Goal: To determine the level of vitamin D and its pathogenetic role in children with Graves disease living in the territory of Uzbekistan. The study included 16 children and adolescents of 917 years old with the first time identified Graves disease. The control group included 12 children without thyroid pathology. The concentration of total vitamin D, TSH, fT4 and Antibodies to TSH receptors (TRAb) in serum was determined using a Cobas e 411 Hitachi closed-type immunochemical analyzer from HoffmanLeRoche (Switzerland) and its reagents. Vitamin D deficiency was determined at its serum level <20 ng/ml, insufficient at a level of 2030 ng / ml. Statistical processing of the results was performed using the Microsoft Statistica 6.1. The significance of differences was established at P <0.05.
Results: At the time of the first treatment, all children with Graves disease had a pronounced clinic of moderate thyrotoxicosis in a state of decompensation, all patients have high TRAb values, the interval of which was 2.540.0 IU/l with a median (Me) of 11.6. Despite the fact that the number of sunny days per year exceeds 300, the content of vitamin D (15.7±4.7 ng/ml) in children with newly diagnosed Graves disease was significantly lower than the control group (29.3±4.8 ng/ml, P <0.05). All children with thyrotoxicosis had an indicator of vitamin D in the serum of less than 30 ng/ml, while a pronounced deficiency of vitamin D was detected in 68.8% (11), the remaining 31.2% (5) had insufficient levels. In the control group of children with vitamin D deficiency it was not diagnosed, but 66.7% (8) had insufficient serum levels. The results of the correlation analysis indicate the presence in patients with Graves disease significant feedback between the content of vitamin D and the level of TRAb (r = −0.38; P <0.05).
Conclusion: Low levels of vitamin D may be the primary factor involved in the pathogenesis of the disease. Further in-depth study of this problem is needed in order to develop effective methods of treatment of Graves disease in children.
27 - 29 Nov 2019
British Society for Paediatric Endocrinology and Diabetes