Evaluation of Vitamin D Status and Its Impact on Thyroid Related Parameters in New Onset Graves' Disease- A Cross-sectional Observational Study

Overview

Journal Indian J Endocrinol Metab

Specialty Endocrinology

Date 2019 Apr 25

PMID 31016150

Citations 8

Authors

Swayamsidha Mangaraj

Arun K Choudhury

Basanta M Swain

Pradosh K Sarangi

Binoy K Mohanty

Anoj K Baliarsinha

Affiliations

Soon will be listed here.

Abstract

Aims And Objective: We aimed to compare serum vitamin D level in new onset Graves' disease versus age and sex matched controls. Furthermore, we assessed the correlation of vitamin D with hormonal parameters and antibody titers in Graves' disease.

Materials And Methods: In total, 84 patients of new onset Graves' disease and 42 age and sex matched healthy individuals were recruited. Biochemical and hormonal investigations that included serum calcium, phosphorous, free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), 25 hydroxy vitamin D (25(OH) D), and parathyroid hormone (PTH) were done for all subjects. Thyrotropin receptor antibody (TRAb) was measured only for Graves' disease patients.

Results: The patients with Graves' disease had significantly lower 25(OH) D levels (19.2 ± 8.9 ng/ml) as compared to control subjects (23.8 ± 12.5 ng/ml) ( = 0.019). Thyroid hormone levels, thyroid volume, and TRAb titers did not differ significantly between vitamin D deficient Graves' disease group (25(OH)D <20 ng/ml) and vitamin D non deficient Graves' disease group (25(OH)D ≥20 ng/ml). Furthermore, serum vitamin D level did not correlate significantly with thyroid hormones, thyroid volume, or TRAb titers among Graves' disease. The odds ratio (OR) for association of vitamin D deficiency (VDD) state and Graves' disease was 1.62 (95% CI 0.77-3.41). Vitamin D sufficiency state was associated significantly with lower risk of Graves' disease (OR = 0.38, 95% CI 0.15-0.95).

Conclusion: Serum vitamin D levels are significantly lower in new onset Graves' disease. No significant correlation between vitamin D and thyroid hormones, thyroid volume, or TRAb titers was found in these patients. VDD state is not associated with Graves' disease.

Citing Articles

Association between serum vitamin D level and Graves' disease: a systematic review and meta-analysis.

Pang B, Li L, Liu X, Cao Z, Pang T, Wang Q Nutr J. 2024; 23(1):60.

PMID: 38849834 PMC: 11157715. DOI: 10.1186/s12937-024-00960-2.

A Mendelian randomization study of the effect of serum 25-hydroxyvitamin D levels on autoimmune thyroid disease.

Yu Y, Yang X, Wu J, Shangguan X, Bai S, Yu R Front Immunol. 2024; 14:1298708.

PMID: 38259461 PMC: 10800945. DOI: 10.3389/fimmu.2023.1298708.

The Role of Vitamin D in Autoimmune Thyroid Diseases: A Narrative Review.

Czarnywojtek A, Florek E, Pietronczyk K, Sawicka-Gutaj N, Ruchala M, Ronen O J Clin Med. 2023; 12(4).

PMID: 36835987 PMC: 9966459. DOI: 10.3390/jcm12041452.

Lower levels of vitamin D are associated with SARS-CoV-2 infection and mortality in the Indian population: An observational study.

Padhi S, Suvankar S, Panda V, Pati A, Panda A Int Immunopharmacol. 2020; 88:107001.

PMID: 33182040 PMC: 7489890. DOI: 10.1016/j.intimp.2020.107001.

Vitamin D and Autoimmune Thyroid Disease-Cause, Consequence, or a Vicious Cycle?.

Vieira I, Rodrigues D, Paiva I Nutrients. 2020; 12(9).

PMID: 32933065 PMC: 7551884. DOI: 10.3390/nu12092791.

References

Noguchi S, Takatsu K, Koike E, Murakami T, Watanabe S, Uchino S . High prevalence of vitamin D deficiency in Japanese female patients with Graves' disease. Endocr J. 2001; 48(1):63-9. DOI: 10.1507/endocrj.48.63. View

Mathieu C, Adorini L . The coming of age of 1,25-dihydroxyvitamin D(3) analogs as immunomodulatory agents. Trends Mol Med. 2002; 8(4):174-9. DOI: 10.1016/s1471-4914(02)02294-3. View

Klecha A, Arcos M, Frick L, Genaro A, Cremaschi G . Immune-endocrine interactions in autoimmune thyroid diseases. Neuroimmunomodulation. 2008; 15(1):68-75. DOI: 10.1159/000135626. View

Misharin A, Hewison M, Chen C, Lagishetty V, Aliesky H, Mizutori Y . Vitamin D deficiency modulates Graves' hyperthyroidism induced in BALB/c mice by thyrotropin receptor immunization. Endocrinology. 2008; 150(2):1051-60. PMC: 2646531. DOI: 10.1210/en.2008-1191. View

Goswami R, Marwaha R, Gupta N, Tandon N, Sreenivas V, Tomar N . Prevalence of vitamin D deficiency and its relationship with thyroid autoimmunity in Asian Indians: a community-based survey. Br J Nutr. 2009; 102(3):382-6. DOI: 10.1017/S0007114509220824. View

Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C . Vitamin D: modulator of the immune system. Curr Opin Pharmacol. 2010; 10(4):482-96. DOI: 10.1016/j.coph.2010.04.001. View

Kivity S, Agmon-Levin N, Zisappl M, Shapira Y, Nagy E, Danko K . Vitamin D and autoimmune thyroid diseases. Cell Mol Immunol. 2011; 8(3):243-7. PMC: 4012880. DOI: 10.1038/cmi.2010.73. View

Jyotsna V, Sahoo A, Ksh S, Sreenivas V, Gupta N . Bone mineral density in patients of Graves disease pre- & post-treatment in a predominantly vitamin D deficient population. Indian J Med Res. 2012; 135:36-41. PMC: 3307182. DOI: 10.4103/0971-5916.93422. View

Effraimidis G, Badenhoop K, Tijssen J, Wiersinga W . Vitamin D deficiency is not associated with early stages of thyroid autoimmunity. Eur J Endocrinol. 2012; 167(1):43-8. DOI: 10.1530/EJE-12-0048. View

10.

Yasuda T, Okamoto Y, Hamada N, Miyashita K, Takahara M, Sakamoto F . Serum vitamin D levels are decreased and associated with thyroid volume in female patients with newly onset Graves' disease. Endocrine. 2012; 42(3):739-41. PMC: 3509322. DOI: 10.1007/s12020-012-9679-y. View

11.

Yasuda T, Okamoto Y, Hamada N, Miyashita K, Takahara M, Sakamoto F . Serum vitamin D levels are decreased in patients without remission of Graves' disease. Endocrine. 2012; 43(1):230-2. PMC: 3536951. DOI: 10.1007/s12020-012-9789-6. View

12.

Prietl B, Treiber G, Pieber T, Amrein K . Vitamin D and immune function. Nutrients. 2013; 5(7):2502-21. PMC: 3738984. DOI: 10.3390/nu5072502. View

13.

Zhang H, Liang L, Xie Z . Low Vitamin D Status is Associated with Increased Thyrotropin-Receptor Antibody Titer in Graves Disease. Endocr Pract. 2014; 21(3):258-63. DOI: 10.4158/EP14191.OR. View

14.

Li X, Wang G, Lu Z, Chen M, Tan J, Fang X . Serum 25-hydroxyvitamin D predict prognosis in radioiodine therapy of Graves' disease. J Endocrinol Invest. 2015; 38(7):753-9. DOI: 10.1007/s40618-015-0252-4. View

15.

Xu M, Cao B, Yin J, Wang D, Chen K, Lu Q . Vitamin D and Graves' disease: a meta-analysis update. Nutrients. 2015; 7(5):3813-27. PMC: 4446781. DOI: 10.3390/nu7053813. View

16.

Ma J, Wu D, Li C, Fan C, Chao N, Liu J . Lower Serum 25-Hydroxyvitamin D Level is Associated With 3 Types of Autoimmune Thyroid Diseases. Medicine (Baltimore). 2015; 94(39):e1639. PMC: 4616844. DOI: 10.1097/MD.0000000000001639. View

17.

Ke W, Sun T, Zhang Y, He L, Wu Q, Liu J . 25-Hydroxyvitamin D serum level in Hashimoto's thyroiditis, but not Graves' disease is relatively deficient. Endocr J. 2017; 64(6):581-587. DOI: 10.1507/endocrj.EJ16-0547. View

18.

Ahn H, Chung Y, Cho B . Serum 25-hydroxyvitamin D might be an independent prognostic factor for Graves disease recurrence. Medicine (Baltimore). 2017; 96(31):e7700. PMC: 5626158. DOI: 10.1097/MD.0000000000007700. View

19.

Planck T, Shahida B, Malm J, Manjer J . Vitamin D in Graves Disease: Levels, Correlation with Laboratory and Clinical Parameters, and Genetics. Eur Thyroid J. 2018; 7(1):27-33. PMC: 5836255. DOI: 10.1159/000484521. View

20.

Knaysi G, CRIKELAIR G, Cosman B . The role of nines: its history and accuracy. Plast Reconstr Surg. 1968; 41(6):560-3. View