Asssociation of vitamin D with autoimmune ophthalmopathy in Graves’ disease
Background: The role of vitamin D in the development of autoimmune thyroid diseases has been actively discussed in the recent literature. Numerous studies have demonstrated an association of low vitamin D levels with autoimmune thyroiditis, with correlations with antithyroid antibody levels, thyroid...
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| Format: | Article |
| Language: | English |
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Ukrainian Society of Ophthalmologists
2020-01-01
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| Series: | Journal of Ophthalmology |
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| Online Access: | https://www.ozhurnal.com/en/archive/2019/6/9-fulltext |
| _version_ | 1797378969129975808 |
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| author | Yu.V. Buldygina G.M. Terekhova L.S. Strafun T.V. Fed’ko V.M. Klochkova I.I. Savosko Z.G. Lysova |
| author_facet | Yu.V. Buldygina G.M. Terekhova L.S. Strafun T.V. Fed’ko V.M. Klochkova I.I. Savosko Z.G. Lysova |
| author_sort | Yu.V. Buldygina |
| collection | DOAJ |
| description | Background: The role of vitamin D in the development of autoimmune thyroid diseases has been actively discussed in the recent literature. Numerous studies have demonstrated an association of low vitamin D levels with autoimmune thyroiditis, with correlations with antithyroid antibody levels, thyroid hormone levels, disease severity and thyroid gland volume, both in adults and in children. However, there are a few relevant reports on Graves’ disease (GD), and only one relevant report is available on GD associated with autoimmune ophthalmopathy (AO). Given that GD complicated by AO is a classic autoimmune disease, it will be interesting to investigate the role of vitamin D in its pathogenesis.
Purpose: To examine vitamin D levels and to determine correlations between this characteristic and thyroid-stimulating hormone receptor antibodies (TSH-R-Ab) in patients with Graves’ disease complicated by immune ophthalmopathy.
Material and Methods: Serum levels of 25(OH)D, TSH, TSH-R-Ab and parathyroidal hormone (PTH) were measured in 131 patients with GD. Study patients were divided into two groups based on the presence or absence of ophthalmopathy. Group 1 comprised 81 GD patients with AO, and group 2 comprised 50 GD patients without AO. Clinical severity of AO was classified using the NOSPECS. Thirty-two, 30 and 19 patients had class 2b, class 3a or 3b, and class 4a, respectively. Variation statistics with Student t test was used for statistical analyses. The level of significance p ? 0.05 was assumed. Data are presented as mean ± standard error of mean. Pearson correlation analysis was used to identify possible correlations between variables.
Results: All patients were euthyroid, and the mean TSH level in group 1 was 1.33±0.35 mU/L, and in group 2, 0.5 ± 0.2 mU/L (Р > 0.05). TSH-R-Ab levels were higher than normal in both groups of patients (group 1: range, 0.8 U/L to 21 U/L , mean value, 14.05± 2.7 U/L ; group 2: range, 1.8 U/L to 14.3 U/L , mean value, 31.0 ± 2.22 U/L; the difference between groups was not significant, р > 0.05). This was anticipated since these abnormalities are pathogenetic in GD. Serum levels of 25(OH)D in both groups were lower than normal (42.98 ± 2.82 nmol/L in group 1 vs 58.12 ± 4.2 nmol/L in group 2; р<0.02). Serum 25(OH)D concentrations were statistically significantly lower in Graves’ disease patients with AO, than in those without ophthalmopathy, and corresponded to vitamin D deficiency and suboptimal status, respectively. There was a significant difference in serum 25(OH)D level, but not in PTH level between the groups. Thus, mean serum PTH level in group 1 was 65.85±4.79 pg/mL, vs 49.73±11.4 pg/mL in group 2 (р > 0.05). TSH-R-Ab levels were negatively linearly correlated with the serum 25(OH)D level in the study cohort (elevated TSH-R-Ab levels correlated with low 25(OH)D levels).
Conclusion: First, there was no statistically significant difference in TSH-R-Ab levels between Graves’ disease patients with AO and those without AO (14.05±2.7 U/L and 31±2.22 U/L, respectively; р > 0.05). Second, the mean serum 25(OH)D level for the study cohort of Graves’ disease patients (47.63 ± 2.48 nmol/L) was insufficient, and the mean level for patients with AO was significantly lower than the mean level for patients without AO (42.98 ± 2.82 nmol/L vs 58.12 ± 4.2 nmol/L; р<0.02). Finally, there was a negative correlation of TSH-R-Ab levels with 25(OH)D levels in Graves disease patients with AO (r= - 0.53; р<0.05).
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| first_indexed | 2024-03-08T20:15:19Z |
| format | Article |
| id | doaj.art-b58ea788144b4e8eb2aa70ed2c84a7c0 |
| institution | Directory Open Access Journal |
| issn | 2412-8740 |
| language | English |
| last_indexed | 2024-03-08T20:15:19Z |
| publishDate | 2020-01-01 |
| publisher | Ukrainian Society of Ophthalmologists |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj.art-b58ea788144b4e8eb2aa70ed2c84a7c02023-12-22T19:02:40ZengUkrainian Society of OphthalmologistsJournal of Ophthalmology2412-87402020-01-016495510.31288/oftalmolzh201964955Asssociation of vitamin D with autoimmune ophthalmopathy in Graves’ diseaseYu.V. Buldygina0G.M. Terekhova1L.S. Strafun2T.V. Fed’ko3V.M. Klochkova4I.I. Savosko5Z.G. Lysova6Komisarenko Institute for Endocrinology and Metabolism of the NAMS of UkraineKomisarenko Institute for Endocrinology and Metabolism of the NAMS of UkraineKomisarenko Institute for Endocrinology and Metabolism of the NAMS of UkraineKomisarenko Institute for Endocrinology and Metabolism of the NAMS of UkraineKomisarenko Institute for Endocrinology and Metabolism of the NAMS of UkraineKomisarenko Institute for Endocrinology and Metabolism of the NAMS of UkraineKomisarenko Institute for Endocrinology and Metabolism of the NAMS of UkraineBackground: The role of vitamin D in the development of autoimmune thyroid diseases has been actively discussed in the recent literature. Numerous studies have demonstrated an association of low vitamin D levels with autoimmune thyroiditis, with correlations with antithyroid antibody levels, thyroid hormone levels, disease severity and thyroid gland volume, both in adults and in children. However, there are a few relevant reports on Graves’ disease (GD), and only one relevant report is available on GD associated with autoimmune ophthalmopathy (AO). Given that GD complicated by AO is a classic autoimmune disease, it will be interesting to investigate the role of vitamin D in its pathogenesis. Purpose: To examine vitamin D levels and to determine correlations between this characteristic and thyroid-stimulating hormone receptor antibodies (TSH-R-Ab) in patients with Graves’ disease complicated by immune ophthalmopathy. Material and Methods: Serum levels of 25(OH)D, TSH, TSH-R-Ab and parathyroidal hormone (PTH) were measured in 131 patients with GD. Study patients were divided into two groups based on the presence or absence of ophthalmopathy. Group 1 comprised 81 GD patients with AO, and group 2 comprised 50 GD patients without AO. Clinical severity of AO was classified using the NOSPECS. Thirty-two, 30 and 19 patients had class 2b, class 3a or 3b, and class 4a, respectively. Variation statistics with Student t test was used for statistical analyses. The level of significance p ? 0.05 was assumed. Data are presented as mean ± standard error of mean. Pearson correlation analysis was used to identify possible correlations between variables. Results: All patients were euthyroid, and the mean TSH level in group 1 was 1.33±0.35 mU/L, and in group 2, 0.5 ± 0.2 mU/L (Р > 0.05). TSH-R-Ab levels were higher than normal in both groups of patients (group 1: range, 0.8 U/L to 21 U/L , mean value, 14.05± 2.7 U/L ; group 2: range, 1.8 U/L to 14.3 U/L , mean value, 31.0 ± 2.22 U/L; the difference between groups was not significant, р > 0.05). This was anticipated since these abnormalities are pathogenetic in GD. Serum levels of 25(OH)D in both groups were lower than normal (42.98 ± 2.82 nmol/L in group 1 vs 58.12 ± 4.2 nmol/L in group 2; р<0.02). Serum 25(OH)D concentrations were statistically significantly lower in Graves’ disease patients with AO, than in those without ophthalmopathy, and corresponded to vitamin D deficiency and suboptimal status, respectively. There was a significant difference in serum 25(OH)D level, but not in PTH level between the groups. Thus, mean serum PTH level in group 1 was 65.85±4.79 pg/mL, vs 49.73±11.4 pg/mL in group 2 (р > 0.05). TSH-R-Ab levels were negatively linearly correlated with the serum 25(OH)D level in the study cohort (elevated TSH-R-Ab levels correlated with low 25(OH)D levels). Conclusion: First, there was no statistically significant difference in TSH-R-Ab levels between Graves’ disease patients with AO and those without AO (14.05±2.7 U/L and 31±2.22 U/L, respectively; р > 0.05). Second, the mean serum 25(OH)D level for the study cohort of Graves’ disease patients (47.63 ± 2.48 nmol/L) was insufficient, and the mean level for patients with AO was significantly lower than the mean level for patients without AO (42.98 ± 2.82 nmol/L vs 58.12 ± 4.2 nmol/L; р<0.02). Finally, there was a negative correlation of TSH-R-Ab levels with 25(OH)D levels in Graves disease patients with AO (r= - 0.53; р<0.05). https://www.ozhurnal.com/en/archive/2019/6/9-fulltextautoimmune ophthalmopathygraves’ diseasevitamin d |
| spellingShingle | Yu.V. Buldygina G.M. Terekhova L.S. Strafun T.V. Fed’ko V.M. Klochkova I.I. Savosko Z.G. Lysova Asssociation of vitamin D with autoimmune ophthalmopathy in Graves’ disease Journal of Ophthalmology autoimmune ophthalmopathy graves’ disease vitamin d |
| title | Asssociation of vitamin D with autoimmune ophthalmopathy in Graves’ disease |
| title_full | Asssociation of vitamin D with autoimmune ophthalmopathy in Graves’ disease |
| title_fullStr | Asssociation of vitamin D with autoimmune ophthalmopathy in Graves’ disease |
| title_full_unstemmed | Asssociation of vitamin D with autoimmune ophthalmopathy in Graves’ disease |
| title_short | Asssociation of vitamin D with autoimmune ophthalmopathy in Graves’ disease |
| title_sort | asssociation of vitamin d with autoimmune ophthalmopathy in graves disease |
| topic | autoimmune ophthalmopathy graves’ disease vitamin d |
| url | https://www.ozhurnal.com/en/archive/2019/6/9-fulltext |
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