Study of Vitamin D Level and Vitamin D Receptor Polymorphism in Hypothyroid Egyptian Patients.

Hoda A Elrawi,Nashwa S Ghanem,Laila A Rashed,Naglaa M Elsayed,Hala M Ali,Mai M Mansour

doi:10.1155/2019/3583250

Abstract

Purpose The current study aimed at assessing vitamin D level and vitamin D receptor polymorphism in hypothyroid Egyptian patients and its effect on hypothyroidism and thyroid morphology, also to find a causal relation between vitamin D and hypothyroidism. Methods This case-control study was conducted on 35 hypothyroid patients and 35 matched unrelated healthy controls. Total serum 25-hydroxyvitamin D3 and thyroid antibodies were measured using a human ELISA kit. Genotyping was performed by using real-time PCR. HOMA-IR was also calculated (fasting insulin in mIU/L × fasting glucose in mg/dL/405). All subjects were assessed for thyroid morphology by thyroid ultrasonography. Results Vitamin D level was lower in hypothyroid patients than in control subjects. Vitamin D was also inversely related to TSH, HOMA-IR, and levels of anti-TG and anti-TPO. VDR polymorphism (Fok1 and Apa1) had no relation to TSH or vitamin D levels in both patients and control groups. Low vitamin D levels were associated with increased thyroid vascularity and nodularity; furthermore, vitamin D was inversely proportional to thyroid gland volume. Correlation of HOMA-IR with the levels of both anti-TG and anti-TPO in the 70 subjects proved that HOMA-IR was positively correlated to both antibodies. Conclusion This study confirmed the association of vitamin D deficiency with hypothyroidism, thyroid autoimmunity, increased volume, nodularity, and vascularity of thyroid gland in hypothyroid patients as well as increased HOMA-IR. It proved the association between HOMA-IR and thyroid autoimmunity. The study proved no association between VDR polymorphisms (Fok1 and Apa1) with either vitamin D levels or TSH levels.

Highlights

Vitamin D deficiency is a global health problem
Some case-control studies have suggested that lower serum vitamin D levels or a higher prevalence of vitamin D insufficiency existed in patients with autoimmune thyroid disorders (AITD) compared with that in healthy controls [3, 5]
5.7% (2) of our control subjects showed vitamin D insufficiency, 2.85% (1) were deficient, and 91.4% (32) were having normal vitamin D levels. is signifies that vitamin D insufficiency and deficiency are more frequent in patients in the hypothyroid group than in the control group

Summary

Introduction

Vitamin D deficiency is a global health problem. Over a billion people worldwide have vitamin D deficiency or insufficiency [1]. e association between vitamin D deficiency and autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, and inflammatory bowel disease was described, and vitamin D supplementation prevents the development of these autoimmune diseases [1, 2].e involvement of vitamin D in autoimmune thyroid disorders “AITD” has been of interest. Vitamin D level was lower in hypothyroid patients than in control subjects (24.20 ± 10.78 versus 48.5 ± 12.57, P value is

Results

Conclusion