Vitamin D in Graves Disease: Levels, Correlation with Laboratory and Clinical Parameters, and Genetics

Planck, Tereza; Shahida, Bushra; Malm, Johan; Manjer, Jonas

doi:10.1159/000484521

Cited by 46 publications

(46 citation statements)

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“…1,25(OH)D 2 binds to the nuclear VDR, which acts on the vitamin D response element (VDRE) of target genes 3 . Recent studies have investigated genetic susceptibilities for the development of Graves' disease associated with specific variants of single nuclear polymorphisms (SNPs) in VDR genes 13,14 . Aside from the diversity in the genetic background of each individual in terms of vitamin D function, most immune cells are involved in vitamin D action by expressing VDRs, 1α-hydroxylase, and a degrading enzyme 15,16 .…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, subjects who supplemented vitamin D achieved vitamin D levels that were twice as high as those of patients who did not supplement vitamin D (25.7 ng/mL vs. 11.6 ng/mL, P < 0.001); however, the TBII titers at the time of ATD discontinuation as well as vitamin D levels were risk factors for the recurrence of Graves' disease in the multivariate analysis. Planck et al reported no difference in vitamin D levels at baseline between individuals who achieved remission (78 subjects) and those who relapsed (22 subjects) within one year after ATD cessation (vitamin D www.nature.com/scientificreports www.nature.com/scientificreports/ levels of 22.8 ng/mL vs. 25.3 ng/mL) 13 . In addition, they reported no correlation between vitamin D levels and thyroid hormone levels, including TBII titers.…”

Section: Discussionmentioning

confidence: 99%

“…However, previous studies, including that conducted by Planck et al, utilized a cross-sectional design, and no prior studies have assessed the role of vitamin D supplementation in the clinical outcomes of Graves' disease. Furthermore, we derived remission/relapse data from a relatively large number of patients (210 patients vs. 100 in the study by Planck et al 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…Graves' disease recurrence was higher when using the cut-off of 25(OH)D ≤ 14.23 ng/mL (hazard ratio (HR) 3.016, 95% confidence interval (CI) 1.163-7.819, P = 0.023) 12 . Recently, Planck et al observed no difference in clinical parameters, including thyroid function, TSH-binding inhibitory immunoglobulin (TBII), and recurrence rate, in 292 patients with Graves' disease in a Swedish cohort 13 .…”

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Vitamin D supplementation does not prevent the recurrence of Graves’ disease

Cho

Chung

2020

Sci Rep

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Recent literature has reported a higher prevalence of vitamin D deficiency among people with Graves' disease. No study has examined the effect of vitamin D supplementation on the clinical outcomes of Graves' disease. We aimed to evaluate whether daily vitamin D supplementation reduces Graves' disease recurrence. We enrolled 210 subjects with Graves' disease and vitamin D deficiency and followed them for at least one year after anti-thyroid drug (ATD) discontinuation. Among 210 individuals, 60 (29%) were amenable to taking vitamin D supplements, resulting in sufficient vitamin D levels (from 10.6 to 25.7 ng/mL), whereas the mean vitamin D level was 11.6 ng/mL in the 150 patients who did not take vitamin D supplements. The recurrence rate was similar in both groups (38% vs. 49%, P = 0.086). However, recurrence occurred earlier in the latter group (7 months vs. 5 months, P = 0.016). In the multivariate analysis, vitamin D levels and TSH-binding inhibitory immunoglobulin (TBII) titers at ATD discontinuation remained significant factors for recurrence. Vitamin D levels and TBII titers at ATD discontinuation exhibited a weak negative correlation (R = −0.143, P = 0.041). Vitamin D supplementation might have a protective effect against Graves' disease recurrence with a borderline significant recurrence rate reduction. Autoimmune thyroid diseases (AITDs), including Graves' disease and Hashimoto's thyroiditis, are the most common organ-specific autoimmune disorders 1. AITDs are caused by various environmental triggers, such as iodine, drugs, radiation, and infection in genetically predisposed individuals 2. AITDs are characterized by T-cell-mediated autoimmune diseases, and Graves' disease is primarily related to hyperactive humoural responses that lead to the production of stimulatory autoantibodies for the thyroid stimulating hormone (TSH) receptor 1. Vitamin D regulates bone metabolism and the homeostasis of calcium and phosphorus. The active form of vitamin D binds to the nuclear vitamin D receptor (VDR) and controls the expression of over 200 genes responsible for the regulation of cell proliferation, differentiation, and apoptosis in most tissues and cells, including immune cells 3. Non-skeletal actions of vitamin D have been studied over the past few decades, and evidence suggests that there is a relationship between vitamin D deficiency and various diseases, such as autoimmune diseases 4 , cardiovascular disease 5,6 , and cancer 5,7. Recent studies have reported that low vitamin D levels are prevalent in patients with Graves' disease. Kivity et al. observed a higher prevalence of vitamin D deficiency (defined as 25-hydroxyvitamin(OH)D < 10 ng/mL) in 22 Graves' disease patients compared with 98 healthy controls (64% vs. 30%, P < 0.01) 8. Yasuda et al. reported reduced levels of vitamin D in 26 Graves' disease patients compared to the levels in 46 controls (25(OH)D 3 levels of 14.4 ng/mL vs. 17.1 ng/mL, P < 0.05) 9. Two meta-analyses implicated vitamin D deficiency as a risk factor for Graves' disease 4,10 , although...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

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Vitamin D supplementation does not prevent the recurrence of Graves’ disease

Cho

Chung

2020

Sci Rep

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“…Bazı çalışmalarda böyle bir ilişki saptanmışken, bazılarında da saptanmamıştır. 16,17,18 D vitamini eksikliğinin GH'ının başlangıcını tetiklediği veya D vitamini replasmanının hastalık üzerinde olumlu etkilerinin olup olmadığı konusu hala çözüm beklemektedir. 19 Bizim çalışmamızda D vitamini düzeylerinin ortalaması düşük (17,87±10,12 µg/L) bulunmuştur.…”

Section: Discussionunclassified

Determining the Level of Knowledge about Graves’ Disease: Single-Center Results

Peynirci¹,

Aksu²,

Doğan³

et al. 2019

Ankara Medical Journal

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Öz Amaç: Ülkemizde Graves hastalarında hastalığın farkındalığı ile ilgili yayınlanan bir çalışma bulunmamaktadır. Biz bu çalışmamızda, Graves tanılı hastaların demografik, klinik ve laboratuar verilerinin yanı sıra hastalık hakkındaki bilgi düzeyini anket çalışması ile belirlemeyi amaçladık. Materyal ve Metot: Mart-Ağustos 2013 tarihleri arasında Graves Hastalığı tanısı konan veya takip edilen 83 hastaya 22 sorudan oluşan anket çalışması yapıldı. Anketin ilk 4 sorusu hastalığın tanımını, 7 soru semptomlarını, 7 soru tedaviyi ve yan etkilerini ve 4 soru gebelik ve emzirme dönemindeki tedavi ile ilgili hastaların bildiklerini kapsamaktaydı. Ankete başlamadan önce hastaların cinsiyeti, yaşı, eğitim durumu, mesleği, sigara kullanım durumu, kullandıkları tuz çeşidi, deniz ürünleri kullanımının sıklığı, eşlik eden hastalıklarının olup olmadığı, başvuru anındaki semptomları ve hastalıkları ile ilgili bilgi edinme kaynakları soruldu. Ayrıca laboratuar verileri ve uygulanan tedaviler kaydedildi. Bulgular: 83 hastanın 43'ü erkek, 40'ı kadın ve yaşlarının ortalama değeri 43,86±13,19 yıl idi. İyotlu tuz kullanım oranı %65,06 iken hastaların %45,78'i ayda günde birden az deniz ürünleri tükettiğini bildirdi. Hastaların %39,76'sına (n: 33) rutin tetkikler esnasında tanı konulduğu saptandı. Tedavide ilk seçenek olarak antitiroid ilaçlar tercih edilmişti. Hastaların bilgi edinme kaynaklarının %75,90'ı doktorlar idi. Bu anket çalışmasında en az fikir sahibi olan konunun gebelik ve emzirme döneminde hastalığın yönetimi olduğu görüldü. Bunun yanında, hastalığın osteoporoza neden olabileceği, kansere dönüşmeyeceği, ilaç tedavisinin kullanım süresi, RAI tedavisinin yan etkileri genel olarak bilinmemekteydi. Sonuç: Hastaların hastalık hakkında bilgi sahibi olması tanı ve tedavi aşamasında olumlu gelişmeler yaratacaktır.

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Evaluation of interleukins 37 and 38 and vitamin D status in the serum of women with Graves' disease

Ibrahim

Sulaiman

Al-Shammaa³

et al. 2022

Clinical Laboratory Analysis

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Background Graves' disease (GD) is an autoimmune thyroid disorder and recent studies have proposed a role for interleukin (IL)‐37, IL‐38, and vitamin D (VitD) in the pathophysiology of disease. Therefore, this study investigated the expression of IL‐37, IL‐38, and VitD in the serum of GD patients and correlations of their levels with some demographic and clinical characteristics. Methods Serum IL‐37, IL‐38, and VitD levels were evaluated in 90 women with GD and 93 control women using enzyme‐linked immunosorbent assay kits. Depending on therapy, six patients were newly diagnosed (ND; untreated), and 50 patients were receiving only carbimazole (CMZ), while 34 patients were also on CMZ but also received one (31 patients), two (one patient), or three (two patients) doses of radioactive iodine (RAI). Results IL‐37 levels were significantly higher in GD patients than in controls, while IL‐38 and VitD levels were significantly decreased. As indicated by the area under the curve (AUC), receiver operating characteristic curve analysis demonstrated the potential of IL‐37, IL‐38, and VitD as biomarkers to distinguish GD patients from controls (AUC = 0.953, 0.959, and 0.793, respectively). Multinomial logistic regression analysis showed that altered levels of IL‐37, IL‐38, and VitD were most likely associated with the pathogenesis of GD. IL‐37 was negatively correlated with IL‐38 and VitD, while IL‐38 and VitD were positively correlated. Conclusion Serum Il‐37 levels were upregulated in women with GD, while IL‐38 and VitD levels showed downregulated levels. The latter two were positively correlated while they showed a negative correlation with IL‐37.

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Vitamin D in Graves Disease: Levels, Correlation with Laboratory and Clinical Parameters, and Genetics

Cited by 46 publications

References 35 publications

Vitamin D supplementation does not prevent the recurrence of Graves’ disease

Vitamin D supplementation does not prevent the recurrence of Graves’ disease

Determining the Level of Knowledge about Graves’ Disease: Single-Center Results

Evaluation of interleukins 37 and 38 and vitamin D status in the serum of women with Graves' disease

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