Vitamin D, selenium in type 2 diabetes and Hashimoto&apos;s thyroiditis: Is it effective?

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Abstract

The study by Feng et al, explores treatment approaches for these coexisting conditions. It emphasizes the potential advantages of selenium and vitamin D supplementation but also raises methodological and patient selection concerns. Findings indicate a complex interplay between interventions and disease markers, prompting the need for further research. Despite limitations, the study offers valuable insights into managing the intricate relationship between type 2 diabetes mellitus and Hashimoto's thyroiditis. The authors' contributions shed light on potential treatment avenues, although careful consideration of study design and patient characteristics is warranted for future investigations in this domain.

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Most cited references 5

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Vitamin D and type 2 diabetes: a systematic review.

J Mitri, M D Muraru, A G Pittas (2011)

Vitamin D may modify the risk of type 2 diabetes mellitus. The aim of this review was to examine the association between vitamin D status and incident type 2 diabetes, and the effect of vitamin D supplementation on glycemic outcomes. We performed a systematic review of English-language studies using MEDLINE through February 2011. Longitudinal cohort studies reporting associations between vitamin D status and incident type 2 diabetes, and randomized controlled trials (RCTs) of vitamin D supplementation, were included. Study characteristics and results were extracted, and study quality was assessed. A total of 8 observational cohort studies and 11 RCTs were included. In meta-analyses of observational studies, vitamin D intake>500 international units (IU)/day decreased the risk of type 2 diabetes by 13% compared with vitamin D intake 25 ng/ml) had a 43% lower risk of developing type 2 diabetes (95% confidence interval 24, 57%) compared with those in the lowest group (<14 ng/ml). In post hoc analyses from eight trials among participants with normal glucose tolerance at baseline and in three small underpowered (n=32-62) trials of patients with established type 2 diabetes, there was no effect of vitamin D supplementation on glycemic outcomes. In two trials among patients with baseline glucose intolerance, vitamin D supplementation improved insulin resistance. Vitamin D may play a role in type 2 diabetes; however, to better define the role of vitamin D in the development and progression of type 2 diabetes, high-quality observational studies and RCTs that measure blood 25-hydroxyvitamin D concentration and clinically relevant glycemic outcomes are needed.

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Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment

Joanna Klubo-Gwiezdzinska, Leonard Wartofsky (2022)

Hashimoto thyroiditis (HT) is a common autoimmune disorder, affecting women 7–10 times more often than men, that develops because of genetic susceptibility, X chromosome inactivation patterns modulated by environmental factors as well as microbiome composition, and leads to an imbalance in self-tolerance mechanisms. The consequential thyroid infiltration by lymphocytes, potentiated by antibody-mediated autoimmune response through the antibodies against thyroid peroxidase (TPOAbs), leads to a destruction of thyrocytes. The presence of TPOAbs is associated with a 2 to 4-fold increase in the risk of recurrent miscarriages and preterm birth in pregnant women. The clinical presentation of HT includes: (A) thyrotoxicosis, when stored thyroid hormones are released to circulation from destroyed thyroid follicles; (B) euthyroidism, when preserved thyroid tissue compensates for destroyed thyrocytes; and (C) hypothyroidism, when thyroid hormone production by the affected thyroid gland is insufficient. The management of Hashitoxicosis is based on symptoms control usually with β-blockers, euthyroidism requires periodical thyroid stimulating hormone measurements to assess for progression to hypothyroidism, and hypothyroidism is treated with thyroid hormone replacement therapy. The dose of levothyroxine (LT4) used for treatment is based on the degree of preserved thyroid functionality and lean body mass, and usually ranges from 1.4 to 1.8 mcg/kg/day. There is insufficient evidence to recommend for or against therapy with triiodothyronine (T3), apart from in pregnancy when only levothyroxine is indicated, as T3 does not sufficiently cross fetal blood-brain barrier. HT is associated with 1.6 times higher risk of papillary thyroid cancer and 60 times higher risk of thyroid lymphoma than in general the population.

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Vitamin D and Hashimoto's Thyroiditis: Observations from CROHT Biobank.

Maja Cvek, Dean Kaličanin, Ana Barić … (2021)

The aims of this study were to evaluate: (1) associations of vitamin D with the presence/severity of Hashimoto's thyroiditis (HT) and (2) correlations of vitamin D with thyroid-related phenotypes. Total 25(OH)D (vitamin D in the text) was measured from stored serum samples of 461 HT patients and 176 controls from a Croatian Biobank of HT patients (CROHT). (1) Vitamin D levels, and proportions of vitamin D deficiency, were compared between HT cases and controls. HT patients were additionally divided into two groups (MILD and OVERT) to take into account HT severity. (2) Correlations between vitamin D and 10 clinical phenotypes in all HT patients and two subgroups of HT patients were tested using the Spearman correlation test. Our analyses were adjusted for age, gender, BMI, smoking status and seasonality of blood sampling. (1) No significant differences in vitamin D levels, or proportions of vitamin D deficiency, were detected between HT patients of all disease stages and controls. However, a nominally significant difference in vitamin D levels between MILD and OVERT subgroups (OR = 1.038, p = 0.023) was observed. Proportions of individuals with vitamin D deficiency during winter-spring were high: all HT cases (64.69%), MILD (60.64%), OVERT (68.7%), controls (60.79%). (2) A nominally significant negative correlation between vitamin D and TSH in all HT patients (r = -0.113, p = 0.029) and a positive correlation between vitamin D and systolic blood pressure in OVERT HT patients (r = 0.205, p = 0.025) were identified. Our study indicates that there is no association between vitamin D and HT; however, there may be a subtle decrease in vitamin D levels associated with overt hypothyroidism.

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Author and article information

Contributors

Kotha Sugunakar Reddy

Vishakha Jain

Sakthivadivel Varatharajan

Janardhana Reddy Pallavali

Journal

Journal ID (nlm-ta): World J Diabetes

Journal ID (publisher-id): WJD

Title: World Journal of Diabetes

Publisher: Baishideng Publishing Group Inc

ISSN (Electronic): 1948-9358

Publication date (Print): 15 May 2024

Publication date (Electronic): 15 May 2024

Volume: 15

Issue: 5

Pages: 1048-1050

Affiliations

Department of General Medicine, All India Institute of Medical Sciences, Telangana, Hyderabad 508126, India. sugs.doc@ 123456gmail.com

Department of General Medicine, All India Institute of Medical Sciences, Telangana, Hyderabad 508126, India

Author notes

Author contributions: Reddy KS designed and formulated the research; Reddy KS, Jain V, Varatharajan S performed study; Reddy KS, Pallavali JR analyzed data; Reddy KS wrote the letter; Jain V, Varatharajan S revised the letter.

Corresponding author: Kotha Sugunakar Reddy, MBBS, MD, Doctor, Occupational Physician, Department of General Medicine, All India Institute of Medical Sciences, Bibinagar, NH 163, Hyderabad Metropolitan Region, Yadadri Bhuvanagiri District, Telangana, Hyderabad 508126, India. sugs.doc@ 123456gmail.com

Article

Other ID: jWJD.v15.i5.pg1048 Publisher-manuscript ID: 93672

DOI: 10.4239/wjd.v15.i5.1048

PMC ID: 11099363

PubMed ID: 38766428

SO-VID: 580ac73d-8539-4070-82d5-58d6fcbacc2e

License:

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

History

Date received : 3 March 2024

Date revision received : 3 April 2024

Date accepted : 10 April 2024

Vitamin D, selenium in type 2 diabetes and Hashimoto's thyroiditis: Is it effective?

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Trace Elements and Electrolytes

Most cited references 5

Vitamin D and type 2 diabetes: a systematic review.

Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment

Vitamin D and Hashimoto's Thyroiditis: Observations from CROHT Biobank.

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