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Background: Hashimoto's thyroiditis (HT) is an inflammatory disease characterized by increased reactive oxygen species. Diets rich in anti-inflammatory and antioxidant properties may be linked to a reduced risk of developing HT. The aim of this study was to investigate the association between the dietary inflammatory index (DII) and dietary total antioxidant capacity (DTAC) with HT in Iranian adults. Methods: The study was a hospital-based case-control study conducted on 230 participants (115 cases and 115 controls). Dietary intake was assessed using a food frequency questionnaire (FFQ). The FFQ data were used to calculate DII and DTAC scores. Anthropometric measurements, thyroid function, and antibody tests were evaluated using standard methods. Multivariable logistic regression analysis was performed in both raw and adjusted models to determine the association between DII and DTAC scores with HT. Results: The average age of the participants was 39.76 ± 9.52 years. The mean body mass index in the case and control groups was 28.03 ± 6.32 and 26.43 ± 5.13 (kg/m2), respectively (P = 0.036). In the HT group, the DII level was higher (P < 0.001) and the DTAC level was lower than those in the healthy group (P = 0.047). In the multivariable logistic regression model, after adjusting for confounding factors, subjects in the last tertile of DII had a nonsignificantly higher HT risk than those in the first tertile (OR = 1.75; 95% CI = 0.83–3.65; P = 0.130). Regarding DTAC, the subjects in the last tertile of DTAC had a significantly decreased risk of HT (OR = 0.47; 95% CI = 0.23–0.98; P = 0.043) compared to those in the first tertile. The DII had a positive correlation with anti-thyroid peroxidase antibody (anti-TPO), thyroglobulin antibodies (TG-Ab) and thyroid-stimulating hormone, while DTAC had a negative correlation with anti-TPO and TG-Ab (P < 0.050). Conclusion: The increase in DII is not associated with an increase in the risk of HT, while DTAC can significantly reduce its risk. Having an anti-inflammatory and antioxidative diet can be effective in improving thyroid function. These conclusions should be confirmed in additional prospective studies. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid Arthritis (RA) and autoimmune thyroid disease (AITD) are the two most prevalent coexisting autoimmune diseases due to their similar pathogenesis. Considering the potential effect of AITD on the severity of RA disease, this study aimed to determine the association between thyroid dysfunction, anti-thyroid peroxidase (anti-TPO) positivity, AITD, and RA disease severity in the Iranian population. Methods: Three hundred and fifty RA patients who presented to Shahid Beheshti tertiary care center, Qom, Iran, were included in this cross-sectional study. The data were collected through the patient's medical records, interviews, physical examinations, and laboratory tests. The RA disease activity score in 28 joints for RA with erythrocyte sedimentation rate (DAS-28-ESR) was used to divide patients into three subgroups, remission (DAS-28-ESR ⩽ 2.6), mild-to-moderate (2.6 < DAS-28-ESR ⩽ 5.1), and severe disease activity (DAS-28-ESR > 5.1). Results: Using the aforementioned method, 111, 96, and 138 patients were put into remission, mild-to-moderate, and severe disease activity groups, respectively. Anti-TPO antibody positivity rate was 2.93 times more prevalent among patients with severe disease compared to the remission subgroup (OR: 2.93; P-value < 0.001). Patients suffering from a more severe disease were almost 2.7 times more probable to have AITD (OR = 2.71; P-value < 0.001) and they were 82% more likely to have thyroid dysfunction compared to patients in remission (OR = 1.82; P-value = 0.006). Conclusions: It was demonstrated that thyroid dysfunction, anti-TPO antibody positivity, and AITD were significantly more common among RA patients with more severe disease activity. [ABSTRACT FROM AUTHOR]

Background: Anti-TPO antibodies are one of the characteristic factors in autoimmune thyroiditis (AIT). Previous studies reported a high prevalence of anti-TPO antibodies (Abs) in Iran. We have therefore assessed the prevalence of anti-TPO Abs in Gorgan, Iran. Methods: This cross-sectional study, conducted from 2015 to 2018 in Gorgan city, Northeast of Iran. The Participants included women with Poly cystic ovary syndrome (PCOs), celiac patients, men with hepatitis C infection, and age and sex-matched controls. ELISA method was used for the analysis of laboratory tests. Results: The number of enrolled subjects in PCOs, celiac disease, and Hepatitis C infection groups were 76, 67, and 60, respectively. Anti-TPO Abs positivity was significantly higher in patients with PCOS than in the control group (18.4% vs. 0.00%; p = 0.000). There were no significant differences in the frequency of anti-TPO Abs positive cases between CD patients and the controls (26.9% vs. 21.1% p =0.413). The incidence of anti-TPO Abs positivity was significantly higher in the control group (10% vs. 25%; P = 0.031). Conclusion: Very high level of anti-TPO Abs was observed in both patients and healthy population in Golestan province. Considering this rate and its association with autoimmune disorders, it is suggested to prioritize screening programs for related disease in this area. [ABSTRACT FROM AUTHOR]

Background: Papillary thyroid carcinoma PTC is the most prevalent of all thyroid carcinomas. On the other hand, Hashimoto's thyroiditis (HT), as part of the spectrum of autoimmune thyroid diseases, is a major cause of thyroid hypofunction worldwide. Several studies have aimed to indicate a possible correlation between PTC and HT over the years. This study aims to investigate the correlation between HT disease and PTC tumor invasion rate. Method: In the present cross-sectional study, PTC patients with HT were selected among patients referred to the surgical ward of Shariati hospital from 2016 to 2019 and compared in terms of tumor invasion and central LN dissection. Also, a similar group of PTC patients without HT undergoing total thyroidectomy was selected for comparison. The tumor invasion rate was assessed based on invasion indices obtained from postoperative permanent pathology specimens. These indices included tumor type and size, number of involved LNs, lymphovascular involvement, perineural involvement, thyroid capsule involvement, multifocal or unifocal tumor, extrathyroidal proliferation, marginal status, and necrosis. Data were obtained and compared in the two groups with SPSS version 22.0 software. Results: Based on the postoperative pathology reports, 50 (56.2%) PTC patients with Hashimoto thyroiditis were compared against 39 PTC patients without Hashimoto thyroiditis. No significant difference was found between the two groups regarding tumor invasion factors such as multifocality, lymphovascular invasion, marginal invasion, extrathyroidal invasion, capsular invasion, and necrosis. Conclusion: HT could not be mentioned as an aggravating factor of PTC invasion based on the invasion factors evaluated in pathology specimens. [ABSTRACT FROM AUTHOR]

Background. Grave's disease (GD) and Hashimoto's thyroiditis (HT) are autoimmune diseases of the thyroid gland in which genetic predisposition plays a major role in their development. Currently, the role of NLRP3 inflammasome and COX-2 has been documented in many autoimmune diseases. The purpose of the study is to delineate the impact of IL-1β (rs1143634), NLRP3 (rs3806265), and COX-2 (rs2745557) gene polymorphisms in the development of GD and HT. Methods. A total of 256 newly diagnosed patients with autoimmune thyroid disease (135 patients with HT and 121 GD patients) as case groups and 145 controls were included in the study. Results. Recessive and overdominant models showed a significant association between IL-1β rs1143634 SNP and HT development risk. The frequency of TT genotype and T allele of IL-1β rs1143634 SNP in the control group was significantly higher than the GD group. There was no significant association between NLRP3 rs3806265 polymorphism and HT and GD development. The frequency of GA genotype of COX-2 (rs2745557) in the control group was significantly higher than that in the HT group. There was no significant association between COX-2 rs2745557 genotypic and allelic distribution and GD development risk. The results revealed a significant relationship between some clinical features of HT and GD groups and SNPs studied. Conclusion. The results manifest the significant impact of IL-1β rs1143634 and COX-2 (rs2745557) SNPs and HT development and IL-1β rs1143634 SNP on GD occurrence risk. Furthermore, a significant relationship was observed between some clinical features of HT and GD groups and studied SNPs. [ABSTRACT FROM AUTHOR]

Background: Although in many studies, the relationship between autoimmune hypothyroidism (Hashimoto) and Vitamin D deficiency was shown, no research has been performed on the role of vitamin D in non-autoimmune hypothyroidism. Methods: This was a case-control study in Endocrinology clinic of Jahrom (south of Iran). The patients with Hashimoto (n = 633) and non-Hashimoto hypothyroidism (n = 305), along with a control group (n = 200) were evaluated. 25(OH) D level, T3 and T4 levels were studied and Anti TPO and Anti TG tests were performed. The results of vitamin D level were analyzed and interpreted using SPSS in terms of the cause of hypothyroidism (immune and non-immune). Results: The results of the study showed a significantly lower level of vitamin D in both immune and non-immune Hashimoto's thyroiditis (HT) in comparison to healthy controls (P < 0.05). We observed a significant inverse correlation between the vitamin D and TGAb level (p = 0.001, r = − 0.261) and a direct correlation of vitamin D with TSH level (p = 0.008, r = 0.108) in Hashimoto thyroiditis patients. Conclusion: Finally, the results indicated that non-autoimmune hypothyroidism, as well as HT, is associated with vitamin D deficiency. The role of vitamin D deficiency in Hashimoto thyroiditis was thought to be in the association of higher autoantibody (TGAb) level; while, there should be further studies determining vitamin D deficiency's role in non-immune hypothyroidism. [ABSTRACT FROM AUTHOR]

Background: Currently, it is shown that pregnancy may have an impact on the thyroid that can be leading to pregnancy complications such as abortion, preeclampsia, and preterm delivery. The objective was to compare the thyroid volume, number and characteristics of thyroid nodules, and prevalence of diffuse thyroid diseases in a sample of Iranian pregnant women in the first trimester to nonpregnant women. Materials and Methods: This case-control study was conducted on 298 pregnant and 290 nonpregnant women. Thyroid volume, maximum diameter of thyroid nodules and prevalence of moderate to highly suspicious thyroid nodules, Hashimoto's appearance and goiter were assessed using thyroid ultrasonography. Antithyroperoxidase (TPO) antibodies were measured if the sonographic features were highly suggested for Hashimoto's thyroiditis. Results: The mean of total thyroid volume in pregnant and nonpregnant women was 6 and 6.5 ml, respectively (P = 0.053), and the median (interquartile range) was 6.2 and 5.5, respectively. Nodules were observed in 16.4% of pregnant and 16.6% of nonpregnant women (P = 0.845). Hashimoto's thyroiditis was detected in 6.7% of pregnant and 12.4% of nonpregnant women (P = 0.013). Anti-TPO antibodies were detected in 5% of pregnant and 9.3% of nonpregnant women (P = 0.034). Conclusion: The thyroid volume and nodule characteristics in the first trimester of pregnancy were similar to nonpregnant women. Hashimoto's thyroiditis and anti-TPO antibodies in pregnant women were significantly lower than in nonpregnant women. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid cancer is reported as the most rapidly increasing and third-most common cancer among females. This study aimed to evaluate the data related to thyroid cancer in Kermanshah, Iran, for the first time. Materials and Methods: The data of thyroid cancers were obtained between March 2008 and March 2017. Tumors were classified into four groups: papillary, follicular, medullary, and anaplastic; age was divided into two groups (<45 years and ≥45 years); and tumor size was divided into three groups (≤2, 2–4, and >4 cm) according to the National Comprehensive Cancer Network guidelines for patients: Thyroid cancer, version 1, 2017. Results: A total of 296 thyroid cancer patients with the mean age of 41.1 years, 75% of whom were female, were studied. Most patients (89%) had papillary thyroid cancer. Of all patients, 8.8%, 21.3%, 20.6%, 27%, 5.7%, and 16.9% of patients had extrathyroidal invasion, lymph node metastasis, capsular invasion, Hashimoto's thyroiditis, distant metastasis, and goiter, respectively. With regard to the stage, 82.4% of patients had Stage I. There were significant differences between the two genders in the mean age and Hashimoto's thyroiditis. There were significant differences between the two age groups in sex and Hashimoto's thyroiditis. In addition, there were significant differences between tumor size group and laterality and vascular invasion. Conclusions: The mean age and female/male ratio in this study were similar to those of other areas of Iran. Papillary thyroid carcinoma is the most common kind of thyroid cancer in Iran. In addition, more attention should be paid to the role of Hashimoto's thyroiditis in Iranian patients with thyroid cancer in the future. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Burning sensation in Hashimoto patient's oral cavity is an unknown prevalent problem. Purpose: This study aimed to evaluate the prevalence and intensity of burning mouth syndrome (BMS) in patients suffering from Hashimoto's thyroiditis in all public hospitals in Shiraz, 2016. Materials and Method: A total of 153 patients with Hashimoto's thyroiditis were selected based on simple random sampling. The initial level of thyroid stimulating hormone (TSH), Anti-TPO (thyroperoxidase), Anti-TG (thyroglobulin), Free T3 (triiodothyronine) and Free T4 (thyroxine) serum as the indices of Hashimoto's thyroiditis was assessed. The BMS intensity was measured according to each patient's verbal or nonverbal expression about the pain experience based on visual analog scale (VAS). Results: Based on the clinical evaluation and interview, only 19out of 153 cases (12%) reported BMS. The mean BMS was 3 based on VAS. Statistically significant association was detected between the level of TSH (p= 0.0001), Anti-TPO (p= 0.035), Anti-TG (p= 0.0001), Free T3 (p= 0.0001), Free T4 (p= 0.0001) indices in patients with BMS. Significant association was also observed between the level of Anti-TPO (p= 0.0001), Anti-TG (p= 0.0001), Free T3 (p= 0.0001) and TSH (p= 0.0001) indices and BMS intensity. However, no significant association was found between the BMS severity and Free T4 (p= 0.056). Conclusion: The level of TSH, Anti-TPO, and Anti-TG, Free T3, and TSH indices of Hashimoto's patients were associated with the presence and severity of BSM. However, Free T4 level was only associated with the presence of BMS and not the intensity. [ABSTRACT FROM AUTHOR]

Background: Hashimoto's thyroiditis is an autoimmune disorder and the most common cause of hypothyroidism. The use of Nigella sativa, a potent herbal medicine, continues to increase worldwide as an alternative treatment of several chronic diseases including hyperlipidemia, hypertension and type 2 diabetes mellitus (T2DM). The aim of the current study was to evaluate the effects of Nigella sativa on thyroid function, serum Vascular Endothelial Growth Factor (VEGF) -- 1, Nesfatin-1 and anthropometric features in patients with Hashimoto's thyroiditis. Methods: Forty patients with Hashimoto's thyroiditis, aged between 22 and 50 years old, participated in the trial and were randomly allocated into two groups of intervention and control receiving powdered Nigella sativa or placebo daily for 8 weeks. Changes in anthropometric variables, dietary intakes, thyroid status, serum VEGF and Nesfatin-1 concentrations after 8 weeks were measured. Results: Treatment with Nigella sativa significantly reduced body weight and body mass index (BMI). Serum concentrations of thyroid stimulating hormone (TSH) and anti-thyroid peroxidase (anti-TPO) antibodies decreased while serum T3 concentrations increased in Nigella sativa-treated group after 8 weeks. There was a significant reduction in serum VEGF concentrations in intervention group. None of these changes had been observed in placebo treated group. In stepwise multiple regression model, changes in waist to hip ratio (WHR) and thyroid hormones were significant predictors of changes in serum VEGF and Nesgfatin-1 values in Nigella sativa treated group (P < 0.05). Conclusions: Our data showed a potent beneficial effect of powdered Nigella sativa in improving thyroid status and anthropometric variables in patients with Hashimoto's thyroiditis. Moreover, Nigella sativa significantly reduced serum VEGF concentrations in these patients. Considering observed health- promoting effect of this medicinal plant in ameliorating the disease severity, it can be regarded as a useful therapeutic approach in management of Hashimoto's thyroiditis. Trial registration: Iranian registry of clinical trials (registration number IRCT2015021719082N4- Registered March-15-2015). [ABSTRACT FROM AUTHOR]

Background: Selenium (Se) can be found in the molecular structure of selenoproteins; including thioredoxin reductase and glutathione peroxidase and also in Type I and II deiodinases. Previous studies have shown that Se deficiency has been linked to autoimmune thyroid disease (AITD). In the present study, we investigated the serum Se levels of patients with Graves' disease (GD), Hashimoto's thyroiditis (HT), and euthyroid individuals as a control group. Materials and Methods: The present study was performed on patients with newly diagnosed AITD (GD and HT). The control group was matched with the case group in terms of parameters such as age and sex. Free thyroxine, free triiodothyronine, thyroid-stimulating hormone, antithyroid peroxidase, antithyroglobulin, and serum Se levels were measured in all participants. These parameters were compared between groups. Results: Data from 132 patients with HT, 120 patients with GD, and 120 healthy euthyroid patients as a control group were analyzed. The Se level in patients with HT (104.36 μg/l) and GD (97.68 μg/l) was significantly lower than in the control group (122.63 μg/l) (P < 0.001). The incidence of Se deficiency in patients with HT, GD, and in the control group was 15.2%, 2.5%, and 2.5%, respectively (P < 0.001). In patients with GD, 34 patients (28.33%) had Graves' orbitopathy. Se levels in patients with orbitopathy were significantly lower than in patients without orbitopathy. Conclusion: The serum Se level was significantly lower in newly diagnosed patients with GD and HT than in the control group. Overall, Se deficiency can be considered a risk factor for AITDs. [ABSTRACT FROM AUTHOR]

It has been also reported that that H. pylori infection may be responsible for some endocrine disorders, such as autoimmune thyroid diseases, diabetes mellitus and primary hyperparathyroidism. H. pylori which express cytotoxin-associated gene A (CagA) may be more virulent than those that do not. The aim was to evaluate the seroprevalence of anti-H. pylori IgG and anti-CagA antibodies in patients with type 2 diabetes mellitus (type 2 DM) and healthy individuals from Rafsanjan city (Iran). A total of 100 patients with type 2 diabetes and 100 age-matched healthy individuals were enrolled to study. A blood sample was collected from each participant. The type 2 DM established according to the fasting blood glucose level of 126 mg/dl. The sera were tested for the presence of anti-H. pylori IgG antibodies and antibody to CagA by use of enzyme linked immunosorbent assay. The seroprevalence of anti-H. pylori antibodies in diabetic patients (76%) was similar to that observed in healthy subjects (75%). The mean titer of anti-H. pylori IgG in healthy control group (131.63±11.68 U/ml) was significantly higher than diabetic group (54.43±4.50 U/ml; P<0.0001). The prevalence of serum anti-CagA IgG antibodies was 78.9% in infected diabetic patients and 77.3% in healthy control group with mean titer of 75.02±4.54 U/ml and 84.34±5.85 U/ml, respectively. No significant differences were observed between diabetic and healthy control groups regarding the prevalence and the mean titer of anti-CagA IgG antibodies. In the diabetic group, the seropositive rate of anti-H. pylori IgG was higher in women as compared to men, but the difference was not statistically significant. These results show that H. pylori seropositivity rate was similar in type 2 DM patients and non-diabetics control group. No association was also found between CagA-positive strains of H. pylori and type 2 DM. [ABSTRACT FROM AUTHOR]

Background and Objectives: Missing the diagnosis of thyroid dysfunction in type 1 diabetes mellitus (DM) may have many deleterious consequences. Screening of these patients for thyroid abnormalities at initial diagnosis of type I DM may identify only a small proportion of affected subjects. The aim of this study was to determine thyroid functional status, the prevalence of thyroid autoimmunity, their natural history and the results of long term follow up of a large cohort of population with type 1 DM. Materials and Methods: A total of 386 type 1 diabetic patients with no known thyroid dysfunction prior to diagnosis of diabetes were enrolled into the study and followed up from 1 to 17 years. (9.8±4 years) Clinical examination was performed and serum TSH and thyroperoxidase antibodies titer were measured at first presentation and repeated at regular intervals. Results: Among 386 studied patients with type 1 DM, aged 15.6±7.7 years, sixty three (16.3%) patients developed thyroid dysfunction during the folloZ XS SHULRG ILIW\ WKUHH subjects with hypothyroidism, 9 patients (2.3%) with hyperthyroidism, and 2 patients with postpartum thyroiditis. In this longitudinal study, 115 (30%) patients had high titers of TPO antibodies in their sera. Using Caplan-Meier curve, 50% of subjects developed thyroid abnormalities during the first 10 years after diagnosis of type 1 DM. Conclusion: The results of this study showed that thyroid dysfunction was more prevalent in type 1 diabetic patients. A large proportion of individuals developed thyroid dysfunction during the long term follow up. [ABSTRACT FROM AUTHOR]