Kawicka Anna, Regulska-Ilow Bożena, Regulska-Ilow Bożena
Department of Dietetics, Wroclaw Medical University, Wroclaw, Poland.
Postepy Hig Med Dosw (Online). 2015 Jan 2;69:80-90. doi: 10.5604/17322693.1136383.
In recent years, the authors of epidemiological studies have documented that autoimmune diseases are a major problem of modern society and are classified as diseases of civilization. Autoimmune thyroid diseases (ATDs) are caused by an abnormal immune response to autoantigens present in the thyroid gland - they often coexist with other autoimmune diseases. The most common dysfunctions of the thyroid gland are hypothyroidism, Graves-Basedow disease and Hashimoto's disease. Hashimoto's thyroiditis can be the main cause of primary hypothyroidism of the thyroid gland. Anthropometric, biochemical and physicochemical parameters are used to assess the nutritional status during the diagnosis and treatment of thyroid diseases. Patients with hypothyroidism are often obese, whereas patients with hyperthyroidism are often afflicted with rapid weight loss. The consequence of obesity is a change of the thyroid hormones' activity; however, weight reduction leads to their normalization. The activity and metabolic rate of thyroid hormones are modifiable. ATDs are associated with abnormalities of glucose metabolism and thus increased risk of developing diabetes mellitus type 1 and type 2. Celiac disease (CD) also increases the risk of developing other autoimmune diseases. Malnutrition or the presence of numerous nutritional deficiencies in a patient's body can be the cause of thyroid disorders. Coexisting deficiencies of such elements as iodine, iron, selenium and zinc may impair the function of the thyroid gland. Other nutrient deficiencies usually observed in patients suffering from ATD are: protein deficiencies, vitamin deficiencies (A, C, B6, B5, B1) and mineral deficiencies (phosphorus, magnesium, potassium, sodium, chromium). Proper diet helps to reduce the symptoms of the disease, maintains a healthy weight and prevents the occurrence of malnutrition. This article presents an overview of selected documented studies and scientific reports on the relationship of metabolic disorders and nutritional status with the occurrence of ATD.
近年来，流行病学研究的作者们记录表明，自身免疫性疾病是现代社会的一个主要问题，被归类为文明病。自身免疫性甲状腺疾病（ATD）是由对甲状腺中自身抗原的异常免疫反应引起的——它们常常与其他自身免疫性疾病共存。甲状腺最常见的功能障碍是甲状腺功能减退、格雷夫斯-巴塞多病和桥本氏病。桥本氏甲状腺炎可能是甲状腺原发性功能减退的主要原因。人体测量学、生物化学和物理化学参数用于评估甲状腺疾病诊断和治疗期间的营养状况。甲状腺功能减退的患者通常肥胖，而甲状腺功能亢进的患者常常体重迅速减轻。肥胖的后果是甲状腺激素活性的改变；然而，体重减轻会使其恢复正常。甲状腺激素的活性和代谢率是可调节的。ATD与葡萄糖代谢异常相关，因此患1型和2型糖尿病的风险增加。乳糜泻（CD）也会增加患其他自身免疫性疾病的风险。营养不良或患者体内存在多种营养缺乏可能是甲状腺疾病的原因。碘、铁、硒和锌等元素的共同缺乏可能损害甲状腺功能。在患有ATD的患者中通常观察到的其他营养缺乏包括：蛋白质缺乏、维生素缺乏（A、C、B6、B5、B1）和矿物质缺乏（磷、镁、钾、钠、铬）。合理饮食有助于减轻疾病症状、维持健康体重并预防营养不良的发生。本文概述了关于代谢紊乱和营养状况与ATD发生之间关系的一些已记录的研究和科学报告。
