Nutrients 2015, 7(5), 3813-3827; doi:10.3390/nu7053813 (registering DOI)
Mei-Yan Xu 1,* Bing Cao 2, Jian Yin 1, Dong-Fang Wang 2 Kai-Li Chen 3 and Qing-Bin Lu 2, qingbinlu at bjmu.edu.cn
1 Department of Nutrition, Aerospace Center Hospital, Beijing 100049, China
2 School of Public Health, Peking University, Beijing 100191, China
3 Department of Respiratory, Aerospace Center Hospital, Beijing 100049, China
The association between vitamin D levels and Graves’ disease is not well studied. This update review aims to further analyze the relationship in order to provide an actual view of estimating the risk. We searched for the publications on vitamin D and Graves’ disease in English or Chinese on PubMed, EMBASE, Chinese National Knowledge Infrastructure, China Biology Medical and Wanfang databases. The standardized mean difference (SMD) and 95% confidence interval (CI) were calculated for the vitamin D levels. Pooled odds ratio (OR) and 95% CI were calculated for vitamin D deficiency. We also performed sensitivity analysis and meta-regression. Combining effect sizes from 26 studies for Graves’ disease as an outcome found a pooled effect of SMD = −0.77 (95% CI: −1.12, −0.42; p < 0.001) favoring the low vitamin D level by the random effect analysis. The meta-regression found assay method had the definite influence on heterogeneity (p = 0.048).
The patients with Graves’ disease were more likely to be deficient in vitamin D compared to the controls (OR = 2.24, 95% CI: 1.31, 3.81) with a high heterogeneity (I2 = 84.1%, p < 0.001). We further confirmed that low vitamin D status may increase the risk of Graves’ disease.
Serum 25-hydroxyvitamin D might be an independent prognostic factor for Graves disease recurrence.
Medicine (Baltimore). 2017 Aug;96(31):e7700. doi: 10.1097/MD.0000000000007700.
Ahn HY1, Chung YJ, Cho BY. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Graves disease is the most common cause of thyrotoxicosis. Although medical intervention with antithyroid drugs (ATDs) is commonly the first choice of treatment in Korea, the remission rate associated with this approach is not satisfactory. During ATD therapy, low or undetectable serum levels of thyroid-stimulating hormone (TSH) receptor antibodies (TRAbs) have been reported to affect the incidence of Graves disease remission. This study evaluated the correlation between serum 25-hydroxyvitamin D levels and TRAb levels, as well as the effect of 25-hydroxyvitamin D on the recurrence of Graves disease.A total of 143 patients, who were diagnosed with Graves disease and treated with ATDs, were retrospectively included in our observational study.
These patients were followed for more than 1 year after ATD discontinuation. The levels of serum 25-hydroxyvitamin D and TRAb (ie, thyroid-stimulating antibody [TSAb], as detected by bioassay, and TSH-binding inhibitory immunoglobulins [TBIIs]) were measured, and a thyroid function test was performed upon ATD discontinuation.
Recurrence was evaluated every 3 months, and was defined as an occurrence of overt thyrotoxicosis during the follow-up period.
A total of 95 patients (66.4%) experienced recurrence with a median latency period of 182 days (ranging 28-1219 days). The serum 25-hydroxyvitamin D levels at the time of ATD discontinuation were not correlated with either TBII or TSAb.
In the Cox proportional hazard regression analysis, higher free T4 levels (>1.4 ng/dL; hazard ratio [HR], 3.252; 95% confidence interval [CI], 1.022-10.347) and low levels of 25-hydroxyvitamin D (≤14.23 ng/mL) were associated with a higher probability of Graves disease recurrence (HR, 3.016; 95% CI, 1.163-7.819).Lower serum 25-hydroxyvitamin D levels were associated with a higher incidence of Graves disease recurrence. Therefore, serum 25-hydroxyvitamin D might be an independent risk factor for predicting Graves disease recurrence after ATD discontinuation.
It frequently results in hyperthyroidism and an enlarged thyroid. Signs and symptoms of hyperthyroidism may include irritability, muscle weakness, sleeping problems, a fast heartbeat, poor tolerance of heat, diarrhea, and weight loss. Other symptoms may include thickening of the skin on the shins, known as pretibial myxedema, and eye problems such as bulging, a condition known as Graves' ophthalmopathy. About 25% to 80% of people develop eye problems
Graves' disease occurs in about 0.5% of people.
It occurs about 7.5 times more often in women than men.
Often it starts between the ages of forty and sixty.
It is the most common cause of hyperthyroidism in the United States (about 50% to 80% of cases)
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Note: More than half of the above risk factors are associated with low vitamin DGraves Disease is 2.2X more likely with low vitamin D – meta-analysis May 2015
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