of vitamin D levels on autoimmune thyroid disease,which may provide new clues for the treatment of AITD.Methods : AITD patients(including hyperthyroidism and hypothyroidism)were included in the outpatient clinic of the affiliated hospital of inner mongolia medical university.patients with serum 25(OH)D 3<30 ng/ml(vitamin D deficiency)in the GD?HT group were divided into the VD intervention group and the unintervention group by a completely random method,each group with 30 cases.GD patients in the non-intervention group were treated only with memercaptoimidazole;HT patients were treated only with levothyroxine;GD patients in the VD intervention group were treated with memercaptoimidazole while taking active vitamin D(Calcitriol Soft Capsules0.25?g/d);HT patients were treated with levothyroxine while taking Calcitriol Soft Capsules(0.25?g/d)for 3 months.The serum free triiodothyronine(FT3),free thyroxine(FT4),thyrotropin(TSH),TRAb,TPOAb,TGAb,liver function,renal function,25(OH)D were measured and recorded in all the selected subjects.Early morning fasting venous blood was extracted every 1 month after medication to detect FT3?FT4?TSH?TGAb?TPOAb?TRAb?25(OH)D,record and statistics.Monitor liver function,ion,blood routine,thyroid function during medication,adjust the dose of methimazole or levothyroxine sodium,and try to maintain thyroid function in normal range.SPSS22.0 statistical software was used for data analysis,and the measurement data were expressed in x±s;the independent t test was used for inter-group comparison;the paired t test was used for intra-group comparison;and the correlation analysis was used for Pearson correlation analysis.P<0.05 was statistically significant.Results: 1.After statistical analysis of the data,it was found that the correlation between VD level and TPOAb and TGAb was not significant(r=-0.04;r=-0.3);It was negatively correlated with TRAb(r=-0.5),that is,the higher the VD level,the smaller the TRAb value.2.After 3 months of treatment,the TPOAb value of HT patients was 314.4±146.5 IU/ml,and the TGAb value was 811.8±1045.8 IU/ml in the non-intervention group.The TRAb value of patients in GD group was 15.3±6.7(IU/L).In the intervention group,TPOAb value of HT patients was 333.9±167.2(IU/ml),TGAb value was 493.6±711.7(IU/ml),and TRAb value of GD patients was 12.8±5.8(IU/L).Compared with baseline,TRAb was significantly lower than before,which was statistically significant(p < 0.05).The changes after antibody treatment were correlated with those before treatment(r > 0.5).3.The results showed that,compared with the non-intervention group,the antibody values of TPOAb and TGAb in the intervention group did not decrease significantly(p >,0.05)and the TRAb values decreased significantly(p < 0.05).Conclusion : 1.The antibody level of GD patients is negatively correlated with the level of VD,which may affect the pathogenesis of GD.Monitoring VD levels during treatment may be helpful in determining prognosis.2.The decrease of TPOAb and TGAb in HT patients was not significant after treatment, and the antibody level did not decrease significantly after VD supplement,suggesting that VD level may have little effect on the antibody of HT patients.It is possible that due to the short follow-up time and small sample size,the expected target could not be achieved.Therefore,large sample size and multi-center study should be carried out in the future.3.The decrease of TRAb in GD patients after treatment was more significant than that before treatment.Compared with the non-intervention group,the decrease of TRAb in the VD intervention group was more significant,suggesting that VD may have an effect on TRAb.Supplementation of VD may improve thyroid autoimmune disorder in GD patients,providing a new idea for future treatment,which can be used in clinical promotion.