原发性甲状腺功能减低症患儿血清25羟维生素D_3水平分析
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摘要
目的分析原发性甲状腺功能减低症患儿血清25羟维生素D_3[25(OH)D_3]水平。方法原发性甲状腺功能减低症患儿175例;其中,先天性甲状腺功能减低症93例,高TSH血症82例。检测血清25(OH)D_3及甲状腺功能相关指标,分析25(OH)D_3与甲状腺功能指标的相关性。结果先天性甲状腺功能减低症患儿血清25(OH)D_3水平低于本地区健康儿童[(67.89±26.04) nmol/L vs.(79.92±22.97) nmol/L](P<0.05);且甲状腺缺如患儿血清25(OH)D_3水平[(59.62±26.55) nmol/L vs.(73.72±23.62) nmol/L]和甲状腺过氧化物酶抗体水平[(0.74±0.57) IU/ml vs.(1.28±1.26) IU/ml]均低于甲状腺未缺如患儿(P<0.05)。维生素D缺乏和不足患儿的TSH水平高于维生素D充足患儿[(9.55±8.79)μIU/ml和(5.55±4.45)μIU/ml vs.(4.23±3.06)μIU/ml](P<0.05),血清25(OH)D_3水平与TSH水平、甲状腺缺如呈负相关(r=-0.18、-0.21,P<0.05)。结论原发性甲状腺功能减低症患儿血清中维生素D不足与高TSH水平有关,甲状腺功能减退与维生素D缺乏之间存在相关性。
Objective To analyze serum 25-hydroxyvitamin D_3[25(OH)D_3] level in children with primary hypothyroidism.Methods Of 175 children with primary hypothyroidism,93 children were with congenital hypothyroidism and 82 children with high blood TSH. Serum 25(OH)D_3 and thyroid function-related indicators were detected.The correlation between serum 25(OH)D_3 level and thyroid function-related indicators was analyzed as well.Results Serum level of 25(OH)D_3 was lower in children with congenital hypothyroidism than that in normal children living in the same district [(67.89±26.04)nmol/L vs.(79.92±22.97) nmol/L](P<0.05).Serum level of 25(OH)D_3 was lower in children with thyroid absence than that in normal children [(59.62±26.55) nmol/L vs.(73.72±23.62) nmol/L](P<0.05).Serum level of hyroid peroxidase antibody was lower in children with thyroid absence [(59.62±26.55) nmol/L vs.(73.72±23.62) nmol/L],so did in children with children with congenital hypothyroidism than that in normal children [(0.74±0.57) IU/ml vs.(1.28±1.26) IU/ml](P<0.05).Serum level of TSH in children with vitamin D absence or insufficiency was higher than that in children with adequate level of vitamin D [(9.55±8.79) IU/ml or(5.55±4.45) μIU/ml vs.(4.23±3.06) μIU/ml](P<0.05).Serum 25(OH)D_3 level was negatively correlated to TSH and thyroid absence(r=-0.18 and-0.21,P<0.05).Conclusion In children with primary hypothyroidism,the vitamin D deficiency is closely related to the increased level of TSH and the hypothyroidism is correlated with vitamin D deficiency.
Objective To analyze serum 25-hydroxyvitamin D_3[25(OH)D_3] level in children with primary hypothyroidism.Methods Of 175 children with primary hypothyroidism,93 children were with congenital hypothyroidism and 82 children with high blood TSH. Serum 25(OH)D_3 and thyroid function-related indicators were detected.The correlation between serum 25(OH)D_3 level and thyroid function-related indicators was analyzed as well.Results Serum level of 25(OH)D_3 was lower in children with congenital hypothyroidism than that in normal children living in the same district [(67.89±26.04)nmol/L vs.(79.92±22.97) nmol/L](P<0.05).Serum level of 25(OH)D_3 was lower in children with thyroid absence than that in normal children [(59.62±26.55) nmol/L vs.(73.72±23.62) nmol/L](P<0.05).Serum level of hyroid peroxidase antibody was lower in children with thyroid absence [(59.62±26.55) nmol/L vs.(73.72±23.62) nmol/L],so did in children with children with congenital hypothyroidism than that in normal children [(0.74±0.57) IU/ml vs.(1.28±1.26) IU/ml](P<0.05).Serum level of TSH in children with vitamin D absence or insufficiency was higher than that in children with adequate level of vitamin D [(9.55±8.79) IU/ml or(5.55±4.45) μIU/ml vs.(4.23±3.06) μIU/ml](P<0.05).Serum 25(OH)D_3 level was negatively correlated to TSH and thyroid absence(r=-0.18 and-0.21,P<0.05).Conclusion In children with primary hypothyroidism,the vitamin D deficiency is closely related to the increased level of TSH and the hypothyroidism is correlated with vitamin D deficiency.
引文
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[6] DeMille DM,Piscitelli M,Ocker A,et al.Vitamin D deficiency in the oncology setting[J].J Community Support Oncol,2014,12(1):13-19.
[7] 中华医学会儿科学分会内分泌遗传代谢学组,中华预防医学会儿童保健分会新生儿疾病筛查学组.先天性甲状腺功能减低症诊疗共识[J]. 中华儿科杂志,2011,49(6):421-423.
[8] 阎雪, 韩笑, 张会丰. 2016版“营养性佝偻病防治全球共识”解读[J].中华儿科杂志, 2016, 54(12): 891-895.
[9] 蒋新液,赵军,裴晶晶. 无锡地区1 462例0-3岁儿童25羟维生素D3状况分析[J]. 中国妇幼保健,2013,28(30):4522-4523.
[10] Kivity S, Agmon-Levin N, Zisappl M, et al. Vitamin D and autoimmune thyroid diseases[J].Cell Mol Immunol,2011,8(3):243-247.
[11] Dohee Kim.Low vitamin D status is associated with hypothyroid Hashimoto’s thyroiditis[J].Hormones,2016,15(3):385-393.
[12] Mackawy AM,Al-Ayed BM,Al-Rashidi BM.Vitamin D deficiency and its association with thyroid disease[J].Int J Health Sci, 2013,7(7):267-275.
[13] Chailurkit LO, Aekplakorn W, Ongphiphadhanakul B. High vitamin D status in younger individuals is associated with low circulating thyrotropin[J].Thyroid,2013, 23(1):25-30.
[14] Zhang Q,Wang Z,Sun M,et,al.Association of high vitamin D status with low circulating thyroid-stimulating hormone independent of thyroid hormone levels in middle-aged and elderly males[J].Int J Endocrinol,2014, 2014:631819
[15] Berg JP,Liane KM,Bj?rhovde SB,et al.Vitamin D receptor binding and biological effects of cholecalciferol analogues in rat thyroid cells[J]. J Steroid Biochem Mol Biol,1994,50(3/4):145-150.
[2] Davies JH,Shaw NJ.Preventable but no strategy: vitamin D deficiency in the UK[J].Arch Dis Child, 2011, 96(7):614-615.
[3] 秦翠,张巧一,时立新,等.维生素D营养状况对自身免疫性甲状腺疾病的影响[J].贵州医科大学学报, 2016, 6(41):692-695.
[4] Agmon-Levin N,Theodor E,Segal RM,et al.Vitamin D in systemic and organ-specific autoimmune diseases[J].Clin Rev Allergy Immunol,2013, 45(2):256-266.
[5] 张文文,石永兵.连续性腹膜透析患者维生素D水平检测及临床相关因素分析[J]. 江苏医药,2014, 40(14):1662-1664.
[6] DeMille DM,Piscitelli M,Ocker A,et al.Vitamin D deficiency in the oncology setting[J].J Community Support Oncol,2014,12(1):13-19.
[7] 中华医学会儿科学分会内分泌遗传代谢学组,中华预防医学会儿童保健分会新生儿疾病筛查学组.先天性甲状腺功能减低症诊疗共识[J]. 中华儿科杂志,2011,49(6):421-423.
[8] 阎雪, 韩笑, 张会丰. 2016版“营养性佝偻病防治全球共识”解读[J].中华儿科杂志, 2016, 54(12): 891-895.
[9] 蒋新液,赵军,裴晶晶. 无锡地区1 462例0-3岁儿童25羟维生素D3状况分析[J]. 中国妇幼保健,2013,28(30):4522-4523.
[10] Kivity S, Agmon-Levin N, Zisappl M, et al. Vitamin D and autoimmune thyroid diseases[J].Cell Mol Immunol,2011,8(3):243-247.
[11] Dohee Kim.Low vitamin D status is associated with hypothyroid Hashimoto’s thyroiditis[J].Hormones,2016,15(3):385-393.
[12] Mackawy AM,Al-Ayed BM,Al-Rashidi BM.Vitamin D deficiency and its association with thyroid disease[J].Int J Health Sci, 2013,7(7):267-275.
[13] Chailurkit LO, Aekplakorn W, Ongphiphadhanakul B. High vitamin D status in younger individuals is associated with low circulating thyrotropin[J].Thyroid,2013, 23(1):25-30.
[14] Zhang Q,Wang Z,Sun M,et,al.Association of high vitamin D status with low circulating thyroid-stimulating hormone independent of thyroid hormone levels in middle-aged and elderly males[J].Int J Endocrinol,2014, 2014:631819
[15] Berg JP,Liane KM,Bj?rhovde SB,et al.Vitamin D receptor binding and biological effects of cholecalciferol analogues in rat thyroid cells[J]. J Steroid Biochem Mol Biol,1994,50(3/4):145-150.