Evaluation of the effect of vitamin D therapy on neutrophil-lymphocyte ratio and choroidal thickness in hashimoto thyroiditis

Introduction and objective: Hashimoto's thyroiditis is a chronic inflammatory disease of the thyroid gland that is considered both the most common autoimmune disease and the most common cause of hypothyroidism. Vitamin D is known to have immunomodulatory effects and its effects on autoimmune diseases have been the subject of many studies. Neutrophil-lymphocyte ratio is an easy and inexpensive inflammatory marker that can be obtained from hemogram parameters. The choroid is the layer that supplies the outer retina, including the photoreceptor. Excessive choroidal thinning often leads to photoreceptor damage and visual impairment. Many factors, including inflammation, affect choroidal thickness. In our study, we aimed to investigate the effect of vitamin D treatment on neutrophil-lymphocyte ratio and choroidal thickness in Hashimoto's thyroiditis. Material and Method: Patients aged 18-65 years who were diagnosed with Hashimoto's thyroiditis with clinical, ultrasonographic and laboratory parameters and had vitamin D deficiency were included in our study. Pregnant women, patients with heart failure, malignancy, advanced liver or kidney disease, hepatitis B and C infection, diabetes mellitus, rheumatological disease, acute coronary syndrome in the last six months, and chronic inflammation were not included in the study. Pregnant women, patients with heart failure, malignancy, advanced liver or kidney disease, hepatitis B and C infection, diabetes mellitus, rheumatological disease, acute coronary syndrome in the last six months, and chronic inflammation were not included in the study. Again, the presence of an ocular disease that would prevent the examination of the cornea and retinal status, previous laser application or any ocular surgery; a history of smoking or alcohol consumption; Patients with a history of any drug use in the last 3 months, including hormone therapy or systemic vasoactive drugs, were excluded. Hemogram parameters, routine laboratory tests, neutrophil/lymphocyte ratio (NLR), thyroid autoantibodies and choroidal thickness of the patients were recorded. These examinations were repeated after the patients were given vitamin D treatment for 3 months. The initial and third month values of the patients were statistically compared. Results: Forty-six patients with Hashimoto's thyroiditis were included in our study. 39 patients (85%) were female and 7 (15%) were male. While the mean age of women was 39 ± 11 years, the mean age of men was 38 ± 10 years (p=0.85). When the diagnosis time of patients with Hashimoto's thyroiditis was compared, no significant difference was found between men and women (p:0.201). It was determined that the neutrophil-lymphocyte ratios of the patients decreased significantly after vitamin D treatment (p:0.027). It was found that there was a significant increase in choroidal thickness after vitamin D treatment (p<0.001). In addition, patients' NLR values and vitamin D levels were negatively correlated (pre-treatment r:-0.296 p:0.046, post-treatment r: -0.432 p:0.003). Choroidal thicknesses and vitamin D levels were positively correlated (pre-treatment r: 0.520 p<0.001 treatment r: 0.921 p<0.001). Anti-thyroglobulin antibody levels, one of the thyroid autoantibodies, were found to decrease significantly with vitamin D treatment (p:0.042). Conclusion: In our study, the decrease in anti-thyroglobulin antibody indicating autoimmunity and NLR, which is an inflammation marker, and the increase in choroidal thickness after vitamin D treatment show that vitamin D deficiency is associated with inflammation in the thyroid gland and eye. As a result, we think that the detection and correct treatment of vitamin D deficiency is important in the prevention of diseases that develop as a result of inflammation.