Vitamin D Status in Hypothyroid Patients

R. Bhowmic, Mohammad Kamrul Hasan, M. U. Bhuiyan, UzzalKanti Das, Md Shahriar Siddiki, Shah Mubdi Un Naafi, Md Faizul Islam Chowdhury
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Abstract

Vitamin D deficiency is a global health problem. It is estimated that about 25-50% of patients commonly encounter vitamin D deficiency in clinical practice. Recent studies show hypothyroid patients suffer from significantly low vitamin D level. As vitamin D and thyroid hormone act through steroid receptors, one can affect the other’s action. Considering the scientific evidence, the study was aimed to assess the vitamin D level among the subjects with hypothyroidism. This hospital-based case-control study was conducted among 70 subjects including 35 cases and 35 controls at the Departments of Medicine and Endocrinology in Dhaka Medical College Hospital in 6 months duration following approval of this protocol. Data were collected by face to face interview, using a structured questionnaire and case record review. Hospital records including laboratory reports were also reviewed.  Thirty-five cases and thirty-five control samples were screened for vitamin D levels. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 23. Among the participants, 55 were female with a male-female ratio of 1: 3.67. The mean age was 44.6 ± 11.69 year. The highest number of patients were in between 41 to 55 year (41%). The majority of cases were from rural areas (67.0%). There was no significant differences in socio-demographic profiles between the cases and control groups (P >0.05). Hypovitaminosis D was found in 67% of cases. Among them 39.0% had mild insufficiency (20-29 ng/ml), 21.0% had moderate deficiency (10-19 ng/ml) and 7.0% had severe deficiency (< 10 ng/ml). The mean vitamin D level was 23.79 ± 8.1 ng/ml. Serum 25(OH)D level was markedly reduced in hypothyroid cases in comparison to the euthyroid control group [22.14 ± 8.02  and 26.22 ± 7.53 respectively ); P < 0.005]. Data showed hypothyroid patient is likely to develop Hypovitaminosis D 3.37 times higher compared to a euthyroid patient (OR=3.37; 95% CI:1.644-9.7440; P=0.02). Moreover, this lower level is not associated with the difference in age, sex and occupation (P< 0.005). Hypovitaminosis D is associated with hypothyroidism with no variation in respect to age, sex and occupation. The hypovitaminosis D is significantly associated with hypothyroi- dism in the study population. Bangladesh Med J. 2021 Sept; 51(1): 25-32
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甲状腺功能减退患者的维生素D状况
维生素D缺乏是一个全球性的健康问题。据估计,约25-50%的患者在临床实践中经常遇到维生素D缺乏症。最近的研究表明,甲状腺功能减退患者的维生素D水平明显偏低。由于维生素D和甲状腺激素通过类固醇受体起作用,其中一种会影响另一种的作用。考虑到科学证据,本研究旨在评估甲状腺功能减退患者的维生素D水平。这项以医院为基础的病例对照研究在达卡医学院医院内科和内分泌科进行,包括35例病例和35例对照,在本方案批准后的6个月内进行。数据收集采用面对面访谈,采用结构化问卷和病例记录回顾。还审查了包括化验报告在内的医院记录。对35例病例和35个对照样本进行了维生素D水平检测。数据分析使用社会科学统计软件包(SPSS)第23版。参与者中,女性55人,男女比例为1:3 .67。平均年龄44.6±11.69岁。41 - 55岁患者最多(41%)。绝大多数病例来自农村(67.0%)。两组间社会人口统计学差异无统计学意义(P >0.05)。67%的病例存在维生素D缺乏症。其中39.0%为轻度不足(20 ~ 29 ng/ml), 21.0%为中度不足(10 ~ 19 ng/ml), 7.0%为重度不足(< 10 ng/ml)。平均维生素D水平为23.79±8.1 ng/ml。甲状腺功能减退患者血清25(OH)D水平明显低于甲状腺功能正常对照组[分别为22.14±8.02和26.22±7.53];P < 0.005]。数据显示,甲状腺功能减退患者发生维生素D缺乏症的可能性是甲状腺功能正常患者的3.37倍(OR=3.37;95%置信区间:1.644—-9.7440;P = 0.02)。此外,这一较低水平与年龄、性别和职业的差异无关(P< 0.005)。维生素D缺乏症与甲状腺功能减退有关,在年龄、性别和职业方面无差异。在研究人群中,维生素D缺乏症与甲状腺功能减退症显著相关。孟加拉国Med . 2021年9月;51 (1): 25-32
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