الفهرس 
VIITAMIIN D
Vitamin D physiology and structureOnly 14 pages are availabe for public view
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Abstract
The vitamin D deficiency pandemic increases the entire
world’s population risk of the most serious chronic illnesses
including deadly cancers, type 2 diabetes, heart disease, stroke,
autoimmune diseases, asthma and infectious diseases. Thus
there needs to be increased awareness on the part of the medical
community and public about the insidious consequences of
vitamin D deficiency.
There is considerable scientific evidence that 1, 25-
dihydroxyvitamin D has a variety of effects on immune system
function, which may enhance innate immunity and inhibit the
development of autoimmunity.
Vitamin D in the form of 1, 25-dihydroxyvitamin D is a
potent immune system modulator. The vitamin D receptor
(VDR) is expressed by most cells of the immune system,
including T cells and antigen-presenting cells, such as dendritic
cells and macrophages.
Recent studies have correlated vitamin D deficiency with
Graves’ disease. Vitamin D plays a major role as an immune
modulator which exerts its biological effects through Vitamin D
receptors, inhibits differentiation of dendritic cells into antigenpresenting
cells, suppresses T-cell proliferation, inhibits
secretion of proinflammatory Th1-related cytokines such as interleukin (IL)-1, IL-2, IL-6, IL-12, tumer necrosis factor and
down regulates the expression of HLA-DR and CD13 antigen
in mononuclear phagocytes.
Eighty five adult Egyptian individuals aged between 20-
40 years accepted to participate in our study. They attended Ain
Shams University Endocrinology clinlic in the duration from
1/4/2014 to 1/10/2014. They included 25 healthy volunteers
who participated as the control group.
The participants were divided to 3 groups as follows:
group 1 included 30 patients with Graves’ disease with
exophthalmos, group 2 included 30 patients with Graves’
disease without exophthalmos and group 3 included 25 healthy
individuals.
All participants were subjected to laboratory
investigations including, thyroid profile (FT3, FT4, TSH) and
measurement of 25(OH) vitamin D level in blood. They were
also subjected to Hertl’s exophthalmometer examination.
The results showed that:
There was a highly significant difference between the 2
studied groups (Grave’s with exophthalmos and Grave’s
without exophthalmos) as regard their disease duration and
carbimazole dose and duration (p0.00).There was a highly significant difference between the 3
studied groups as regard exopthalmometer examination Rt
and Lt (P<0.01), In addition; there is a highly significant
difference between the 3 studied groups as regard the
occurrence of exophthalmos (Rt or Lt) (P<0.01).
There was significant difference between 3 studied
groups as regard vitamin D measurement and Levels
(P<0.01).
· All subjects in group 1 were vitamin D deficient (100%).
· In group 2, 66.7% were vitamin D deficient, 23.3% were
insufficient and 10%were normal.
· In the control group 56% were vitamin D deficient, 40%
were insufficient and 4% were normal.
There was a significant inverse correlation between
Serum “vitamin D level” & “exopthalmometer (Lt) (P0.009),
exopthalmometer (Rt) (P0.031)” in group 1.
There was a significant positive correlation between
“vitamin D level” & “TSH” in group 2 (p0.019).
TSH levels were independent predictors of vitamin
D Levels in the studied subjects (P<0.05).