Investigation of Vitamin D Levels and Metabolic Parameters in Patients With Subclinical Hyperthyroidism

Abstract

Objectives: Subclinical hyperthyroidism is a major health problem that is common in the population and requires long-term follow-up due to various complications including atrial fibrillation and osteoporosis. In recent years, vitamin D has been investigated in the pathogenesis of autoimmune diseases including endocrine system beside well known skeletal effects. The aim of this study is to investigate vitamin D levels, metabolic parameters and the relationship between these parameters and vitamin D and TSH levels in patients with subclinical hyperthyroidism.
Materials and Methods:  A total of 128 subjects were included in the study between April 2017 and April 2018 which are 39 patients with subclinical hyperthyroidism diagnosed with toxic adenoma, toxic multinodular goiter (TMNG), toxic diffuse goiter (TDG) and 35 subject 1≤TSH<4 (control 1), 54 subject 0,5≤TSH<1 (control 2) which is healthy controls. Glucose, creatinine, AST, ALT, GFR, vitamin D, thyroid autoantibody levels were retrospectively analyzed.
Results: There was no statistically significant difference between the groups in terms of median vitamin D levels (p = 0.928). Between groups; there was no statistically significant difference in median glucose, creatinine, ALT, GFR levels (p = 0.857, p = 0.124, p = 0.355, p = 0.553). In group 2 (control 2), we found a significant increase in GFR as fT3 levels increased. In the subclinical hyperthyroidism group (Group 3) there was a positive correlation between fT3 and creatine (r=0.502 and p<0.001, r=0.362 and p=0.024).
Conclusion: Vitamin D levels and metabolic parameters in subclinical hyperthyroid patients were similar to healthy controls. No significant change was found the control group, according to different TSH levels in metabolic parameters.

Keywords

• Subclinical hyperthyroidism,vitamin D,metabolic parameters

Subklinik Hipertiroidili Hastalarda Vitamin D Düzeyinin ve Metabolik Parametrelerin İncelenmesi

Abstract

Amaç: Subklinik hipertiroidi toplumda oldukca sık görülen, atriyal fibrilasyon ve osteoporoz gibi çeşitli komplikasyonlar nedeni ile uzun süreli takip gereken önemli bir sağlık problemidir. Vitamin D ise endokrin sistemi de kapsayan otoimmün hastalıkların patogenezindeki yeri, son yıllarda daha çok araştırılmaktadır. Çalışmamızda, subklinik hipertiroidili hastalarda vitamin D düzeylerini ve çeşitli biyokimyasal parametreleri incelemeyi amaçladık. Ayrıca vitamin D ile biyokimyasal parametreler ve tiroid fonksiyon testleri arasındaki ilişkiyi inceledik.
Materyal ve Metot: Nisan 2017-Nisan 2018 tarihleri arasında endokrinoloji polikliniğine başvuran ve subklinik hipertiroidi tanısı almış; toksik adenom, toksik multinodüler guatr (TMNG), toksik diffuz guatr (TDG) tanılı 39 hasta ile 89 sağlıklı kontrol grubu dahil edildi. Kontrol grubu ayrıca TSH düzeyleri 1≤TSH<4 (Grup 1) ve 0,5≤TSH<1 (Grup 2) olacak şekilde 2 gruba ayrıldı. Tüm hastalarda ve kontrol grubunda serum glukoz, kreatinin, AST, ALT, GFR, vitamin D, tiroid otoantikor düzeyleri hastanemiz kayıtlarından not edildi.
Bulgular: Subklinik hipertiroidi ve sağlıklı kontrol grubu arasında vitamin D düzeyleri açısından istatistiksel olarak anlamlı farklılık yoktu (p=0,928). Sırasıyla; açlık kan şekeri (AKŞ), kreatinin, glomerüler filtrasyon hızı (GFR) ve ALT düzeyleri her iki grupta benzerdi (p=0,857, p=0,124, p=0,355, p=0,553). Grup 2- kontrol grubu içerisinde AST düzeyleri grup-1 kontrol grubu ve subklinik hipertiroidi grubuna göre daha düşüktü (p=0,024). Grup 2- kontrol grubu içerisinde kreatinin düzeyi ile vitamin D arasında (r=0,366 ve p=0,007), GFR ile TSH (r=0,345, p=0,011) ve sT3 ( r= 0,300, p= 0,028) arasında pozitif bir korelasyon vardı. Subklinik hipertiroidi grubunda (Grup 3) sT3 ile kreatin ve ALT arasında pozitif bir korelasyon mevcuttu (r=0,502 ve p<0,001, r=0,362 ve p=0,024).
Sonuç: Çalışmamızda subklinik hipertiroidili hastalarda vitamin D düzeyleri ve metabolik parametreler sağlıklı kontrollerle benzer düzeydeydi. Sağlıklı kontrol grubunda ise farklı TSH düzeylerinde metabolik parametrelerde önemli bir değişiklik saptanmadı.

Keywords

• Subklinik hipertiroidi,vitamin D,metabolik parametreler

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