Re: Verband vitamine D-tekort en trage schildklier?
Geplaatst: 19 okt 2015, 14:23
In een abstract van het 15de Thyroid congress van de ETA kwam ik het volgende abstract tegen
short Oral Communication 80
Autoimmunity Tuesday Short Oral Communication Clinical 1:18 PM
VITAMIN-D SUPPLEMENTATION REDUCES THYROID PEROXIDASE ANTIBODY LEVELS IN PATIENTS WITH AUTOIMMUNE THYROID DISEASE: AN OPEN LABELED RANDOMIZED CONTROLLED TRIAL
S. chaudhary1, M. Kumar1, D. Dutta2, S.A. Mondal3, S. Chowdhury1, S. Mukhopadhyay1
1ENDOCRINOLOGY, IPGME&R, Kolkata, India
2ENDOCRINOLOGY, Post Graduate Institute of Medical Education & Research & Dr. Ram Manohar Lohia Hospital, New Delhi, India
3Biochemistry, IPGME&R, Kolkata, India
Although vitamin-D deficiency has been linked to autoimmune thyroid disorders (AITD), the impact of vitamin-D supplementation on thyroid autoimmunity is not known. This study aimed to evaluate impact of vitamin-D supplementation on thyroid autoimmunity (thyroid peroxidase antibody [TPO-Ab] titers) in patients with newly diagnosed AITD in a randomized controlled trial (RCT).
100 patients with newly diagnosed AITD (TPO-Ab>34kIU/L and/or sonographic evidence of thyroiditis), selected from 981 screened patients, were randomized into GROUP-1(intervention group) and GROUP-2 (control group). Group-1 received cholecalciferol 60,000 IU weekly and calcium 500mg/day for 8 weeks; GROUP-2 received calcium 500mg/day for 8 weeks. Responders were defined as ≥25% fall in TPO-Ab titers. Individuals with at least 3-months follow-up were analyzed. Serum 25OHD was estimated using radioimmunoassay (RIA) (Diasorin, MN; analytical sensitivity 4ng/ml;range 5-100ng/ml; intra-assay and inter-assayCV 4.5% and 11.3% respectively). Estimation of fT4, TSH, TPOAB and i-PTH were performed using CLIA (Immulite-1000, Gwynedd,UK). The trial was registered with the Clinical Trial Registry of India (CTRI/2015/04/005713).
AITD patients (n=100) (68 with TSH≤10mIU/L,38 with TSH>10mIU/L), with 93% having vitamin-D insufficiency were analyzed. TPO-Ab titers were highest among patients in lowest quartile of 25 hydroxy-vitamin-D (P=0.084). At 3 months follow-up, there was significant fall in TPOAb in Group-1 (−46.73%) as compared to Group-2 (−16.6%) (P=0.028). Sixty-eight percent patients in Group-1 were responders compared to 44% in Group-2 (P=0.015). Sub-group analysis revealed significantly greater reduction in TPO-Ab titers in subclinical hypothyroidism, but not in overt primary hypothyroidism. Cox-regression revealed vitamin-D supplementation (Group-1) followed by baseline TPO-Ab and fT4 levels to be good predictor of response to therapy (P=0.042, 0.069 and 0.074 respectively).
Vitamin-D supplementation in AITD may have a beneficial effect on autoimmunity as evidence by significant reductions in TPO-Ab titers.
short Oral Communication 80
Autoimmunity Tuesday Short Oral Communication Clinical 1:18 PM
VITAMIN-D SUPPLEMENTATION REDUCES THYROID PEROXIDASE ANTIBODY LEVELS IN PATIENTS WITH AUTOIMMUNE THYROID DISEASE: AN OPEN LABELED RANDOMIZED CONTROLLED TRIAL
S. chaudhary1, M. Kumar1, D. Dutta2, S.A. Mondal3, S. Chowdhury1, S. Mukhopadhyay1
1ENDOCRINOLOGY, IPGME&R, Kolkata, India
2ENDOCRINOLOGY, Post Graduate Institute of Medical Education & Research & Dr. Ram Manohar Lohia Hospital, New Delhi, India
3Biochemistry, IPGME&R, Kolkata, India
Although vitamin-D deficiency has been linked to autoimmune thyroid disorders (AITD), the impact of vitamin-D supplementation on thyroid autoimmunity is not known. This study aimed to evaluate impact of vitamin-D supplementation on thyroid autoimmunity (thyroid peroxidase antibody [TPO-Ab] titers) in patients with newly diagnosed AITD in a randomized controlled trial (RCT).
100 patients with newly diagnosed AITD (TPO-Ab>34kIU/L and/or sonographic evidence of thyroiditis), selected from 981 screened patients, were randomized into GROUP-1(intervention group) and GROUP-2 (control group). Group-1 received cholecalciferol 60,000 IU weekly and calcium 500mg/day for 8 weeks; GROUP-2 received calcium 500mg/day for 8 weeks. Responders were defined as ≥25% fall in TPO-Ab titers. Individuals with at least 3-months follow-up were analyzed. Serum 25OHD was estimated using radioimmunoassay (RIA) (Diasorin, MN; analytical sensitivity 4ng/ml;range 5-100ng/ml; intra-assay and inter-assayCV 4.5% and 11.3% respectively). Estimation of fT4, TSH, TPOAB and i-PTH were performed using CLIA (Immulite-1000, Gwynedd,UK). The trial was registered with the Clinical Trial Registry of India (CTRI/2015/04/005713).
AITD patients (n=100) (68 with TSH≤10mIU/L,38 with TSH>10mIU/L), with 93% having vitamin-D insufficiency were analyzed. TPO-Ab titers were highest among patients in lowest quartile of 25 hydroxy-vitamin-D (P=0.084). At 3 months follow-up, there was significant fall in TPOAb in Group-1 (−46.73%) as compared to Group-2 (−16.6%) (P=0.028). Sixty-eight percent patients in Group-1 were responders compared to 44% in Group-2 (P=0.015). Sub-group analysis revealed significantly greater reduction in TPO-Ab titers in subclinical hypothyroidism, but not in overt primary hypothyroidism. Cox-regression revealed vitamin-D supplementation (Group-1) followed by baseline TPO-Ab and fT4 levels to be good predictor of response to therapy (P=0.042, 0.069 and 0.074 respectively).
Vitamin-D supplementation in AITD may have a beneficial effect on autoimmunity as evidence by significant reductions in TPO-Ab titers.