Association between serum vitamin levels and differentiated thyroid cancer

doi:10.3877/cma.j.issn.1674-0785.2024.07.004

Abstract

Abstract:

Objective

To investigate the association between serum vitamin levels and differentiated thyroid cancer （DTC）.

Methods

We retrospectively analyzed 50 patients with differentiated thyroid cancer admitted to the Fourth Hospital of Hebei Medical University from January 2021 to December 2022. Fifty patients with nodular goiter who underwent thyroidectomy were included as controls. The levels of vitamins A， E， and D in serum， as well as the concentration of methylmalonic acid （MMA）， were by high performance liquid chromatography-tandem mass spectrometry （LC-MS/MS）.

Results

The serum concentrations of vitamin A and E in patients with DTC were significantly lower than those of controls（P＜0.05）. Patients with BRAF-positive DTC had significantly serum vitamin D concentrations than those with BRAF-negative DTC （P＜0.05）. As the clinical stage of DTC patients increased， vitamin D concentrations decreased significantly （P＜0.05）， indicating an increase in disease severity.

Conclusion

Serum vitamin levels are associated with the occurrence and disease progression of DTC， especially vitamin D. This finding provides new ideas for future prevention and treatment of DTC， including monitoring and possible supplementation of vitamins to improve patients’ quality of life and prognosis.

Key words: Serum vitamin levels, Differentiated thyroid cancer, Clinical stage, T stage, Correlation

Fei Yang, Tengfei Liu, Zhijun Zhao, Ruicong Li, Jie Zhang, Yan Liu, Zhen Zhao. Association between serum vitamin levels and differentiated thyroid cancer[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(07): 633-640.

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https://zhlcyszz.cma-cmc.com.cn/EN/Y2024/V18/I07/633

Figures/Tables 5

特征	DTC组（n=50）	对照组（n=50）	F/χ ²值	P值
性别［例（%）］			1.300	0.361
男性	12（24.0）	11（22.0）
女性	38（76.0）	39（78.0）
年龄（岁， $\bar{x}$ ±s）	51.33±9.65	52.15±8.68	1.236	0.461
TSH（μIU/ml， $\bar{x}$ ±s）	1.82±0.83	1.62±0.65	1.631	0.090
游离T4（pmol/L， $\bar{x}$ ±s）	1.25±0.46	1.26±0.51	1.229	0.473
游离T3（pmol/L， $\bar{x}$ ±s）	1.13±0.57	1.33±0.65	1.300	0.361
BMI	21.79±3.51	19.50±4.61	1.725	0.592
结节数［例（%）］			2.554	0.110
单个	42（84.0）	47（94.0）
多发	8（16.0）	3（6.0）
总蛋白（g/dl）	7.3（6.9～7.9）	7.2（6.7～7.8）	1.199	0.261
TC（mmol/L， $\bar{x}$ ±s）	6.12±1.58	4.43±0.96
HDL（mmol/L， $\bar{x}$ ±s）	1.21±0.36	2.26±0.73
LDL（mmol/L， $\bar{x}$ ±s）	1.46±0.53	3.93±1.25
手术方式［例（%）］			1.438	0.395
甲状腺全切除术	6（12.0）	41（82.0）
甲状腺次全切除术	-	5（10.0）
单侧腺叶切除术+Bilateral CCLND	-	4（8.0）
甲状腺全切除术+Unilateral CCLND	26（52.0）	-
甲状腺全切除术+Bilateral CCLND	13（26.0）	-
甲状腺全切除术+Bilateral CCLND+CLND	5（10.0）	-

特征	DTC组（n=50）	对照组（n=50）	F/χ ²值	P值
性别［例（%）］			1.300	0.361
男性	12（24.0）	11（22.0）
女性	38（76.0）	39（78.0）
年龄（岁， $\bar{x}$ ±s）	51.33±9.65	52.15±8.68	1.236	0.461
TSH（μIU/ml， $\bar{x}$ ±s）	1.82±0.83	1.62±0.65	1.631	0.090
游离T4（pmol/L， $\bar{x}$ ±s）	1.25±0.46	1.26±0.51	1.229	0.473
游离T3（pmol/L， $\bar{x}$ ±s）	1.13±0.57	1.33±0.65	1.300	0.361
BMI	21.79±3.51	19.50±4.61	1.725	0.592
结节数［例（%）］			2.554	0.110
单个	42（84.0）	47（94.0）
多发	8（16.0）	3（6.0）
总蛋白（g/dl）	7.3（6.9～7.9）	7.2（6.7～7.8）	1.199	0.261
TC（mmol/L， $\bar{x}$ ±s）	6.12±1.58	4.43±0.96
HDL（mmol/L， $\bar{x}$ ±s）	1.21±0.36	2.26±0.73
LDL（mmol/L， $\bar{x}$ ±s）	1.46±0.53	3.93±1.25
手术方式［例（%）］			1.438	0.395
甲状腺全切除术	6（12.0）	41（82.0）
甲状腺次全切除术	-	5（10.0）
单侧腺叶切除术+Bilateral CCLND	-	4（8.0）
甲状腺全切除术+Unilateral CCLND	26（52.0）	-
甲状腺全切除术+Bilateral CCLND	13（26.0）	-
甲状腺全切除术+Bilateral CCLND+CLND	5（10.0）	-

特征	维生素A（μmol/L）	维生素D（ng/ml）	维生素E（μmol/L）	甲基丙二酸（μmol/L）
BRAF基因突变
阴性（n=43）	1.40±0.51	16.0±3.46	26.3±5.61	102.5±16.98
阳性（n=7）	1.46±0.62	8.9±1.65	26.1±5.72	96.2±11.57
t值	0.280	5.297	0.087	0.942
P值	0.780	＜0.0001	0.931	0.351

特征	维生素A（μmol/L）	维生素D（ng/ml）	维生素E（μmol/L）	甲基丙二酸（μmol/L）
T分期
T ₁（n=14）	1.45±0.58	15.3±3.97	25.7±5.63	92.6±13.77
T ₂（n=26）	1.37±0.47	13.9±2.65	26.5±5.79	106.2±17.59
T ₃（n=8）	1.45±0.55	15.6±4.01	25.9±5.83	94.7±13.90
T ₄（n=2）	1.38±0.49	13.8±2.64	26.8±5.90	108.6±18.03
t值	0.150	1.297	0.327	0.871
P值	0.980	0.669	0.579	0.460

特征	维生素A（μmol/L）	维生素D（ng/ml）	维生素E（μmol/L）	甲基丙二酸（μmol/L）
临床分期
StageI（n=12）	1.43±0.52	15.7±3.47	26.1±5.63	93.1±13.87
StageII（n=17）	1.35±0.45	12.8±2.62	27.3±5.77	107.3±17.51
StageIII（n=13）	1.02±0.33	10.2±2.37	27.8±5.49	109.4±18.06
StageIV（n=8）	0.97±0.28	9.4±1.93	28.4±5.90	110.6±18.91
t值	0.144	0.001	0.411	0.088
P值	1.667	0.682	0.540	0.579

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