| Objectives By measuring serum 25(OH)D level,thyroid function antibody index and thyroid ultrasound in patients with initial Graves’ disease,the relationship between serum25(OH)D level and thyroid function,antibody index and ultrasound results in different patients was observed.Multivariate regression analysis was performed on the above indicators to clarify the effects of different baseline 25(OH)D levels on the changes of TRAB and TPOAb in patients after drug treatment,so as to provide theoretical basis for the disease assessment and prognosis of Graves’ disease.Methods Patients with Graves disease diagnosed in the Department of Endocrinology,affiliated Hospital of North China University of Technology from July 2019 to July 2020 were collected.According to the serum 25(OH)D level,the patients with Graves disease were divided into 25(OH)D deficiency group(n=68),25(OH)D relative deficiency group(n=70)and 25(OH)D adequacy group(n=40).The general data of the patients and the results of various examinations were collected.Physical examination was performed to record the baseline serum 25(OH)D level,TRAb,TPOAb,Tg Ab,FT3,FT4,TSH and thyroid ultrasound results.During the follow-up,the recovery time of FT3,FT4,TSH and TRAb and TPOAb indexes of Graves disease patients with different 25(OH)D levels after drug treatment were recorded.All the data were integrated and the corresponding database was established.Finally,statistical analysis was carried out.The counting data were tested by 2-test,the measurement data were compared by single factor analysis of variance,the two-factor repeated measurement variance analysis was used to compare the mean of the main observation indexes at different observation points,and the linear regression model was used in multi-factor analysis.the results were obtained and analyzed.Results A total of 207 eligible Graves’ disease patients were included in the study,including 27 patients who dropped out midway or were lost to follow-up.A total of 180 patients were enrolled and followed up,and the patients were divided into three groups according to 25(OH)D level.1.Three groups of patients with baseline survey on age,sex,smoking,drinking,whether hypertension,exophthalmos,thyroid nodules,and thyroid artery diameter,artery flow velocity difference has no statistical significance(P>0.05),FT3,FT4 levels and thyroid ultrasonic volume and 25(OH)D levels were significantly negative correlation(P<0.05),There was a significant positive correlation between TSH and 25(OH)D.2.The time required for FT3,FT4 and TSH to return to normal in patients with Graves’ disease after methimazole treatment was earlier in the 25(OH)D normal group than in the 25(OH)D deficient group than in the 25(OH)D deficient group(P<0.05).3.The comparison of TRAb and TPOAb levels between the three groups before treatment showed statistically significant differences(P<0.05).Pair comparison showed that the levels of Trab and TPOAb in the 25(OH)D deficiency group were higher than those in the 25(OH)D deficiency group,and those in the 25(OH)D deficiency group were higher than those in the 25(OH)D deficiency group(P<0.05).There was no significant difference in Tg Ab among the three groups(P>0.05).4.After treatment,the changes of TRAb and TPOAb showed statistically significant differences among different groups and at different time points(P<0.05).There was an interaction between groups and time,indicating that the level of TRAb after treatment was affected by both the level of 25(OH)D before treatment and the time of treatment.There was no interaction with TPOAb(P > 0.05),indicating that the gradual decrease of TPOAb level after treatment had nothing to do with 25(OH)D level,but was only influenced by drugs.5.A negative correlation was found between the higher baseline 25(OH)D level and the lower TRAb level after treatment by multiple linear regression after excluding other factors.Baseline 25(OH)D levels were not associated with post-treatment TPOAb levels.Conclusion TRAb and TPOAb were negatively correlated with baseline 25(OH)D levels in patients with newly diagnosed Graves’ disease before treatment.High levels of 25(OH)D were more conducive to remission of TRAb after treatment for Graves’ disease,but had no effect on TRAb level after treatment.Figure0;Table12;Reference 180... |
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