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Serum 25-hydroxyvitamin D predict prognosis in radioiodine therapy of Graves’ disease

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Abstract

Purpose

To investigate serum 25-hydroxyvitamin D 25(OH)D status and assess the predictability of outcome in patients with Graves’ disease (GD) who received a patient-specific calculated dose of radioiodine therapy (RIT).

Methods

128 patients with GD who received RIT from July 2010 to September 2010 were included. Pre-therapy serum levels of 25(OH)D, calcium, phosphorus, parathyroid hormone, free triiodothyronine, free thyroxine, thyroid stimulating hormone and creatinine were measured. 60 age- and BMI-matched healthy subjects were chosen as the normal control group.

Results

Post-therapy follow-up results revealed that therapy failed in 25.00 % of the patients. Serum 25(OH)D levels were found to be significantly lower in patients who failed in therapy. The prevalence of vitamin D deficiency in GD patients was significantly higher compared with control subjects (56.25 vs. 10.00 %, P < 0.001), and therapy failed in 27 (37.50 %) of these patients whose serum 25(OH)D levels < 20 ng/ml. Out of the 56 patients (43.75 %) in whom serum 25(OH)D levels ≥20 ng/ml, therapy was unsuccessful in only 5 (8.93 %). Cox regression analysis suggested that serum 25(OH)D levels <20 ng/ml might be an independent risk factor for predicting failure of RIT in GD patients (relative risk = 8.83, 95 % confidence interval = 3.34–23.38, P < 0.001).

Conclusions

Serum 25(OH)D levels were lower in patients who failed than in those who succeeded in RIT of GD. Therefore, serum 25(OH)D < 20 ng/ml might be an independent risk factor for predicting failure of RIT in GD patients.

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Acknowledgments

The authors thank Dr. Amal Kumar Ghimeray and Prof. Weicheng Hu for assisting in preparation of this manuscript.

Conflict of interest

The authors have no conflict of interests.

Ethical approval

Ethical approval was given by the medical ethics committee of Huai’an First People’s Hospital, Nanjing Medical University, with the following reference number: IRB-PJ2010-002-01. All procedures performed in studies involving human participants were in accordance with the ethical standards of the research committee of University.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Author notes

    Authors and Affiliations

    1. Department of Gerontology, Huai’an First People’s Hospital, Nanjing Medical University, 6 Beijing Xi Road, Huai’an, 223300, Jiangsu, China

      X. Li, Z. Lu, M. Chen, J. Tan & X. Fang

    2. Department of Urology, Huai’an First People’s Hospital, Nanjing Medical University, 6 Beijing Road, Huai’an, 223300, Jiangsu, China

      G. Wang

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    1. X. Li
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    2. G. Wang
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    3. Z. Lu
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    Correspondence to X. Fang.

    Additional information

    X. Li and G. Wang contributed equally to this work.

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    Li, X., Wang, G., Lu, Z. et al. Serum 25-hydroxyvitamin D predict prognosis in radioiodine therapy of Graves’ disease. J Endocrinol Invest 38, 753–759 (2015). https://doi.org/10.1007/s40618-015-0252-4

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    • DOI: https://doi.org/10.1007/s40618-015-0252-4

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