The relationship between Hashimoto's thyroiditis and vitamin D and the inflammatory marker platelet-to-lymphocyte ratio

Year 2023, Volume: 6 Issue: 3, 693 - 698, 31.05.2023

Gönül Koç , Ayşe Arslan-süzer , Gül Gürsoy

https://doi.org/10.32322/jhsm.1293585

Abstract

Aim: Hashimoto's thyroiditis (HT) is a chronic autoimmune-mediated disease that leads to overt hypothyroidism. Vitamin D is essential for immunity. This study examines possible impacts of vitamin D on the progression of HT and evaluates the use of platelet-lymphocyte ratio (PLR) as an indicator of its relationship with the inflammatory process.
Material and Method: This is a retrospective case-control study, consisting of 60 individuals with HT and 40 healthy controls. Thyroid function tests, thyroid antibodies, vitamin D levels, erythrocyte sedimentation rate (ESR), parameters of complete blood count and C-reactive protein (CRP) levels were scanned retrospectively using participants' medical files between September 2018 and March 2019. Platelet count was divided by lymphocyte count to determine PLR.
Results: HT patients had both considerably lower median vitamin D levels and higher percentages of vitamin D deficiency than the controls [12.08 (8.79–17.00) vs. 20.09 (20.00–34.00) and 80% vs. 22.5%, respectively, p<0.001). Vitamin D deficiency was also higher within the hypothyroid HT group than in the euthyroid HT group (p<0.001). The vitamin D levels of HT patients with subclinical hypothyroidism were lower than those with euthyroidism (p<0.004). The study groups showed no differences regarding CRP levels, higher levels of ESR were reported only in the overt hypothyroid patients (p=0.001), and higher PLRs were found in those euthyroid HT patients. Vitamin D was negatively correlated with TSH and anti-thyroid peroxidase (anti-TPO) levels (r=−0.294, p=0.023; r=−0.281, p=0.030, respectively). A positive correlation existed between TSH and anti-TPO (r=0.411, p=0.001) and ESR (r=0.365, p=0.002), but TSH and PLR were negatively correlated (r=−0.390, p=0.002).
Conclusion: According to these findings, vitamin D may play a role in the transition to the hypothyroid phase in HT patients, and thus, vitamin D replacement may inhibit this progression. Moreover, our results indicate that PLR may not be a good inflammatory indicator for vitamin D-deficient HT patients.

Keywords

Hashimoto, vitamin D, platelet lymphocyte ratio, autoimmune thyroiditis, hypothyroidism, inflammation

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