Candussi Catharina J, Bell William, Thompson Alysha S, Knüppel Sven, Gaggl Martina, Světnička Martin, Gojda Jan, Cassidy Aedín, Weikert Cornelia, Córdova Reynalda, Kühn Tilman
Department of Nutritional Sciences, University of Vienna, Vienna, Austria.
Center for Public Health, Medical University of Vienna, Vienna, Austria.
BMC Med. 2025 May 7;23(1):269. doi: 10.1186/s12916-025-04045-7.
Plant-based diets are gaining popularity due to their well-documented cardiometabolic benefits and environmental sustainability. However, these diets are often lower in specific micronutrients such as iodine, raising concerns about their potential impact on thyroid health. Therefore, we examined the associations between plant-based diets and the risk of hypothyroidism.
We analysed data from the UK (United Kingdom) Biobank cohort. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incident hypothyroidism across vegans, vegetarians, pescatarians, poultry-eaters, low meat-eaters, and high meat-eaters aged 40-69 years. Ancillary to this, we carried out logistic regression analyses to evaluate associations between the diet groups and prevalent hypothyroidism according to International Classification of Diseases (ICD) codes at baseline.
We included 466,362 individuals from the UK Biobank, of which 220,514 followed a high meat, 221,554 a low meat, 5242 a poultry-based, 10,598 a pescatarian, 8057 a vegetarian, and 397 a vegan diet. During a median SD (Standard Deviation) follow-up of 12.7 (± 3.2) years, 10,831 participants developed hypothyroidism. In multivariable Cox regression models without adjustment for body mass index (BMI), none of the diets were significantly associated with the risk of hypothyroidism. However, there was a tendency for a higher risk of hypothyroidism among vegetarians compared to people following a high meat diet (HR = 1.13, 95% CI 0.98-1.30). After controlling for BMI, a potential collider, the association for vegetarians (HR = 1.23, 95% CI 1.07-1.42) became stronger and statistically significant. Furthermore, we observed a positive association between low meat-eaters (OR = 1.05, 95% CI 1.03-1.08), poultry-eaters (OR = 1.15, 95% CI 1.04-1.28), pescatarians (OR = 1.10, 95% CI 1.01-1.19) and vegetarian (OR = 1.26, 95% CI 1.15-1.38) with hypothyroidism prevalence.
In the present study, we found a moderately higher risk of hypothyroidism among vegetarians, after controlling for BMI, a potential collider. This slightly higher risk of hypothyroidism among vegetarians requires further investigation, taking iodine status and thyroid hormone levels into account.
基于植物的饮食因其已被充分证明的对心脏代谢的益处和环境可持续性而越来越受欢迎。然而，这些饮食中的特定微量营养素（如碘）含量往往较低，这引发了人们对其对甲状腺健康潜在影响的担忧。因此，我们研究了基于植物的饮食与甲状腺功能减退风险之间的关联。
我们分析了英国生物银行队列的数据。使用多变量Cox比例风险回归模型来估计40至69岁的纯素食者、素食者、鱼素者、食禽肉者、低肉食者和高肉食者发生甲状腺功能减退的风险比（HR）和95%置信区间（95%CI）。除此之外，我们进行了逻辑回归分析，以根据基线时的国际疾病分类（ICD）代码评估饮食组与甲状腺功能减退患病率之间的关联。
我们纳入了来自英国生物银行的466,362名个体，其中220,514人遵循高肉食饮食，221,554人遵循低肉食饮食，5242人遵循食禽肉饮食，10,598人遵循鱼素饮食，8057人遵循素食饮食，397人遵循纯素食饮食。在中位标准差（SD）为12.7（±3.2）年的随访期间，10,831名参与者发生了甲状腺功能减退。在未调整体重指数（BMI）的多变量Cox回归模型中，没有一种饮食与甲状腺功能减退风险显著相关。然而，与遵循高肉食饮食的人相比，素食者患甲状腺功能减退的风险有升高的趋势（HR = 1.13，95%CI 0.98 - 1.30）。在控制了潜在的混杂因素BMI后，素食者的关联（HR = 1.23，95%CI 1.07 - 1.42）变得更强且具有统计学意义。此外，我们观察到低肉食者（OR = 1.05，95%CI 1.03 - 1.08）、食禽肉者（OR = 1.15，95%CI 1.04 - 1.28）、鱼素者（OR = 1.10，95%CI 1.01 - 1.19）和素食者（OR = 1.26，95%CI 1.15 - 1.38）与甲状腺功能减退患病率呈正相关。
在本研究中，我们发现，在控制了潜在的混杂因素BMI后，素食者患甲状腺功能减退的风险略高。素食者中这种略高的甲状腺功能减退风险需要进一步研究，同时考虑碘状态和甲状腺激素水平。
