Evaluation of 25-Hydroxy-Vitamin D Levels in Hypothyroid Patients Receiving Levothyroxine Sodium Therapy
Öz
Aim: It was aimed to evaluate 25-hydroxy-vitamin D (25 (OH) D)
levels in hypothyroid patients with levothyroxine sodium (LT4)
therapy and euthyroidism.
Material and Method: 116 patients with hypothyroidism with LT4
treatment and euthyroidism in the Internal Medicine Policlinic, as
control group, 110 patients with similar age and sex without hypothyroidism were enrolled to study. Patients were recorded in terms
of age, sex, LT4 drug doses and free T4, TSH, 25 (OH) D, BUN,
Creatinine, Calcium (Ca), Phosphorus (P), Albumin values. There
was a significant difference between the groups.
Results: In study, 25 (OH) D level was significantly lower in patients
with hypothyroid patients receiving LT4 therapy and euthyroidism
than in control group (p<0.001). In the patient group there was no
significant relationship between the 25 (OH) D levels and the LT4
drug doses received by the patients (r=0.060 p=0.52). There was
no relationship in the 25 (OH) D levels between the women and the
men (p=0.75).
Conclusion: It was concluded that 25 (OH) D levels may be lower
in hypothyroid patients treated with LT4 and that low vitamin D
levels may be involved in the etiology of hypothyroidism and that
active vitamin D supplementation in addition to LT4 therapy with
hypothyroidism may be beneficial.
Kaynakça
- 1. Chistiakov DA. Immunogenetics of Hashimoto thyroiditis. J Autoimmune Dis 2005;2:1. 2. Wiersinga WM. Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease. Endocrinol Metab 2016;31(2):213–22 3. Bindra A, Braunstein GD. Thyroiditis. Am. Fam. Physician 2006;73:1769–76. 4. Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New Engl J Med 2003;348:2646–55. 5. Hollick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancer and cardiovascular disease. Am J Clin Nutr 2004;80:1678–88. 6. Ward LM. Vitamin D deficiency in the 21st century: a persistent problem among Canadian infants and mothers. CMAJ 2005;172:769–70. 7. Holick MF. The Vitamin D epidemic and its health consequences. J Nutr 2005;135:2739–48. 8. Heaney RP. Long-latency deficiency disease: insights from calcium and vitamin D. Am J Clin Nutr 2003;78:912–9. 9. Holick MF. Vitamin D. important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. South Med J 2005;98:1024–7. 10. Mathieu C, Van Etten E, Decallonne B et al. Vitamin D and 1, 25 dihydroxyvitamin D3 as modulators in immun system. J Steroid Biochem Mol Biol 2004;90:449–52. 11. Mathieu C, Adorini L, The coming age of 1, 25 dihydroxyvitamin D3 analogs as immunomodulatory agents. Trends Mol Med 2002;8:174–9. 12. Lin WY, Wan L, Tsai CH, Chen RH, Lee CC, Tsai FC. Vitamin D receptor gene polymorphisms are associated with risk of Hashimoto’s thyroiditis in Chinese patients in Taiwan. J Clin Lab Anal 2006;20:109–12. 13. Safit HF. Thyroid disorders. İn Fitzgerald PAed. Handbook of Clinical Endocrinology, 2nd ed. Appletonand Lange Publ 1992:2256–64. 14. Greenspan FS. The thyroidgoland. İn Greenspan and Baxter ed. Basic and Clinical Endocrinology, Fourth Ed, Appletonand Lange Publ 1994:160–226. 15. Amino N, Tada H. Autoimmune Thyroid Disease Thyroiditis in Leslie J, De Groot ed. Endocrinology, Third Ed 1995:726–40. 16. Larsen PR, Ingbar SH. The Thyroid Gland in Wilson JD, Foster DW ed. Villiams Textbook of Endocrinology. WB Saunders Company 8th ed 1992:357–87. 17. Slatosky J, Shipton B, Wahba H. Thyroiditis: differential diagnosis and management. Am. Fam. Physician 2000;61:1047–52. 18. Çorapoğlu D, Uysal AR, Çetinarslan B. Haşhimoto tiroiditli olgularımızın klinik ve laboratuvar değerlendirilmesi. Ankara Üniv Tıp Fak Derg 1996;49:33–7. 19. Varenna M, Manara M, Cantatore FP, Del Puente A, Di Munno O. Determinants and effects of vitamin D supplementation on serum 25-Hydroxy-vitaminD levels in patients with rheumatoid arthritis. Clin Exp Rheumatol 2012;30:714–9. 20. Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid 2011;21:891–96. 21. Arslan MS, Topaloglu O, Ucan B ve ark. Isolated vitamin D deficiency is not associated with nonthyroidal illnesss yndrome, but with thyroid autoimmunity. Sci World J 2015;2:239. 22. Kivity S, Agmon-Levin N, Zisappl M. Vitamin D and autoimmune thyroid diseases. Cell Mol Immunol 2011;8:243– 7. 23. Bozkurt NC, Karbek B, Ucan B. The association between severity of vitamin D deficiency and Hashimoto’s thyroiditis. Endocr Pract 2013;19:479–84. 24. Erkal MZ, Wilde J, Bilgin Y. High prevalence of vitamin D deficiency, secondary hyperparathyroidism and generalized bone pain in Turkish immigrants in Germany: identification of risk factors. Osteoporos Int 2006;17:1133–40. 25. Engelsen O, Brustad M, Aksnes L. Daily duration of vitamin D synthesis in human skin with relation to latitude, total ozone, altitude, ground cover, aerosols and cloud thickness. Photochem Photobiol 2005;81:1287–9. 26. Youshiyuki B, Matsuo T, Yoshio B. Vitamin D receptor gene polymorphism in Hashimoto’s thyroiditis. Thyroid 2002;11:607–8. 27. Mansournia N, Mansournia MA, Saeedi S, Dehghan J. The association between serum 25OHD3 levels and hypothyroid Hashimoto’s thyroiditis. J Endocrinol Invest 2014;37:473–6. 28. Cappa M, Bizzarri C, Crea F. Autoimmune thyroid diseases. J Thyroid Res 2011;12:675–83. 29. Salive ME. Multimorbidity in older adults. Epidemiol Rev 2013;35:75–83 30. Sözen T. D hormonu: Güncel gelişmeler. Hacettepe Tıp Derg 2011;42:14–7.
Levotiroksin Sodyum Tedavisi Alan Hipotiroid Hastalarda 25-Hidroksi-Vitamin D Düzeylerinin Değerlendirilmesi
Öz
Amaç: Bu çalışma ile levotiroksin sodyum (LT4) tedavisi alan ve
ötiroid seyreden hipotiroid hastalarda 25-Hidroksi-Vitamin D (25
(OH) D) düzeyinin değerlendirilmesi amaçlandı.
Materyal ve Metot: Çalışmaya İç Hastalıkları polikliniğinde LT4 tedavisi alan ve ötiroid seyreden hipotiroidili 116 hasta ile, kontrol grubu olarak benzer yaş ortalamasında ve cinsiyette hipotiroid olmayan
110 hasta alınmıştır. Hastalar yaş, cinsiyet, aldıkları LT4 ilaç dozları ilserbest T4, TSH, 25 (OH) D, BUN, Kreatinin, Kalsiyum (Ca), Fosfor
(P), Albümin değerleri açısından kaydedildi. Gruplar arasında anlamlı
fark olup olmadığı araştırıldı.
Bulgular: Çalışmada LT4 tedavisi alan ve ötiroid seyreden hipotiroid tanılı hastalarda, kontrol grubu hastalarına göre 25 (OH) D
düzeyi, anlamlı olarak düşük bulundu (p<0,001). Hasta grubunda
25 (OH) D düzeyleri ile hastaların aldıkları LT4 ilaç dozları arasında
anlamlı bir ilişki yoktu (r=0,060 p=0,52). Kadınlar ve erkekler arasında 25 (OH) D düzeyleri açısından anlamlı bir ilişki yoktu (p=0,75).
Sonuç: LT4 tedavisi alan ve ötiroid seyreden hipotiroid hastalarda,
25 (OH) D düzeyinin düşük bulunması, hipotiroidinin etiyolojisinde
düşük vitamin D düzeyinin rolünün olabileceği, ayrıca düşük vitamin D düzeyi olan hipotiroidili hastalara LT4 tedavisine ilave olarak
aktif vitamin D verilmesinin faydalı olabileceği sonucuna varıldı.
Kaynakça
- 1. Chistiakov DA. Immunogenetics of Hashimoto thyroiditis. J Autoimmune Dis 2005;2:1. 2. Wiersinga WM. Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease. Endocrinol Metab 2016;31(2):213–22 3. Bindra A, Braunstein GD. Thyroiditis. Am. Fam. Physician 2006;73:1769–76. 4. Pearce EN, Farwell AP, Braverman LE. Thyroiditis. New Engl J Med 2003;348:2646–55. 5. Hollick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancer and cardiovascular disease. Am J Clin Nutr 2004;80:1678–88. 6. Ward LM. Vitamin D deficiency in the 21st century: a persistent problem among Canadian infants and mothers. CMAJ 2005;172:769–70. 7. Holick MF. The Vitamin D epidemic and its health consequences. J Nutr 2005;135:2739–48. 8. Heaney RP. Long-latency deficiency disease: insights from calcium and vitamin D. Am J Clin Nutr 2003;78:912–9. 9. Holick MF. Vitamin D. important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. South Med J 2005;98:1024–7. 10. Mathieu C, Van Etten E, Decallonne B et al. Vitamin D and 1, 25 dihydroxyvitamin D3 as modulators in immun system. J Steroid Biochem Mol Biol 2004;90:449–52. 11. Mathieu C, Adorini L, The coming age of 1, 25 dihydroxyvitamin D3 analogs as immunomodulatory agents. Trends Mol Med 2002;8:174–9. 12. Lin WY, Wan L, Tsai CH, Chen RH, Lee CC, Tsai FC. Vitamin D receptor gene polymorphisms are associated with risk of Hashimoto’s thyroiditis in Chinese patients in Taiwan. J Clin Lab Anal 2006;20:109–12. 13. Safit HF. Thyroid disorders. İn Fitzgerald PAed. Handbook of Clinical Endocrinology, 2nd ed. Appletonand Lange Publ 1992:2256–64. 14. Greenspan FS. The thyroidgoland. İn Greenspan and Baxter ed. Basic and Clinical Endocrinology, Fourth Ed, Appletonand Lange Publ 1994:160–226. 15. Amino N, Tada H. Autoimmune Thyroid Disease Thyroiditis in Leslie J, De Groot ed. Endocrinology, Third Ed 1995:726–40. 16. Larsen PR, Ingbar SH. The Thyroid Gland in Wilson JD, Foster DW ed. Villiams Textbook of Endocrinology. WB Saunders Company 8th ed 1992:357–87. 17. Slatosky J, Shipton B, Wahba H. Thyroiditis: differential diagnosis and management. Am. Fam. Physician 2000;61:1047–52. 18. Çorapoğlu D, Uysal AR, Çetinarslan B. Haşhimoto tiroiditli olgularımızın klinik ve laboratuvar değerlendirilmesi. Ankara Üniv Tıp Fak Derg 1996;49:33–7. 19. Varenna M, Manara M, Cantatore FP, Del Puente A, Di Munno O. Determinants and effects of vitamin D supplementation on serum 25-Hydroxy-vitaminD levels in patients with rheumatoid arthritis. Clin Exp Rheumatol 2012;30:714–9. 20. Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto’s thyroiditis. Thyroid 2011;21:891–96. 21. Arslan MS, Topaloglu O, Ucan B ve ark. Isolated vitamin D deficiency is not associated with nonthyroidal illnesss yndrome, but with thyroid autoimmunity. Sci World J 2015;2:239. 22. Kivity S, Agmon-Levin N, Zisappl M. Vitamin D and autoimmune thyroid diseases. Cell Mol Immunol 2011;8:243– 7. 23. Bozkurt NC, Karbek B, Ucan B. The association between severity of vitamin D deficiency and Hashimoto’s thyroiditis. Endocr Pract 2013;19:479–84. 24. Erkal MZ, Wilde J, Bilgin Y. High prevalence of vitamin D deficiency, secondary hyperparathyroidism and generalized bone pain in Turkish immigrants in Germany: identification of risk factors. Osteoporos Int 2006;17:1133–40. 25. Engelsen O, Brustad M, Aksnes L. Daily duration of vitamin D synthesis in human skin with relation to latitude, total ozone, altitude, ground cover, aerosols and cloud thickness. Photochem Photobiol 2005;81:1287–9. 26. Youshiyuki B, Matsuo T, Yoshio B. Vitamin D receptor gene polymorphism in Hashimoto’s thyroiditis. Thyroid 2002;11:607–8. 27. Mansournia N, Mansournia MA, Saeedi S, Dehghan J. The association between serum 25OHD3 levels and hypothyroid Hashimoto’s thyroiditis. J Endocrinol Invest 2014;37:473–6. 28. Cappa M, Bizzarri C, Crea F. Autoimmune thyroid diseases. J Thyroid Res 2011;12:675–83. 29. Salive ME. Multimorbidity in older adults. Epidemiol Rev 2013;35:75–83 30. Sözen T. D hormonu: Güncel gelişmeler. Hacettepe Tıp Derg 2011;42:14–7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ağustos 2018 |
| Yayımlandığı Sayı | Yıl 2018 |