Vitamin D status in children with autoimmune thyroiditis

Authors

  • Gomathi Priya J Department of Pediatric, Medicine, Institute of Child Health and Hospital for Children, Egmore, Chennai, India
  • Seenivasan Venkatasamy Department of Pediatric, Medicine, Institute of Child Health and Hospital for Children, Egmore, Chennai, India
  • Karamath S Pyarejan Department of Pediatric, Medicine, Institute of Child Health and Hospital for Children, Egmore, Chennai, India
  • Jayachandran K. Department of Pediatric, Medicine, Institute of Child Health and Hospital for Children, Egmore, Chennai, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20173125

Keywords:

Autoimmune thyroiditis, Vitamin D

Abstract

Background: Deficiency of 25 hydroxyvitamin D has been linked with predisposition to autoimmune disorders. Also, vitamin D has been found to be a causal factor in many autoimmune diseases. Objective of the study was to investigate vitamin D status in children with autoimmune thyroiditis attending endocrinology OPD at a tertiary centre in southern India.

Methods: It is a case control study done in which 75 children (70 female, 5 male) with age and sex matched healthy controls were chosen. Free thyroxine, TSH, anti TPOAb, anti TGAb, 25 hydroxyvitamin D, serum calcium, phosphorus, alkaline phosphatase levels were estimated in both cases and control subjects. Children with anti TPO or anti TG positivity were divided into four groups based on their level of antibody titers.

Results: The mean age in cases was 9.8±0.34 years. 25(OH)D levels were significantly lower in cases (15.07±1.14 ng/ml) compared to controls (17.82±1.13 ng/ml) (p<0.0006). Mean serum calcium levels in cases (9.35±0.16 mg/dl) were significantly lower when compared to controls (9.73±0.14 mg/dl) (p<0.0005). Similarly mean serum alkaline phosphatase level in cases (184.97±11.10 IU/L) were significantly elevated when compared with controls (122.37±6.82 IU/L) (p<0.0001). However, there was no significant difference in serum phosphorus levels between cases (4.42±0.10 mg/dl) and controls (4.43±0.14 mg/dl) (p=0.83). There was no significant difference in vitamin D level among the groups in both anti TPO (p< 0.283) and anti TG (p<0.148).

Conclusions: The significant decrease in vitamin D levels in cases signifies that 25(OH)D may be an independent causal factor related to the autoimmunity in thyroid diseases. 

References

M Fletcher J, A Basdeo S, C Allen A, J Dunne P. Therapeutic use of vitamin D and its analogues in autoimmunity. Recent Patents Inflamm Aller Drug Discovery. 2012;6(1):22-34.

Harinarayan CV, Joshi SR. Vitamin D status in India-Its implications and remedial measures. J Assoc Physicians India. 2009 Jan;57:40-8.

Sudha K, Hegde A, Manjrekar P, Kumarachandra R. Prevalence of vitamin D deficiency and its relationship with subclinical hypothyroidism. Int J Pharm Bio Sci. 2013;4(4):B1380-4.

Goswami R, Marwaha RK, Gupta N, Tandon N, Sreenivas V, Tomar N, et al. Prevalence of vitamin D deficiency and its relationship with thyroid autoimmunity in Asian Indians: a community-based survey. B J Nutr. 2009;102(3):382-6.

Wang J, Lv S, Chen G, Gao C, He J, Zhong H, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients. 2015;7(4):2485-98.

Joshi S, Pantalena LC, Liu XK, Gaffen SL, Liu H, Rohowsky-Kochan C, et al. 1, 25-Dihydroxyvitamin D3 ameliorates Th17 autoimmunity via transcriptional modulation of interleukin-17A. Molecular Cellular biol. 2011;31(17):3653-69.

Palmer MT, Lee YK, Maynard CL, Oliver JR, Bikle DD, Jetten AM, et al. Lineage-specific effects of 1, 25-dihydroxyvitamin D3 on the development of effector CD4 T cells. J Biologic Chemist. 2011;286(2):997-1004.

Kawakami-Tani T, Fukawa E, Tanaka H, Abe Y, Makino I. Effect of 1α-hydroxyvitamin D3 on serum levels of thyroid hormones in hyperthyroid patients with untreated graves' disease. Metabolism. 1997;46(10):1184-8.

Çamurdan OM, Döğer E, Bideci A, Çelik N, Cinaz P. Vitamin D status in children with Hashimoto thyroiditis. J Pediatr Endocrinol Metabol. 2012;25(5-6):467-70.

Fawzy E, Al-Sayed Mohamed S, El-Rabat AM. Hypovitaminosis D In Autoimmune Hypothyroidism. J Am Sci. 2013;99:60-5.

Shin DY, Kim KJ, Kim D, Hwang S, Lee EJ. Low serum vitamin D is associated with anti-thyroid peroxidase antibody in autoimmune thyroiditis. Yonsei Medic J. 2014;55(2):476-81.

Kivity S, Agmon-Levin N, Zisappl M, Shapira Y, Nagy EV, Dankó K, et al. Vitamin D and autoimmune thyroid diseases. Cellular Molecular Immunol. 2011;8(3):243-7.

Tamer G, Arik S, Tamer I, Coksert D. Relative vitamin D insufficiency in Hashimoto's thyroiditis. Thyroid. 2011;21(8):891-6.

Kiran B, Prema A, Thilagavathi R, Rani RJ. Serum 25-Hydroxy Vitamin D, Calcium, Phosphorus and Alkaline Phosphatase Levels In Healthy Adults Above the age of 20 Living in Potheri Village of Kancheepuram District, Tamilnadu. J Appl Pharmaceut Sci. 2014;4(12)30-4.

Downloads

Published

2017-08-23

Issue

Section

Original Research Articles