弥漫性毒性甲状腺肿与25羟维生素D的关系研究  

Study on the relationship between diffuse toxic goiter and 25-hydroxyvitamin D

作　　者：张弦[1] 向茜[1] 栾艳[1] 徐静[1] 阮小荟 李万碧[1] 李勇军[1] ZHANG Xuan;XIANG Qian;LUAN Yan;XU Jing;RUAN Xiaohui;LI Wanbi;LI Yongjun(The Fifth Affiliated Hospital of Kunming Medical University/Diannan Central Hospital of Honghe Prefecture, Gejiu 661000, Yunnan, China)

机构地区：[1]昆明医科大学第五附属医院/红河州滇南中心医院

出　　处：《现代中西医结合杂志》2019年第23期2514-2517,2522,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：云南省教育厅科学研究基金指导性项目(2016ZDX066)

摘　　要：目的探讨弥漫性毒性甲状腺肿(GD)患者血清25羟维生素D[25(OH)D]水平及其与GD的关系。方法选取个旧地区96例新诊断GD患者作为患者组,66例健康体检者作为健康组。采用全自动免疫化学发光分析仪测定2组受试者25(OH)D水平及甲状腺功能、甲状腺自身抗体、甲状旁腺激素等指标水平,统计2组25(OH)D充足、不足、缺乏情况,用Pearson相关性分析及多元线性逐步回归分析25(OH)D的相关因素。结果患者组血清25(OH)D、抗酒石酸酸性磷酸酶(TRACP)、促甲状腺激素受体抗体(TRAb)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平均显著高于健康组(P均<0.05),而促甲状腺激素(TSH)、甲状旁腺激素(PTH)水平均显著低于健康组(P均<0.05)。患者组25(OH)D充足的比例(16.67%)显著高于健康组(7.58%)(P<0.05),不足的比例(23.95%)显著低于健康组(42.42%)(P<0.05),缺乏的比例2组间比较差异无统计学意义(P>0.05)。Pearson单因素相关分析提示PTH与25(OH)D有相关性(r=-0.302,P=0.001),多元线性逐步回归分析提示PTH与25(OH)D水平呈负相关(B=-5.221,P<0.001)。结论个旧地区人群普遍存在维生素D缺乏。GD患者血清25(OH)D水平及25(OH)D充足的比例较高,不足的比例较低。25(OH)D水平与甲状腺功能及TRAb无关,与PTH呈负相关。Objective It is to investigate the relationship between 25-hydroxyvitamin D[25(OH)D] levels and GD in patients with diffuse toxic goiter (GD). Methods A total of 96 newly diagnosed GD patients in Gejiu area were selected as the patient group, and 66 healthy subjects were used as the healthy group. The levels of 25(OH)D and thyroid function, thyroid autoantibodies and parathyroid hormone were measured by automatic immunochemiluminescence analyzer. The scores of 25 (OH)D sufficient 25 (OH)D, insufficient 25 (OH)D and lacking 25 (OH)D were calculated in the two groups. 25(OH)D related factors were analyzed by Pearson correlation analysis and multiple linear stepwise regression analysis. Results The levels of serum 25(OH)D, tartrate-resistant acid phosphatase (TRACP), thyrotropin receptor antibodies (TRAb), total triiodothyronine (TT 3), total thyroxine (TT 4), free triiodo thyroxine (FT 3) and free thyroxine (FT 4) in the patient group were significantly higher than those in the healthy group ( P <0.05), while the levels of thyroid stimulating hormone (TSH) and parathyroid hormone (PTH) were significantly lower than those in healthy group( P <0.05). The proportion of patients with adequate 25(OH)D (16.67%) was significantly higher than that of healthy group (7.58%)( P <0.05), and the proportion of deficiency (23.95%) was significantly lower than that of healthy group (42.42%)( P <0.05). There was no significant difference in the proportion of lacking 25 (OH)D between the two groups ( P >0.05). Pearson’s one-way correlation analysis suggested that PTH was correlated with 25(OH)D ( r =-0.302, P =0.001). Multiple linear stepwise regression analysis indicated that PTH was negatively correlated with 25(OH)D level ( B =-5.221, P <0.001). Conclusion Vitamin D deficiency is prevalent in the population in Gejiu area. The proportion of adequate 25(OH)D and the level of serum 25(OH)D, and the proportion of deficiency 25(OH)D was lower in GD patients. 25(OH)D level was not associated with thyroid function and TRAb, but was ne

关 键 词：弥漫性毒性甲状腺肿 甲状腺功能亢进症 25羟维生素D 甲状旁腺激素 抗酒石酸酸性磷酸酶 

分 类 号：R581[医药卫生—内分泌]