Investigation of Vitamin D Levels and Metabolic Parameters in Patients With Subclinical Hyperthyroidism

Yıl 2019, Cilt: 19 Sayı: 2, 261 - 269, 28.06.2019

Müge Keskin , Esra Ademoğlu Arzu Or Koca Derun Taner Ertugrul

https://doi.org/10.17098/amj.581991

Öz

Objectives: Subclinical hyperthyroidism is a
major health problem that is common in the population and requires long-term
follow-up due to various complications including atrial fibrillation and
osteoporosis. In recent years, vitamin D has been investigated in the
pathogenesis of autoimmune diseases including endocrine system beside well
known skeletal effects. The aim of this study is to investigate vitamin D
levels, metabolic parameters and the relationship between these parameters and vitamin
D and TSH levels in patients with subclinical hyperthyroidism.

Materials and Methods:  A total
of 128 subjects were included in the study between April 2017 and April 2018
which are 39 patients with subclinical hyperthyroidism diagnosed with toxic adenoma,
toxic multinodular goiter (TMNG), toxic diffuse goiter (TDG) and 35 subject
1≤TSH<4 (control 1), 54 subject 0,5≤TSH<1 (control 2) which is healthy
controls. Glucose, creatinine, AST, ALT, GFR, vitamin D, thyroid autoantibody
levels were retrospectively analyzed.

Results: There was no
statistically significant difference between the groups in terms of median
vitamin D levels (p = 0.928). Between groups; there was no statistically
significant difference in median glucose, creatinine, ALT, GFR levels (p =
0.857, p = 0.124, p = 0.355, p = 0.553). In group 2 (control 2), we found a
significant increase in GFR as fT3 levels increased. In the subclinical
hyperthyroidism group (Group 3) there was a positive correlation between fT3
and creatine (r=0.502 and p<0.001, r=0.362 and p=0.024).

Conclusion: Vitamin D levels and
metabolic parameters in subclinical hyperthyroid patients were similar to
healthy controls. No significant change was found the control group, according
to different TSH levels in metabolic parameters.

Anahtar Kelimeler

Subclinical hyperthyroidism, vitamin D, metabolic parameters

Subklinik Hipertiroidili Hastalarda Vitamin D Düzeyinin ve Metabolik Parametrelerin İncelenmesi

Öz

Amaç: Subklinik hipertiroidi toplumda oldukca sık görülen, atriyal
fibrilasyon ve osteoporoz gibi çeşitli komplikasyonlar nedeni ile uzun süreli
takip gereken önemli bir sağlık problemidir. Vitamin D ise endokrin sistemi de
kapsayan otoimmün hastalıkların patogenezindeki yeri, son yıllarda daha çok
araştırılmaktadır. Çalışmamızda, subklinik hipertiroidili hastalarda vitamin D
düzeylerini ve çeşitli biyokimyasal parametreleri incelemeyi amaçladık. Ayrıca
vitamin D ile biyokimyasal parametreler ve tiroid fonksiyon testleri arasındaki
ilişkiyi inceledik.

Materyal ve Metot: Nisan 2017-Nisan
2018 tarihleri arasında endokrinoloji polikliniğine başvuran ve subklinik
hipertiroidi tanısı almış; toksik adenom, toksik multinodüler guatr (TMNG),
toksik diffuz guatr (TDG) tanılı 39 hasta ile 89 sağlıklı kontrol grubu dahil
edildi. Kontrol grubu ayrıca TSH düzeyleri 1≤TSH<4 (Grup 1) ve 0,5≤TSH<1
(Grup 2) olacak şekilde 2 gruba ayrıldı. Tüm hastalarda ve kontrol grubunda
serum glukoz, kreatinin, AST, ALT, GFR, vitamin D, tiroid otoantikor düzeyleri
hastanemiz kayıtlarından not edildi.

Bulgular: Subklinik hipertiroidi ve
sağlıklı kontrol grubu arasında vitamin D düzeyleri açısından istatistiksel
olarak anlamlı farklılık yoktu (p=0,928). Sırasıyla; açlık kan şekeri (AKŞ),
kreatinin, glomerüler filtrasyon hızı (GFR) ve ALT düzeyleri her iki grupta
benzerdi (p=0,857, p=0,124, p=0,355, p=0,553). Grup 2- kontrol grubu içerisinde
AST düzeyleri grup-1 kontrol grubu ve subklinik hipertiroidi grubuna göre daha
düşüktü (p=0,024). Grup 2- kontrol grubu içerisinde kreatinin düzeyi ile
vitamin D arasında (r=0,366 ve p=0,007), GFR ile TSH (r=0,345, p=0,011) ve sT3
( r= 0,300, p= 0,028) arasında pozitif bir korelasyon vardı. Subklinik
hipertiroidi grubunda (Grup 3) sT3 ile kreatin ve ALT arasında pozitif bir
korelasyon mevcuttu (r=0,502 ve p<0,001, r=0,362 ve p=0,024).

Sonuç: Çalışmamızda subklinik
hipertiroidili hastalarda vitamin D düzeyleri ve metabolik parametreler
sağlıklı kontrollerle benzer düzeydeydi. Sağlıklı kontrol grubunda ise farklı
TSH düzeylerinde metabolik parametrelerde önemli bir değişiklik saptanmadı.

Anahtar Kelimeler

Subklinik hipertiroidi, vitamin D, metabolik parametreler

Kaynakça

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