Title:Low 25 Hydroxyvitamin D Levels are Independently Associated with Autoimmune Thyroiditis in a Cohort of Apparently Healthy Overweight and Obese Subjects
Volume: 18
Issue: 6
Author(s): Giovanni De Pergola*, Vincenzo Triggiani, Nicola Bartolomeo, Vito Angelo Giagulli, Michele Anelli, Michele Masiello, Vittoria Candita, Dario De Bellis and Franco Silvestris
Affiliation:
- Clinical Nutrition Unit, Medical Oncology, Department of Internal Medicine and Clinical Oncology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, 70124 Bari,Italy
Keywords:
Vitamin D, autoimmune thyroiditis, obesity, overweight, subjects, 25(OH)D, TSH.
Abstract: Background: Low vitamin D levels have been associated with autoimmune disorders and,
then, with the Hashimoto’s autoimmune thyroiditis (AT), the most common autoimmune disease. Obesity
is characterized by lower vitamin D levels and higher risk to develop autoimmune diseases. The
aim of the study was to examine the possibility of an association between AT and decreased 25(OH)
vitamin D (25(OH)D) levels in a cohort of otherwise healthy overweight and obese subjects.
Materials and Methods: Two hundred sixty one overweight subjects (mean age: 40.9 + 15.6 years,
200 women and 61 men) were enrolled for this study. All of them did not show any clinically evident
metabolic or chronic diseases (i.e. hypertension, diabetes mellitus, renal failure, etc.) and did not use
any kind of drug. Serum fasting levels of 25(OH)D, anti-thyroid peroxidase (TPO-Ab) and antithyroglobulin
(TG-Ab) antibodies, free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating
hormone (TSH), glucose, uric acid and lipids (triglycerides, total, HDL and LDL cholesterol) were
measured. Demographic, anthropometric and clinical parameters (age, body mass index (BMI), waist
circumference, blood pressure) were also assessed.
Results: Fifty five percent of all subjects (144/261) showed vitamin D deficiency (≤ 20 ng/ml), and
17% of all individuals had AT (45/261). The percentage of subjects having vitamin D deficiency was
significantly higher among those with AT (31 of 45, 69%) than in those without AT (113 of 216, 52%)
(χ2= 4.1, p = 0.042). TSH levels were significantly higher in subjects with AT as compared to those
without AT (M-W = 7715.5, p < 0.0001). The final logistic model of a multivariate analysis, performed
with AT as the dependent variable and sex, age, BMI category, 25(OH)D category, and HDLcholesterol
and TSH levels as the independent ones, showed that patients with AT were more likely to
have deficiency of 25(OH)D (p = 0.031) and higher TSH (p < 0.005) levels. Seventy six percent of
patients with vitamin D deficiency (110 of 144) were obese whereas 59% of patients without vitamin
D deficiency were obese (69 of 117) (p=0.003). Waist circumference was different between subjects
with deficiency or normal 25 (OH) D levels (p=0.016).
Conclusion: This study clearly shows that vitamin D deficiency is significantly associated to AT in
overweight and obese subjects and confirms that obesity is associated to lower vitamin D circulating
levels. We suggest that screening for AT should be suggested in all obese subjects with vitamin D
deficiency and that vitamin D deficiency should be researched in all obese subjects with AT.
