الفهرس 
VIITAMIIN DOnly 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 antigen-presenting 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).