Low Levels of Serum Vitamin D3 are Associated with Autoimmune Thyroid Disease in Pre-Menopausal Women.
Thyroid. 2013 Dec 10.
Choi YM, Kim WG, Kim TY, Bae SJ, Kim HK, Jang EK, Jeon M, Han JM, Lee SH, Baek JH, Shong Y, Kim WB.
Backgroud: Low serum vitamin D level has been associated with several autoimmune diseases, but its association with thyroid autoimmunity is unclear. We evaluated the association of serum vitamin D level with the prevalence of autoimmune thyroid disease (AITD).
Methods: Our cross-sectional study included subjects who underwent routine health check-ups, which included assays of serum 25-hydroxy vitamin D3 (25(OH)D3) and anti-thyroid peroxidase antibody (TPO-Ab), as well as thyroid ultrasonography (US) between 2008 and 2012 at Asan Medical Center. We defined AITD according to the level of TPO-Ab and US findings.
Results: Total 6,685 subjects (Male, 58%; Female, 42%) were enrolled for this study. Overall prevalence of TPO-Ab positivity and both TPO-Ab/US positivity were 10.1% (Male, 6.3%; Female, 15.3%) and 5.4% (Male, 2.3%; Female, 9.7%), respectively. In female subjects, mean serum 25(OH)D3 levels were significantly lower in TPO-Ab(+) (22.0 vs. 23.5 ng/mL, P=0.030), and TPO-Ab(+)/US(+) group (21.6 vs. 23.4 ng/mL, P=0.027) as compared with corresponding control group, respectively. According to the level of serum 25(OH)D3, the prevalence of TPO-Ab positivity (21.2%, 15.5% and 12.6% in deficient, insufficient, and sufficient group, respectively, P=0.001) and both TPO-Ab/US positivity (14.7%, 9.9% and 7.1% in deficient, insufficient, and sufficient group, respectively, P<0.001) was decreased in female subjects. Interestingly, this pattern was significant only in pre-menopausal women (P=0.003 and P<0.001, respectively), but not in post-menopausal women.
Multivariate analysis indicated that the adjusted odds ratios (OR) for AITD among those in the 25(OH)D3-deficient (TPO-Ab(+); OR=1.95, P=0.001 and TPO-Ab(+)/US(+); OR=2.36, P<0.001), and -insufficient group (TPO-Ab(+); OR=1.31, P=0.043 and TPO-Ab(+)/US(+); OR=1.50, P=0.017) were significantly increased when compared with -sufficient group.
Conclusions: The level of serum vitamin D was significantly lower in pre-menopausal women with AITD.
Vitamin D deficiency and insufficiency were significantly associated with AITD in pre-menopausal women.
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