Association of vitamin D insufficiency/deficiency with thyroid artery Doppler ultrasonography in patients with Hashimoto thyroiditis.

Ahmet Nalbant,Ayhan Aydın,Alper Karacan,Hakan Cinemre,Attila Onmez,Ali Tamer

doi:10.12669/pjms.332.12566

Ahmet Nalbant, Ayhan Aydın + Show 4 more

Open Access

https://doi.org/10.12669/pjms.332.12566

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Abstract

Background & Objective:During the course of the autoimmune thyroid diseases, ultrasonography change parallel to histopathology. Vitamin D is associated with autoimmune diseases and thus can affect thyroid blood flow. Our aim was to investigate the relationship between vitamin D insufficiency/deficiency and thyroid hemodynamic indices in patients with Hashimoto thyroiditis.Methods:A total of 93 patients who presented to Sakarya University Endocrinology outpatient clinic from April to September 2016 and diagnosed with Hashimoto thyroiditis were included in this study. Clinical and serologic data, thyroid antibodies and 25(OH)D3 were evaluated. Mean peak systolic velocity(mPSV), mean end-diastolic velocity (EDV), mean resistive index (RI) flows of superior and inferior thyroid arteries were measured with B-mode Doppler ultrasonography.Results:Vitamin D insufficiency/deficiency was detected in 59 (63.4%). TPO Ab and TgAb levels were found higher in patients with vitamin D insufficiency/deficiency. In the normal vitamin D group, superior thyroid artery mPSV (32.21±6.73cm/s) and EDV(13.27±2.80 cm/s) were higher than in the low vitamin D group [mPSV (28.32±8.99cm/s) and EDV(10.67±3.68 cm/s)] (P=0.034, P=0.001, respectively). Inferior thyroid artery EDV value was higher in the normal compared to the low vitamin D group (0.032). RI measured in all arteries were higher in the vitamin D insufficient/deficient group compared to the Vitamin D normal group (p=0.001).Conclusion:Vitamin-D insufficiency/deficiency has led to reduced parenchymal blood supply and increased micro-vascular resistance in Hashimoto thyroiditis patients.

Highlights

Hashimoto thyroiditis (HT) is the most common chronic autoimmune thyroid disease characterized by painless goiter and elevated serum thyroid antibodies
A total of 93 patients who presented to Sakarya University Endocrinology outpatient clinic from April to September 2016 and diagnosed with Hashimoto thyroiditis were included in this study
Age, thyroid peroxidase auto-antibodies (TPOAb), thyro-globulin autoantibodies, thyroid stimulant hormone (TSH), B-mode ultrasonography, mean peak systolic velocity, mean end-diastolic velocity (EDV), mean resistive index (RI) flows of superior thyroid artery, inferior thyroid artery measured with proper angle (45-60°C) were measured

Summary

Introduction

Hashimoto thyroiditis (HT) is the most common chronic autoimmune thyroid disease characterized by painless goiter and elevated serum thyroid antibodies. Vitamin D receptors (VDR) were shown to be present in intestinal epithelium cells, osteoblasts, renal cells and most importantly immune system cells (T lymphocytes, monocytes, dendritic cells and B lymphocytes).[3] Vitamin D inhibits T lymphocyte proliferation, T helper 1 (Th1) lymphocytes. It may increase T helper 2 (Th2) lymphocyte formations. RI measured in all arteries were higher in the vitamin D insufficient/deficient group compared to the Vitamin D normal group (p=0.001). Conclusion: Vitamin-D insufficiency/deficiency has led to reduced parenchymal blood supply and increased micro-vascular resistance in Hashimoto thyroiditis patients

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