Changes of peripheral blood vitamin D and monocyte chemotactic protein 1 levels in patients with Hashimoto thyroiditis and their clinical significance
10.3760/cma.j.cn115455-20231005-00318
- VernacularTitle:桥本甲状腺炎患者外周血维生素D和单核细胞趋化蛋白1水平及其临床意义
- Author:
Lihua SUN
1
;
Shulong SHI
;
Fangzhi HU
;
Lin SUN
Author Information
1. 济宁医学院临床医学院，济宁 272013
- Keywords:
Thyroiditis;
Hypothyroidism;
Vitamin D;
Monocyte chemoattractant proteins
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(5):438-445
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the peripheral blood levels of vitamin D and monocyte chemotactic protein 1 (MCP-1) in patients with Hashimoto thyroiditis (HT) and their clinical significance.Methods:Adopting a prospective research approach, 100 patients with HT from October 2022 to April 2023 in Jining First People′s Hospital were selected. Among them, the normal thyroid function was in 50 cases (HT normal thyroid function group), and the hypothyroidism was in 50 cases (HT hypothyroidism group). Another 50 cases of physical examination in the same period were selected as healthy control group. The general data were recorded. The levels of free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), vitamin D and MCP-1 were measured. Correlation analysis was performed using Pearson method or Spearman method. Binary Logistic regression analysis was used to analyze the risk factors leading to the development of HT, and the receiver operating characteristic (ROC) was used to assess the diagnostic value of vitamin D and MCP-1 for HT. Results:The FT 3 and FT 4 in HT hypothyroidism group were significantly lower than those in healthy control group and HT normal thyroid function group: (3.48 ± 1.00) pmol/L vs. (4.48 ± 0.49) and (4.28 ± 0.47) pmol/L, 12.40 (10.01, 14.23) pmol/L vs. 15.70 (14.30, 17.33) and 15.00 (13.10, 16.00) pmol/L, the TSH was significantly higher than that in healthy control group and HT normal thyroid function group: 8.60 (5.56, 27.13) mU/L vs. 1.97 (1.23, 2.89) and 3.06 (2.34, 3.42) mU/L, and there were statistical differences ( P<0.01); there were no statistical differences in FT 3, FT 4 and TSH between healthy control group and HT normal thyroid function group ( P>0.05). The TPOAb, TgAb and MCP-1 in HT normal thyroid function group and HT hypothyroidism group were significantly higher than those in healthy control group: 367.90 (151.60, 547.30) and 426.00 (175.30, 600.00) kU/L vs. 9.00 (9.00, 9.30) kU/L, 410.00 (222.00, 1 218.00) and 1 061.00 (427.30, 1 604.00) kU/L vs. 13.20 (12.08, 15.03) kU/L, 66.20 (54.43, 105.3) and 79.47 (41.57, 114.1) ng/L vs. 21.78 (15.23, 45.83) ng/L, the vitamin D was significantly lower than that in healthy control group: 14.32 (11.24, 16.99) and 12.73 (10.87, 15.36) μg/L vs. 18.12 (15.49, 21.92) μg/L, and there were statistical differences ( P<0.01); there were no statistical difference in TPOAb, TgAb, MCP-1 and vitamin D between HT normal thyroid function group and HT hypothyroidism group ( P>0.05). In healthy control group, there were no correlation between vitamin D, MCP-1 and FT 3, FT 4, TSH, TPOAb, TgAb ( P>0.05). In HT normal thyroid function group, vitamin D was positively correlated with FT 4 ( r = 0.376, P<0.01), negatively correlated with TPOAb ( r = - 0.400, P<0.01), and not correlated with FT 3, TSH and TgAb ( P>0.05); MCP-1 was positively correlated with TgAb ( r = 0.579, P<0.01), and not correlated with FT 3, FT 4, TSH, TPOAb ( P>0.05). In HT hypothyroidism group, vitamin D was positively correlated with FT 3 and FT 4 ( r = 0.522 and 0.567, P<0.01), negatively correlated with TSH, TPOAb and TgAb ( r = - 0.568, - 0.404 and - 0.328; P<0.01 or <0.05); MCP-1 was negatively correlated with FT 3 and FT 4 ( r = - 0.351 and - 0.469, P<0.05 or <0.01), positively correlated with TSH, TPOAb and TgAb ( r = 0.508, 0.431 and 0.522; P<0.01). In healthy control group, MCP-1 was not correlated with vitamin D ( P>0.05); in HT normal thyroid function group and HT hypothyroidism group, MCP-1 was negatively correlated with vitamin D ( r = - 0.457 and - 0.533, P<0.01). Binary Logistic regression analysis result showed that female, family history of thyroid disease, reduced vitamin D and elevated MCP-1were independent risk factors for the development of HT ( OR = 3.619, 3.675, 0.730 and 1.050; 95% CI 1.140 to 12.590, 1.174 to 16.220, 0.637 to 0.818 and 1.033 to 1.070; P<0.05 or <0.01). ROC curve analysis result showed that vitamin D, MCP-1 and vitamin D combined with MCP-1 had moderate diagnostic value for HT (area under the curve was 0.808, 0.858 and 0.886), and the combined diagnostic value was higher than that of the single index. Conclusions:In patients with HT, the serum vitamin D levels decrease and MCP-1 levels increase, which are related to thyroid function and antibodies. Insufficient vitamin D and increased MCP-1 can both increase the risk of HT.
