Skip to main content
Erschienen in: Endocrine 2/2017

21.09.2017 | Original Article

Vitamin D deficiency affects thyroid autoimmunity and dysfunction in iodine-replete area: Korea national health and nutrition examination survey

verfasst von: Mijin Kim, Eyun Song, Hye-Seon Oh, Suyeon Park, Hyemi Kwon, Min Ji Jeon, Won Gu Kim, Won Bae Kim, Young Kee Shong, Tae Yong Kim

Erschienen in: Endocrine | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We evaluated the effects of vitamin D levels and iodine intake on thyroid autoimmunity and dysfunction in the Korean population.

Methods

In this nationwide population-based study, data were obtained from the Korea National Health and Nutrition Examination Survey VI-1 and 2 (2013 and 2014), which was the first nationwide survey that measured both serum 25-hydroxy vitamin D [25(OH)D] levels and urinary iodine concentrations (UICs) in Korea. A total of 4181 participants who underwent laboratory tests for thyroid function, serum 25(OH)D levels, and UICs were included.

Results

Anti-thyroid peroxidase antibody (TPOAb) positivity was more prevalent in the vitamin D deficient group (9.1%) than the vitamin D insufficient and sufficient groups (5.3% each; P = 0.016). The rate of TPOAb positivity was significantly higher in the iodine deficient group (P = 0.032). Thyroid dysfunction was significantly more prevalent in the iodine excessive group than in the other groups in total (P = 0.016) and TPOAb negative participants (P = 0.007). In the vitamin D deficient group, excessive iodine intake was significantly associated with high prevalence of thyroid dysfunction in total and TPOAb negative participants (P = 0.021 and P = 0.033, respectively). In the vitamin D insufficient and sufficient groups, association between thyroid dysfunction and iodine intake disappeared in total and TPOAb negative participants.

Conclusions

This nationwide survey revealed a significant association between vitamin D deficiency and high prevalence of thyroid autoimmunity and dysfunction in participants with excessive iodine intake. Our findings might be helpful for elucidating the potential benefit of vitamin D supplements in TPOAb negative patients with excessive iodine intake.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
4.
Zurück zum Zitat H.S. Choi, H.J. Oh, H. Choi, W.H. Choi, J.G. Kim, K.M. Kim, K.J. Kim, Y. Rhee, S.K. Lim, Vitamin D insufficiency in Korea--a greater threat to younger generation: the Korea national health and nutrition examination survey (KNHANES) 2008. J. Clin. Endocrinol. Metab. 96(3), 643–651 (2011). https://doi.org/10.1210/jc.2010-2133 CrossRefPubMed H.S. Choi, H.J. Oh, H. Choi, W.H. Choi, J.G. Kim, K.M. Kim, K.J. Kim, Y. Rhee, S.K. Lim, Vitamin D insufficiency in Korea--a greater threat to younger generation: the Korea national health and nutrition examination survey (KNHANES) 2008. J. Clin. Endocrinol. Metab. 96(3), 643–651 (2011). https://​doi.​org/​10.​1210/​jc.​2010-2133 CrossRefPubMed
5.
Zurück zum Zitat P. Pludowski, M.F. Holick, S. Pilz, C.L. Wagner, B.W. Hollis, W.B. Grant, Y. Shoenfeld, E. Lerchbaum, D.J. Llewellyn, K. Kienreich, M. Soni, Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun. Rev. 12(10), 976–989 (2013). https://doi.org/10.1016/j.autrev.2013.02.004 CrossRefPubMed P. Pludowski, M.F. Holick, S. Pilz, C.L. Wagner, B.W. Hollis, W.B. Grant, Y. Shoenfeld, E. Lerchbaum, D.J. Llewellyn, K. Kienreich, M. Soni, Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun. Rev. 12(10), 976–989 (2013). https://​doi.​org/​10.​1016/​j.​autrev.​2013.​02.​004 CrossRefPubMed
11.
Zurück zum Zitat Q. Zhang, Z. Wang, M. Sun, M. Cao, Z. Zhu, Q. Fu, Y. Gao, J. Mao, Y. Li, Y. Shi, F. Yang, S. Zheng, W. Tang, Y. Duan, X. Huang, W. He, T. Yang, Association of high vitamin d status with low circulating thyroid-stimulating hormone independent of thyroid hormone levels in middle-aged and elderly males. Int. J. Endocrinol. 2014, 631819 (2014). https://doi.org/10.1155/2014/631819 PubMedPubMedCentral Q. Zhang, Z. Wang, M. Sun, M. Cao, Z. Zhu, Q. Fu, Y. Gao, J. Mao, Y. Li, Y. Shi, F. Yang, S. Zheng, W. Tang, Y. Duan, X. Huang, W. He, T. Yang, Association of high vitamin d status with low circulating thyroid-stimulating hormone independent of thyroid hormone levels in middle-aged and elderly males. Int. J. Endocrinol. 2014, 631819 (2014). https://​doi.​org/​10.​1155/​2014/​631819 PubMedPubMedCentral
12.
Zurück zum Zitat I. Clinckspoor, A.C. Gerard, J. Van Sande, M.C. Many, L. Verlinden, R. Bouillon, G. Carmeliet, C. Mathieu, A. Verstuyf, B. Decallonne, The vitamin d receptor in thyroid development and function. Eur. Thyr. J. 1(3), 168–175 (2012). https://doi.org/10.1159/000342363 CrossRef I. Clinckspoor, A.C. Gerard, J. Van Sande, M.C. Many, L. Verlinden, R. Bouillon, G. Carmeliet, C. Mathieu, A. Verstuyf, B. Decallonne, The vitamin d receptor in thyroid development and function. Eur. Thyr. J. 1(3), 168–175 (2012). https://​doi.​org/​10.​1159/​000342363 CrossRef
14.
Zurück zum Zitat P. Laurberg, K.M. Pedersen, A. Hreidarsson, N. Sigfusson, E. Iversen, P.R. Knudsen, Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J. Clin. Endocrinol. Metab. 83(3), 765–769 (1998). https://doi.org/10.1210/jcem.83.3.4624 CrossRefPubMed P. Laurberg, K.M. Pedersen, A. Hreidarsson, N. Sigfusson, E. Iversen, P.R. Knudsen, Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J. Clin. Endocrinol. Metab. 83(3), 765–769 (1998). https://​doi.​org/​10.​1210/​jcem.​83.​3.​4624 CrossRefPubMed
15.
Zurück zum Zitat I. Bulow Pedersen, N. Knudsen, T. Jorgensen, H. Perrild, L. Ovesen, P. Laurberg, Large differences in incidences of overt hyper- and hypothyroidism associated with a small difference in iodine intake: a prospective comparative register-based population survey. J. Clin. Endocrinol. Metab. 87(10), 4462–4469 (2002). https://doi.org/10.1210/jc.2002-020750 CrossRefPubMed I. Bulow Pedersen, N. Knudsen, T. Jorgensen, H. Perrild, L. Ovesen, P. Laurberg, Large differences in incidences of overt hyper- and hypothyroidism associated with a small difference in iodine intake: a prospective comparative register-based population survey. J. Clin. Endocrinol. Metab. 87(10), 4462–4469 (2002). https://​doi.​org/​10.​1210/​jc.​2002-020750 CrossRefPubMed
16.
Zurück zum Zitat Y. Li, D. Teng, Z. Shan, X. Teng, H. Guan, X. Yu, C. Fan, W. Chong, F. Yang, H. Dai, X. Gu, Y. Yu, J. Mao, D. Zhao, J. Li, Y. Chen, R. Yang, C. Li, W. Teng, Antithyroperoxidase and antithyroglobulin antibodies in a five-year follow-up survey of populations with different iodine intakes. J. Clin. Endocrinol. Metab. 93(5), 1751–1757 (2008). https://doi.org/10.1210/jc.2007-2368 CrossRefPubMed Y. Li, D. Teng, Z. Shan, X. Teng, H. Guan, X. Yu, C. Fan, W. Chong, F. Yang, H. Dai, X. Gu, Y. Yu, J. Mao, D. Zhao, J. Li, Y. Chen, R. Yang, C. Li, W. Teng, Antithyroperoxidase and antithyroglobulin antibodies in a five-year follow-up survey of populations with different iodine intakes. J. Clin. Endocrinol. Metab. 93(5), 1751–1757 (2008). https://​doi.​org/​10.​1210/​jc.​2007-2368 CrossRefPubMed
18.
Zurück zum Zitat W. Teng, Z. Shan, X. Teng, H. Guan, Y. Li, D. Teng, Y. Jin, X. Yu, C. Fan, W. Chong, F. Yang, H. Dai, Y. Yu, J. Li, Y. Chen, D. Zhao, X. Shi, F. Hu, J. Mao, X. Gu, R. Yang, Y. Tong, W. Wang, T. Gao, C. Li, Effect of iodine intake on thyroid diseases in China. N. Engl. J. Med. 354(26), 2783–2793 (2006). https://doi.org/10.1056/NEJMoa054022 CrossRefPubMed W. Teng, Z. Shan, X. Teng, H. Guan, Y. Li, D. Teng, Y. Jin, X. Yu, C. Fan, W. Chong, F. Yang, H. Dai, Y. Yu, J. Li, Y. Chen, D. Zhao, X. Shi, F. Hu, J. Mao, X. Gu, R. Yang, Y. Tong, W. Wang, T. Gao, C. Li, Effect of iodine intake on thyroid diseases in China. N. Engl. J. Med. 354(26), 2783–2793 (2006). https://​doi.​org/​10.​1056/​NEJMoa054022 CrossRefPubMed
21.
Zurück zum Zitat X. Teng, Z. Shan, Y. Chen, Y. Lai, J. Yu, L. Shan, X. Bai, Y. Li, N. Li, Z. Li, S. Wang, Q. Xing, H. Xue, L. Zhu, X. Hou, C. Fan, W. Teng, More than adequate iodine intake may increase subclinical hypothyroidism and autoimmune thyroiditis: a cross-sectional study based on two Chinese communities with different iodine intake levels. Eur. J. Endocrinol. 164(6), 943–950 (2011). https://doi.org/10.1530/eje-10-1041 CrossRefPubMed X. Teng, Z. Shan, Y. Chen, Y. Lai, J. Yu, L. Shan, X. Bai, Y. Li, N. Li, Z. Li, S. Wang, Q. Xing, H. Xue, L. Zhu, X. Hou, C. Fan, W. Teng, More than adequate iodine intake may increase subclinical hypothyroidism and autoimmune thyroiditis: a cross-sectional study based on two Chinese communities with different iodine intake levels. Eur. J. Endocrinol. 164(6), 943–950 (2011). https://​doi.​org/​10.​1530/​eje-10-1041 CrossRefPubMed
23.
Zurück zum Zitat Z. Shan, L. Chen, X. Lian, C. Liu, B. Shi, L. Shi, N. Tong, S. Wang, J. Weng, J. Zhao, X. Teng, X. Yu, Y. Lai, W. Wang, C. Li, J. Mao, Y. Li, C. Fan, W. Teng, Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for 16 years in China: A cross-sectional study in 10 cities. Thyroid. 26(8), 1125–1130 (2016). https://doi.org/10.1089/thy.2015.0613 CrossRefPubMed Z. Shan, L. Chen, X. Lian, C. Liu, B. Shi, L. Shi, N. Tong, S. Wang, J. Weng, J. Zhao, X. Teng, X. Yu, Y. Lai, W. Wang, C. Li, J. Mao, Y. Li, C. Fan, W. Teng, Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for 16 years in China: A cross-sectional study in 10 cities. Thyroid. 26(8), 1125–1130 (2016). https://​doi.​org/​10.​1089/​thy.​2015.​0613 CrossRefPubMed
24.
Zurück zum Zitat W.G. Kim, W.B. Kim, G. Woo, H. Kim, Y. Cho, T.Y. Kim, S.W. Kim, M.H. Shin, J.W. Park, H.L. Park, K. Oh, J.H. Chung, Thyroid stimulating hormone reference range and prevalence of thyroid dysfunction in the Korean population: Korea national health And nutrition examination survey 2013 to 2015. Endocrinol. Metab. 32(1), 106–114 (2017). https://doi.org/10.3803/EnM.2017.32.1.106 CrossRef W.G. Kim, W.B. Kim, G. Woo, H. Kim, Y. Cho, T.Y. Kim, S.W. Kim, M.H. Shin, J.W. Park, H.L. Park, K. Oh, J.H. Chung, Thyroid stimulating hormone reference range and prevalence of thyroid dysfunction in the Korean population: Korea national health And nutrition examination survey 2013 to 2015. Endocrinol. Metab. 32(1), 106–114 (2017). https://​doi.​org/​10.​3803/​EnM.​2017.​32.​1.​106 CrossRef
26.
Zurück zum Zitat J.G. Hollowell, N.W. Staehling, W.H. Hannon, D.W. Flanders, E.W. Gunter, G.F. Maberly, L.E. Braverman, S. Pino, D.T. Miller, P.L. Garbe, D.M. DeLozier, R.J. Jackson, Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from national health and nutrition examination surveys I and III (1971-1974 and 1988-1994). J. Clin. Endocrinol. Metab. 83(10), 3401–3408 (1998). https://doi.org/10.1210/jcem.83.10.5168 PubMed J.G. Hollowell, N.W. Staehling, W.H. Hannon, D.W. Flanders, E.W. Gunter, G.F. Maberly, L.E. Braverman, S. Pino, D.T. Miller, P.L. Garbe, D.M. DeLozier, R.J. Jackson, Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from national health and nutrition examination surveys I and III (1971-1974 and 1988-1994). J. Clin. Endocrinol. Metab. 83(10), 3401–3408 (1998). https://​doi.​org/​10.​1210/​jcem.​83.​10.​5168 PubMed
28.
Zurück zum Zitat Z. Baloch, P. Carayon, B. Conte-Devolx, L.M. Demers, U. Feldt-Rasmussen, J.F. Henry, V.A. LiVosli, P. Niccoli-Sire, R. John, J. Ruf, P.P. Smyth, C.A. Spencer, J.R. Stockigt, Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 13(1), 3–126 (2003). https://doi.org/10.1089/105072503321086962 CrossRefPubMed Z. Baloch, P. Carayon, B. Conte-Devolx, L.M. Demers, U. Feldt-Rasmussen, J.F. Henry, V.A. LiVosli, P. Niccoli-Sire, R. John, J. Ruf, P.P. Smyth, C.A. Spencer, J.R. Stockigt, Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 13(1), 3–126 (2003). https://​doi.​org/​10.​1089/​1050725033210869​62 CrossRefPubMed
29.
Zurück zum Zitat J.R. Garber, R.H. Cobin, H. Gharib, J.V. Hennessey, I. Klein, J.I. Mechanick, R. Pessah-Pollack, P.A. Singer, K.A. Woeber, Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American association of clinical endocrinologists and the American thyroid association. Endocr. Pract. 18(6), 988–1028 (2012). https://doi.org/10.4158/ep12280.gl CrossRefPubMed J.R. Garber, R.H. Cobin, H. Gharib, J.V. Hennessey, I. Klein, J.I. Mechanick, R. Pessah-Pollack, P.A. Singer, K.A. Woeber, Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American association of clinical endocrinologists and the American thyroid association. Endocr. Pract. 18(6), 988–1028 (2012). https://​doi.​org/​10.​4158/​ep12280.​gl CrossRefPubMed
31.
Zurück zum Zitat J.Y. Joung, Y.Y. Cho, S.M. Park, T.H. Kim, N.K. Kim, S.Y. Sohn, S.W. Kim, J.H. Chung, Effect of iodine restriction on thyroid function in subclinical hypothyroid patients in an iodine-replete area: a long period observation in a large-scale cohort. Thyroid. 24(9), 1361–1368 (2014). https://doi.org/10.1089/thy.2014.0046 CrossRefPubMed J.Y. Joung, Y.Y. Cho, S.M. Park, T.H. Kim, N.K. Kim, S.Y. Sohn, S.W. Kim, J.H. Chung, Effect of iodine restriction on thyroid function in subclinical hypothyroid patients in an iodine-replete area: a long period observation in a large-scale cohort. Thyroid. 24(9), 1361–1368 (2014). https://​doi.​org/​10.​1089/​thy.​2014.​0046 CrossRefPubMed
34.
36.
Zurück zum Zitat B. Jastrup, L. Mosekilde, F. Melsen, B. Lund, B. Lund, O.H. Sorensen, Serum levels of vitamin D metabolites and bone remodelling in hyperthyroidism. Metabolism. 31(2), 126–132 (1982)CrossRefPubMed B. Jastrup, L. Mosekilde, F. Melsen, B. Lund, B. Lund, O.H. Sorensen, Serum levels of vitamin D metabolites and bone remodelling in hyperthyroidism. Metabolism. 31(2), 126–132 (1982)CrossRefPubMed
37.
Zurück zum Zitat A.M. Mackawy, B.M. Al-Ayed, B.M. Al-Rashidi, Vitamin d deficiency and its association with thyroid disease. Int. J. Health. Sci. 7(3), 267–275 (2013)CrossRef A.M. Mackawy, B.M. Al-Ayed, B.M. Al-Rashidi, Vitamin d deficiency and its association with thyroid disease. Int. J. Health. Sci. 7(3), 267–275 (2013)CrossRef
38.
Zurück zum Zitat L. Rasooly, C.L. Burek, N.R. Rose, Iodine-induced autoimmune thyroiditis in NOD-H-2h4 mice. Clin. Immunol. Immunopathol. 81(3), 287–292 (1996)CrossRefPubMed L. Rasooly, C.L. Burek, N.R. Rose, Iodine-induced autoimmune thyroiditis in NOD-H-2h4 mice. Clin. Immunol. Immunopathol. 81(3), 287–292 (1996)CrossRefPubMed
Metadaten
Titel
Vitamin D deficiency affects thyroid autoimmunity and dysfunction in iodine-replete area: Korea national health and nutrition examination survey
verfasst von
Mijin Kim
Eyun Song
Hye-Seon Oh
Suyeon Park
Hyemi Kwon
Min Ji Jeon
Won Gu Kim
Won Bae Kim
Young Kee Shong
Tae Yong Kim
Publikationsdatum
21.09.2017
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 2/2017
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-017-1425-z

Weitere Artikel der Ausgabe 2/2017

Endocrine 2/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.