Vergatti Anita, Abate Veronica, Garofano Francesca, Fiore Antonella, De Filippo Gianpaolo, Strazzullo Pasquale, Rendina Domenico
Department of Clincal Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy.
Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d'Endocrinologie et Diabétologie, 75019 Paris, France.
Nutrients. 2025 Jun 25;17(13):2109. doi: 10.3390/nu17132109.
Bone metabolism is a dynamic process involving continuous bone formation and resorption, orchestrated by the interplay between osteoblasts and osteoclasts. Osteoporosis (Op), the most prevalent osteo-metabolic disorder globally, results from an imbalance in this remodeling cycle. Hashimoto's thyroiditis (HT), a chronic autoimmune thyroid disorder, has been increasingly recognized as a contributor to bone loss, even in euthyroid individuals. HT is marked by immune dysregulation, autoantibody production, and chronic inflammation, factors that can alter bone remodeling. Furthermore, both thyroid-stimulating hormone (TSH) and thyroid hormones (THs) independently influence bone health. Low TSH and elevated TH levels, including in subclinical states, have been linked to reduced bone mineral density (BMD) and increased fracture risk. Nutritional factors, particularly selenium and iodine intake, modulate both thyroid and bone function, and can be considered as a link between HT and Op. In particular, antioxidant-rich diets such as the Mediterranean diet may confer protective effects. This review integrates current clinical and experimental evidence linking HT with bone metabolism disorders, emphasizing the multifactorial nature of bone fragility in autoimmune thyroid disease and the potential role of diet in mitigating its impact.
骨代谢是一个动态过程，涉及由成骨细胞和破骨细胞之间的相互作用精心调控的持续骨形成和骨吸收。骨质疏松症（Op）是全球最普遍的骨代谢紊乱疾病，由这种重塑周期的失衡引起。桥本甲状腺炎（HT）是一种慢性自身免疫性甲状腺疾病，即使在甲状腺功能正常的个体中，它也日益被认为是导致骨质流失的一个因素。HT的特征是免疫失调、自身抗体产生和慢性炎症，这些因素可改变骨重塑。此外，促甲状腺激素（TSH）和甲状腺激素（THs）均独立影响骨骼健康。低TSH和升高的TH水平，包括亚临床状态下的情况，都与骨矿物质密度（BMD）降低和骨折风险增加有关。营养因素，特别是硒和碘的摄入量，可调节甲状腺和骨骼功能，可被视为HT与Op之间的一个联系。特别是，富含抗氧化剂的饮食，如地中海饮食，可能具有保护作用。本综述整合了将HT与骨代谢紊乱联系起来的当前临床和实验证据，强调了自身免疫性甲状腺疾病中骨脆性的多因素性质以及饮食在减轻其影响方面的潜在作用。
