Study On The Relationship Between Serum Levels Of Classified 25-hydroxyvitamin D And Benign Thyroid Nodules And Thyroid Cancer

Objective:The aim of this study was to investigate the relationship between serum levels of 25-hydroxyvitamin D₂?25-?OH?D₂?,25-hydroxyvitamin D₃?25-?OH?D₃?,and total25-hydroxyvitamin D?25-?OH?D?,and benign thyroid nodules?BTN?or thyroid cancer?TC?,and to provide laboratory basis for the precise diagnosis,treatment,and risk predicting of BTN or TC.Methods:From July 2018 to January 2020,236 patients diagnosed with BTN or TC were enrolled in this study in the Affiliated Zhongshan Hospital of Dalian University.The enrolled 236 patients were divided into two groups:the BTN group?N=118?and the TC group?N=118?.The health personnel who did the physical examination in the same hospital during the same period,were also enrolled in this study as the control group?N=118?.The informed consent was signed by participants.The clinical data and the general information of the patients were collected and statistically analyzed respectively.The 5mL of venous blood were collected from all the participants.The serum levels of25-?OH?D₂,25-?OH?D₃,and total 25-?OH?D,were tested by Liquid Chromatography-tandem Mass Spectrometry?LC-MS/MS?respectively.The serum levels of FT3,FT4,TSH,TPO-Ab,and Tg-Ab were tested by chemiluminescent immune analyzer respectively.The statistical software SPSS?version 23.0?was used to analyze and process data.The multivariate logistic regression model was used to analyze the relationship between serum levels of 25-hydroxyvitamin D₂,25-hydroxyvitamin D₃,and total 25-hydroxyvitamin D,and BTN or TC.The odds ratio?OR?of 95%Confidence Intervals?CI?was used as the evaluation criteria.The method of Spearman correlation analysis was used for the correlation analysis between the variables.Results:The general clinical data of the participants in the three groups showed that the proportion of women in the TC group was higher than that in the control group and the BTN group?P<0.05?,and that the family genetic history rate between the TC group and the BTN group was significantly higher than that in the control group?P<0.05?.There were no significant differences in age,BMI,smoking,whether or not using vitamin D or calcium,whether or not having a history of radiation exposure,and serum levels of thyroid function indexes?FT3,FT4,TSH,Tg-Ab,TPO-Ab??P>0.05?.Compared with in the control group,in the BTN group or TC group,the serum levels of the classified 25-?OH?D in the participants,the serum levels of the classified 25-?OH?D in the participants receiving strong and weak light intensity at the time of blood collection,and the serum levels of the classified 25-?OH?D in the participants with different nutritional status of 25-?OH?D?absence,deficiency,normal?,were all associated with the risk of BTN or TC?P<0.05?.After adjusting for confounding factors,the result of Logistic regression analysis showed that the deficiency of serum level of 25-?OH?D was associated with the higher risk of BTN?normal vs.insufficient:OR=3.934,95%CI:1.682-9.200;normal vs.deficiency:OR=27.979,95%CI:9.875-79.274,P<0.05?.With increasing of serum levels of25-?OH?D₃ and total 25?OH?D,the risk of BTN decreased?Q4 vs Q1:OR=0.054,95%CI:0.017-0.170,P<0.05;Q4 vs Q1:OR=0.043,95%CI:0.013-0.147,P<0.05?.The serum level of 25-?OH?D₂ was associated with the risk of BTN?Q4 vs Q1:OR=7.310,95%CI:2.321-23.027,P<0.05?.Compared to the patients whose serum level of 25?OH?D was normal,the patients whose serum level of 25?OH?D was deficiency,were at the higher risk of TC?normal vs.insufficient:OR=5.312,95%CI:1.949-14.479;normal vs.deficiency:OR=34.528,95%CI:10.212-131.623,P<0.05?.With the increasing of serum levels of25?OH?D₃ and total 25?OH?D,the risk of TC decreased?Q4 vs Q1:OR=0.022,95%CI:0.006-0.079,P<0.05;Q4 vs Q1:OR=0.032,95%CI:0.010-0.103,P<0.05?.The serum level of 25-?OH?D₂ was not significantly associated with the risk of TC?P>0.05?.The result of Spearman correlation analysis showed that the serum levels of 25-?OH?D₃ and total 25-?OH?D were positively associated with the serum level of FT3?r=0.108;r=0.105,P<0.05?.Conclusion:The higher risk of BTN or TC was associated with the lower serum nutrition level of 25-?OH?D₃ or total 25-?OH?D in the patients.The risk of BTN was negatively associated with serum level of 25-?OH?D₃,or total 25-?OH?D.The risk of TC was also negatively associated with serum level of 25-?OH?D₃ or total 25-?OH?D,but not with the serum level of 25-?OH?D₂.The serum levels of classified vitamin D could provide reliable laboratory basis for the precise diagnosis,treatment,and risk predicting of BTN or TC.