Krysiak Robert, Kowalcze Karolina, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Scand J Clin Lab Invest. 2022 Nov-Dec;82(7-8):518-524. doi: 10.1080/00365513.2022.2129434. Epub 2022 Oct 6.
Although both exogenous vitamin D and a gluten-free diet were found to reduce thyroid antibody titers, no study investigated interactions between gluten intake and vitamin D status in patients with autoimmune thyroid disorders. The aim of the present study was to assess whether the gluten-free diet determines the effect of vitamin D treatment on thyroid autoimmunity and thyroid function in young women with autoimmune (Hashimoto's) thyroiditis. The study compared two groups of euthyroid premenopausal women with this disorder, matched for thyroid antibody titers: 31 women with non-celiac gluten sensitivity complying for at least 12 months with the gluten-free diet and 31 unaffected sisters of women with non-celiac gluten sensitivity remaining without any dietary intervention. Plasma titers of thyroid peroxidase and thyroglobulin antibodies, as well as plasma concentrations of thyrotropin, free thyroid hormones, prolactin, 25-hydroxyvitamin D and high-sensitive C-reactive protein were measured at entry and after a six-month follow-up. Moreover, at both time points, the structure parameters of thyroid homeostasis were assessed. Although exogenous vitamin D decreased titers of thyroid peroxidase and thyroglobulin antibodies and increased 25-hydroxyvitamin D levels in each treatment group, this effect was less pronounced in patients on the gluten-free diet than in patients not following any dietary recommendations. Only in the latter group of patients, vitamin D increased SPINA-GT. Treatment-induced changes in thyroid peroxidase and thyroglobulin antibodies correlated with the impact of treatment on 25-hydroxyvitamin D levels. The obtained results suggest that gluten-free diet may impair beneficial effects of exogenous vitamin D in individuals with Hashimoto's thyroiditis.
尽管外源性维生素D和无麸质饮食都能降低甲状腺抗体滴度，但尚无研究调查自身免疫性甲状腺疾病患者麸质摄入量与维生素D状态之间的相互作用。本研究的目的是评估无麸质饮食是否能决定维生素D治疗对患有自身免疫性（桥本氏）甲状腺炎的年轻女性甲状腺自身免疫和甲状腺功能的影响。该研究比较了两组甲状腺抗体滴度匹配的甲状腺功能正常的绝经前女性：31名非乳糜泻性麸质敏感女性，她们遵循无麸质饮食至少12个月；以及31名非乳糜泻性麸质敏感女性的未受影响的姐妹，她们未接受任何饮食干预。在入组时和六个月随访后，测量甲状腺过氧化物酶和甲状腺球蛋白抗体的血浆滴度，以及促甲状腺激素、游离甲状腺激素、催乳素、25-羟基维生素D和高敏C反应蛋白的血浆浓度。此外，在两个时间点，都评估了甲状腺内环境稳定的结构参数。尽管外源性维生素D降低了每个治疗组中甲状腺过氧化物酶和甲状腺球蛋白抗体的滴度，并提高了25-羟基维生素D水平，但这种效果在遵循无麸质饮食的患者中不如未遵循任何饮食建议的患者明显。仅在后者这组患者中，维生素D增加了SPINA-GT。治疗引起的甲状腺过氧化物酶和甲状腺球蛋白抗体变化与治疗对25-羟基维生素D水平的影响相关。所得结果表明，无麸质饮食可能会损害外源性维生素D对桥本氏甲状腺炎患者的有益作用。
