ArticleFrontiers in endocrinology2026
Tuber intake is independently associated with reduced risk of Hashimoto's thyroiditis: a community-based cross-sectional study.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hashimoto's thyroiditis (HT) is the leading cause of autoimmune hypothyroidism, and dietary factors have been implicated in its pathogenesis through immune and metabolic pathways. We aimed to identify dietary and metabolic factors associated with HT risk in a large community cohort and to evaluate whether tuber-associated metabolites causally influence HT susceptibility using Mendelian randomization (MR). Methods: Cross-sectional analysis of 7,878 community-dwelling adults (≥40 years) from the REACTION cohort, Dalian, China. HT was defined by thyroid autoantibody seropositivity (anti-TPO ≥5.61 IU/mL or anti-Tg ≥4.11 IU/mL). Forty-nine variables spanning dietary intake, lifestyle behaviours, anthropometrics, and metabolic parameters were screened by univariable and multivariable logistic regression. For MR, eight tuber-associated metabolites identified via the FoodB database were analysed as instrumental variable exposures against a published HT genome-wide association study (GWAS; N = 395,640; 15,654 cases) using inverse-variance weighted (IVW) as the primary method, with MR-Egger and weighted median as sensitivity analyses, and MR-PRESSO to assess and correct for horizontal pleiotropy. Results: HT prevalence was 29.3% (2,305/7,878). Female sex (OR 1.97, 95% CI 1.68 to 2.33), elevated total cholesterol (OR 1.13, 95% CI 1.02 to 1.26), and lower fasting glucose (OR 0.95, 95% CI 0.91 to 1.00) were independent metabolic predictors. Adequate tuber intake (50-100 g/day; OR 0.75, 95% CI 0.64 to 0.88; Conclusions: Adequate tuber intake is an independent, novel protective dietary factor for HT, with a U-shaped dose-response pattern confirmed across four sensitivity analyses. Mendelian randomization identifies folic acid supplementation as a causal risk factor for HT, a finding with direct public health relevance given widespread supplement use in women of reproductive age. These findings support moderate tuber and vegetable consumption as a low-cost HT prevention strategy, and warrant caution regarding high-dose folic acid supplementation in HT-susceptible individuals.
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