Clinical analysis of the correlation between food-specific IgG antibody positivity and inflammatory factors in patients with Hashimoto's thyroiditis

Clinical analysis of the correlation between food-specific IgG antibody positivity and inflammatory factors in patients with Hashimoto's thyroiditis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical analysis of the correlation between food-specific IgG antibody positivity and inflammatory factors in patients with Hashimoto's thyroiditis Yingchao Chen, Ping Gong, Hua Wei This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9256069/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background: The pathogenesis of Hashimoto’s thyroiditis (HT) involves immune dysregulation, where food sensitivity-mediated by food-specific IgG antibodies-may contribute to the disease progression by inducing chronic low-grade inflammation. Pro-inflammatory cytokines have been shown to be causally linked to the development of HT. This study aims to investigate the correlation between food-specific IgG antibody levels and inflammatory factors in HT patients to evaluate the impact of food exposure on the systemic inflammatory response. Aims: This study aims to investigate the correlation between food-specific IgG antibody positivity and systemic inflammatory factors (IL-6, TNF-α, hs-CRP, ESR) in patients with Hashimoto's thyroiditis. Specifically, we sought to evaluate whether the variety and severity of food-specific IgG antibodies serve as independent predictors of systemic inflammation levels across different thyroid functional statuses. Methods: A retrospective analysis was conducted on clinical data from 184 HT patients (case group) and 100 healthy controls who were admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine between January 2021 and December 2024. The case group was categorized into euthyroid, subclinical hypothyroidism, hypothyroidism, and hyperthyroidism (thyrotoxicosis phase) groups based on thyroid function. Levels of 14 common food-specific IgG antibodies, thyroid-related autoantibodies (TPOAb, TGAb), and inflammatory markers (IL-6, TNF-α, hs-CRP, ESR) were measured. Spearman rank correlation and multiple linear regression analyses were performed. Results: HT patients exhibited high positivity rates for various food-specific IgG antibodies, with milk being the most prevalent (38.46%–51.02%). While antibody positivity was also detected in healthy controls with no significant inter-group difference (P > 0.05), inflammatory factor levels were significantly higher in all HT subgroups compared to controls (P < 0.001), peaking in the hypothyroidism group. Spearman analysis revealed that the number of positive food antibody types was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR (P < 0.05). Multiple linear regression confirmed that the variety of food-specific IgG antibodies was an independent positive predictor of systemic inflammation levels (P < 0.05). Conclusions: In HT patients, the variety of food-specific IgG antibody positivity is significantly associated with systemic inflammatory levels. Although these antibodies primarily reflect food exposure rather than direct intolerance, monitoring and dietary intervention based on antibody profiles may help manage the inflammatory burden in HT patients. Hashimoto’s thyroiditis Food-specific IgG Inflammatory factors Autoantibodies Immune response Figures Figure 1 Figure 2 Figure 3 Figure 4 1. Introduction Hashimoto’s thyroiditis (Hashimoto’s thyroiditis, HT) is a common autoimmune thyroid disease characterized by lymphocytic infiltration in thyroid tissue and elevated levels of serum anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibodies (TGAb) [ 1 – 3 ]. In recent years, the incidence of HT has been on the rise, especially in the female population, and it has become one of the main causes of hypothyroidism [ 4 , 5 ]. Although the exact etiology is not fully understood, genetic susceptibility, environmental factors, and immune imbalance are believed to play key roles in its pathogenesis [ 6 – 8 ]. In recent years, increasing attention has been paid to the relationship between HT, food intolerance, and inflammatory factors, hoping to provide new directions for disease prevention and treatment [ 9 , 10 ]. Food intolerance refers to a non-immunoglobulin E (IgE)-mediated immune response produced by the body against specific food components, often manifested as digestive discomfort, fatigue, skin reactions, and other symptoms [ 11 , 12 ]. Studies have found that food intolerance is prevalent in HT patients, especially with a higher proportion of intolerance to dairy products, eggs, wheat, and other foods [ 11 ]. This may exacerbate immune disorder through chronic low-grade inflammation mechanisms, thereby affecting thyroid function [ 13 , 14 ]. In addition, inflammatory factors also play an important role in the pathogenesis of HT. Studies have confirmed that the levels of pro-inflammatory factors such as IL-6, IL-12, IL-17, and TNF-α are significantly elevated in HT patients and are positively correlated with disease activity [ 15 , 16 ]. Mendelian randomization studies have further revealed the potential causal relationship between factors such as VEGF, IL-12p70, and MIP-1β and HT [ 17 ], providing strong evidence for disease mechanism research. Diet, as an important factor affecting inflammatory status, has also received attention regarding its relationship with HT. Studies have shown that dietary patterns with a higher Dietary Inflammatory Index (DII) may exacerbate inflammatory responses and affect thyroid function [ 18 , 19 ]. In addition, gluten-free diets and Mediterranean diets have been proven to reduce autoantibody levels and improve the immune status of HT patients [ 20 , 21 ]. Therefore, the pathogenesis of HT is complex, and the interaction between food intolerance and inflammatory factors may play an important role in disease progression[ 22 , 23 ]. In-depth exploration of the correlation between food intolerance and inflammatory factors in HT not only helps to reveal the immune regulation mechanism of the disease but also provides a theoretical basis for clinicians to formulate individualized dietary intervention and anti-inflammatory treatment strategies. 2. Methods 2.1 Study Design This study was a retrospective study. Patients diagnosed with Hashimoto’s thyroiditis in the Department of Endocrinology of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2024 were included as the case group, and healthy volunteers from the physical examination center during the same period were selected as the control group. 2.2 Inclusion Criteria: (1) Case group: Diagnosis met the clinical and laboratory criteria for HT (TPOAb or TGAb positive, thyroid ultrasound suggested diffuse lesions); (2) Control group: Normal thyroid function (TSH 0.4–4.0 mIU/L, FT4 12–22 pmol/L), no history of autoimmune diseases; (3) Age 18–60 years, gender unlimited; (4) All patients signed informed consent; (5) Complete data on thyroid function, autoantibodies, food intolerance, and inflammatory factors. 2.3 Exclusion Criteria: (1) Complicated with other autoimmune diseases (such as systemic lupus erythematosus, rheumatoid arthritis); (2) Use of immunosuppressants or hormonal drugs within the last 3 months; (3) Complicated with infectious diseases or malignant tumors; (4) Pregnant or lactating women; (5) Incomplete or missing data. In this study, the “food intolerance” detection was actually a food-specific IgG antibody test. The positive result reflects the immune system’s exposure response to food and is not directly equivalent to clinical food intolerance. Clinical diagnosis requires combination with dietary exclusion methods and symptom assessment. 2.4 Study Subjects A total of 184 cases in the case group and 100 cases in the healthy control group were included in this study. The case group was further divided into the euthyroid group (TSH 0.4-4.0 mIU/L) with 52 cases, the subclinical hypothyroidism group (TSH > 4.0 mIU/L and free thyroxine FT4 level normal) with 47 cases, the hypothyroidism group (TSH > 4.0 mIU/L and FT4 < 12 pmol/L) with 49 cases, and the hyperthyroidism group (TSH 22 pmol/L) with 36 cases based on thyroid function status. Hyperthyroidism patients in the case group were all in the thyrotoxicosis phase caused by Hashimoto’s thyroiditis, excluding Graves’ disease and other causes of hyperthyroidism. All patients did not receive levothyroxine, antithyroid drugs, or other immunomodulatory treatments during the study period to avoid interference from drugs on inflammatory indicators and antibody levels. The healthy control group consisted of 100 healthy people with normal thyroid function and no history of thyroid disease. All study subjects came from the same period of medical treatment or physical examination population. General data such as gender and age were balanced and comparable among groups (P > 0.05). 2.5 Observation Indicators Demographic data included age, gender, and Body Mass Index (BMI). Thyroid function indicators included Thyroid Stimulating Hormone (TSH), Free Triiodothyronine (FT3), and Free Thyroxine (FT4), measured by chemiluminescence in a standardized laboratory after blood sample collection. Autoantibody indicators included Anti-Thyroid Peroxidase Antibody (TPOAb) and Anti-Thyroglobulin Antibody (TGAb), used to assess the presence of autoimmune thyroid disease. Detected by blood sample testing, using chemiluminescence or ELISA methods. Food-specific IgG antibody detection assessed whether individuals had food sensitivity reactions by detecting specific IgG antibody levels in serum against common foods. The food types tested included 14 common foods such as dairy products, wheat, corn, eggs, soybeans, beef, pork, fish, etc. According to antibody concentration, the reaction degree was divided into four grades: Negative ( 200 U/mL). The test was performed using Enzyme-Linked Immunosorbent Assay (ELISA). Inflammatory factor levels included Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), High-sensitivity C-reactive protein (hs-CRP), and Erythrocyte Sedimentation Rate (ESR). IL-6 and TNF-α were detected by chemiluminescence, hs-CRP by immunoturbidimetry, and ESR by the Westergren method. All tests were completed in a standard laboratory. 2.6 Detection Methods Blood Sample Collection: Performed in the early morning fasting state of subjects, using sterile venipuncture technology, collected in vacuum blood collection tubes without anticoagulants for serum separation. After collection, samples were left at room temperature for 30 minutes to allow blood to coagulate fully, then centrifuged at 3000 rpm for 10 minutes, separated serum was aliquoted and stored in a -80℃ refrigerator to avoid repeated freeze-thaw cycles. All samples were uniformly numbered, registered, and collection time was recorded to ensure traceability and consistency of the subsequent detection process. Chemiluminescence: The substance to be tested is combined with its specific antibody or antigen to form an immune complex, and a light signal is generated through an enzyme or chemiluminescent substrate. The light intensity is proportional to the concentration of the substance to be tested. The sample to be tested is mixed with reagents labeled with luminescent substances in the reaction system, and a specific binding reaction occurs. After washing to remove unbound components, a trigger is added to cause the luminescent substrate to undergo an oxidation reaction, generating photon signals. The instrument detects the luminescence intensity and converts it into the concentration of the substance to be tested. Enzyme-Linked Immunosorbent Assay (ELISA): Known antigens or antibodies are coated on the surface of microplates. After adding the sample to be tested, if the corresponding antibody or antigen exists in the sample, it will specifically bind to the coating. Then enzyme-labeled secondary antibodies are added to form an antigen-antibody-enzyme-labeled secondary antibody complex. After washing away unbound components, substrate solution is added, and the enzyme catalyzes the substrate reaction to produce a color change. The absorbance value is measured by a microplate reader, and the concentration of the substance to be tested is calculated according to the standard curve. Immunoturbidimetry: The antigen to be tested (such as hs-CRP) and specific antibodies are added to the buffer solution. The two combine to form an immune complex, causing a turbidity change in the solution. The increase in solution turbidity is measured by a turbidimeter. The strength of the turbidity is proportional to the antigen concentration. This method uses standards to draw a standard curve to achieve quantitative analysis of antigens in samples. Westergren Method: Anticoagulated venous blood is injected into a special Westergren erythrocyte sedimentation tube, placed vertically on a special stand, left at room temperature for 1 hour, and the distance of red blood cell sinking is observed, recorded in millimeters/hour (mm/h). 2.7 Statistical Methods SPSS 26.0 statistical software was used for data analysis. For continuous variables conforming to normal distribution, independent sample t-test (two-group comparison) or one-way analysis of variance (ANOVA, multi-group comparison) was used; for data not conforming to normal distribution, non-parametric test methods were used, such as Mann-Whitney U test (two-group comparison) or Kruskal-Wallis test (multi-group comparison). To explore the correlation between variables, Spearman rank correlation analysis was used. In addition, to further analyze the potential causal relationship between food intolerance and inflammatory factors, multiple linear regression analysis was performed, with inflammatory factors (IL-6, TNF-α, hs-CRP, ESR) as dependent variables and the number of food intolerance types as independent variables to evaluate the independent impact of food intolerance on inflammatory response. All statistical analyses regarded P < 0.05 as the standard for statistical significance. 3. Results 3.1 Comparison of Basic Characteristics of Study Subjects There were no statistically significant differences in age, gender, and BMI among groups (P > 0.05) (Table 1 .) Table 1 Comparison of General Data Among Groups Group Cases Age (years) Gender (Male/Female) BMI (kg/m²) Healthy Control Group 100 38.42 ± 9.13 32/68 23.12 ± 2.89 Euthyroid Group 52 37.81 ± 8.74 15/37 23.45 ± 2.71 Subclinical Hypothyroidism Group 47 40.12 ± 9.32 12/35 23.67 ± 2.64 Hypothyroidism Group 49 41.35 ± 8.97 10/39 23.82 ± 2.56 Hyperthyroidism Group 36 36.73 ± 8.51 8/28 22.98 ± 2.43 χ²/t value F = 1.23 χ²=2.17 F = 0.89 P value 0.301 0.537 0.442 3.2 Comparison of Thyroid Function and Autoantibody Levels TSH in the hypothyroidism group was significantly higher than in other groups, and the lowest in the hyperthyroidism group (P < 0.001). FT3 and FT4 were highest in the hyperthyroidism group and lowest in the hypothyroidism group, indicating that thyroid hormone levels were consistent with functional status (P < 0.001). TPOAb and TGAb in all groups of Hashimoto’s thyroiditis were significantly higher than in the healthy control group (P < 0.001), and antibody levels increased with the aggravation of thyroid dysfunction (Table 2 .) Table 2 Comparison of Thyroid Function and Autoantibody Levels Indicator Healthy Control (n = 100) Euthyroid (n = 52) Subclinical Hypo (n = 47) Hypothyroidism (n = 49) Hyperthyroidism (n = 36) F value P value TSH 2.37 ± 0.92 2.21 ± 0.87 5.12 ± 0.93 7.61 ± 1.23 0.21 ± 0.17 98.312 < 0.001 FT3 4.84 ± 0.71 4.73 ± 0.68 4.59 ± 0.61 3.96 ± 0.55 6.17 ± 0.72 31.241 < 0.001 FT4 16.32 ± 2.13 16.01 ± 1.98 15.84 ± 1.88 12.44 ± 1.58 26.73 ± 2.03 67.417 < 0.001 TPOAb 15.24 ± 8.15 58.32 ± 21.47 89.42 ± 28.34 112.71 ± 35.17 61.27 ± 24.62 48.731 < 0.001 TGAb 12.13 ± 6.76 47.84 ± 19.23 73.57 ± 26.13 98.30 ± 31.46 51.23 ± 22.31 39.627 < 0.001 3.3 Distribution of Food-Specific IgG Antibodies Table 3 results show that milk was the most common positive food, with a positive rate exceeding 38% in all groups, and showing a trend of increasing IgG antibody positive proportion as the degree of hypothyroidism aggravated, but no significant difference was found among groups statistically (P > 0.05). Other foods such as wheat, eggs, soybeans, cheese, etc., also showed similar trends, suggesting that Hashimoto’s thyroiditis patients generally have food-specific IgG antibody positivity, but the differences between different food types and different functional status groups were not statistically significant. Table 4 further analyzed the distribution of food antibody positive grading. The results showed that the negative proportion was highest in the euthyroid group, and the Grade III (severe positive) proportion was highest in the hypothyroidism group. Although from the data trend it appears that hypothyroidism patients have more severe antibody positivity, it also did not reach a statistically significant level (P > 0.05). There were no statistical differences in antibody positive rates and grading distribution among subgroups within the case group (P > 0.05), suggesting that food antibody positivity may more reflect dietary exposure rather than pathological status. Table 3 Occurrence of Antibody Positivity for Different Food Types Food Type Euthyroid Positive Cases (%) Subclinical Hypo Positive Cases (%) Hypothyroidism Positive Cases (%) Hyperthyroidism Positive Cases (%) χ² value P value Milk 20 (38.46) 22 (46.81) 25 (51.02) 15 (41.67) 0.743 0.236 Eggs 12 (23.08) 14 (29.79) 16 (32.65) 10 (27.78) 0.715 0.372 Wheat 17 (32.69) 19 (40.43) 23 (46.94) 13 (36.11) 0.942 0.141 Soybeans 10 (19.23) 12 (25.53) 14 (28.57) 8 (22.22) 0.515 0.401 Beef 8 (15.38) 10 (21.28) 12 (24.49) 6 (16.67) 0.681 0.317 Chicken 6 (11.54) 8 (17.02) 10 (20.41) 5 (13.89) 0.548 0.411 Corn 7 (13.46) 9 (19.15) 11 (22.45) 4 (11.11) 0.785 0.367 Crab 5 (9.62) 7 (14.89) 9 (18.37) 3 (8.33) 0.641 0.467 Shrimp 4 (7.69) 6 (12.77) 8 (16.33) 2 (5.56) 0.425 0.526 Fish (Salmon) 3 (5.77) 5 (10.64) 7 (14.29) 2 (5.56) 0.438 0.574 Rice 4 (7.69) 5 (10.64) 6 (12.24) 2 (5.56) 0.442 0.571 Citrus 6 (11.54) 7 (14.89) 9 (18.37) 4 (11.11) 0.614 0.431 Chocolate 5 (9.62) 6 (12.77) 8 (16.33) 3 (8.33) 0.485 0.524 Cheese 12 (23.08) 15 (31.91) 18 (36.73) 9 (25.00) 0.921 0.181 Table 4 Distribution of Food Positive Antibodies by Grade Grading Distribution Euthyroid (%) Subclinical Hypo (%) Hypothyroidism (%) Hyperthyroidism (%) χ² value P value Negative 18 (34.62) 13 (27.66) 11 (22.45) 14 (38.89) 1.024 0.099 Grade I 15 (28.85) 14 (29.79) 13 (26.53) 12 (33.33) 0.814 0.208 Grade II 12 (23.08) 11 (23.40) 14 (28.57) 6 (16.67) 0.895 0.163 Grade III 7 (13.46) 9 (19.15) 11 (22.45) 4 (11.11) 0.814 0.184 3.4 Comparison of Inflammatory Factor Levels All inflammatory factors (IL-6, TNF-α, hs-CRP, ESR) were significantly higher in all groups of Hashimoto’s thyroiditis than in the healthy control group (P < 0.001). Among them, the inflammatory factor levels in the hypothyroidism group were the highest, followed by the subclinical hypothyroidism group and the hyperthyroidism group, and the euthyroid group was relatively low, but still significantly higher than the control group. See Table 5 . Table 5 Differences in IL-6, TNF-α, hs-CRP, ESR Among Groups Indicator Healthy Control Euthyroid Subclinical Hypo Hypothyroidism Hyperthyroidism F value P value IL-6 1.21 ± 0.36 2.37 ± 0.52 2.74 ± 0.62 3.23 ± 0.67 2.16 ± 0.48 23.857 < 0.001 TNF-α 2.46 ± 0.52 3.12 ± 0.64 3.54 ± 0.71 4.01 ± 0.74 3.02 ± 0.63 18.942 < 0.001 hs-CRP 0.85 ± 0.23 1.36 ± 0.32 1.58 ± 0.41 1.82 ± 0.48 1.27 ± 0.32 14.653 < 0.001 ESR 12.34 ± 3.45 17.44 ± 4.18 19.83 ± 4.66 22.11 ± 4.84 16.27 ± 3.93 11.724 < 0.001 3.5 Correlation Analysis Between Number of Food Antibody Positive Types and Inflammatory Factors Spearman analysis showed that the number of food antibody positive types was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR (P < 0.05). (Fig. 1 – 4 .) Figure 1 . Correlation Analysis Between Food Antibody Positive Grade and IL-6 Figure 2 . Correlation Analysis Between Food Antibody Positive Grade and TNF-α Figure 3 . Correlation Analysis Between Food Antibody Positive Grade and hs-CRP Figure 4 . Correlation Analysis Between Food Antibody Positive Grade and ESR 3.6 Results of Multivariate Regression Analysis Multiple linear regression analysis results showed that the number of food antibody positive types was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR levels (P values were 0.002, 0.008, 0.003, 0.001 respectively), indicating that the more types of food antibody positivity, the stronger the inflammatory response. In addition, thyroid function status, TPOAb, and TGAb and other variables were also correlated with inflammatory factor levels to varying degrees. This indicates that food antibody positivity is one of the independent influencing factors of inflammatory response in Hashimoto’s thyroiditis patients. See Table 6 . Table 6 Multiple Linear Regression Analysis of the Impact of Food Antibody Positivity on Inflammatory Factors Dependent Variable Independent Variable β Coefficient SE Beta t value P value IL-6 Food Antibody Positive Types 0.327 0.106 0.243 3.089 0.002 Age 0.011 0.004 0.192 1.773 0.086 BMI 0.079 0.026 0.218 0.944 0.103 Thyroid Function Status 0.214 0.091 0.165 2.352 0.019 Gender (Female = 1) 0.152 0.074 0.143 0.957 0.141 TSH -0.019 0.026 -0.058 -0.829 0.408 FT3 0.144 0.111 0.097 1.284 0.195 FT4 -0.286 0.145 -0.134 -1.927 0.053 TPOAb 0.001 0.000 0.256 2.941 0.003 TGAb 0.001 0.000 0.187 2.134 0.034 TNF-α Food Antibody Positive Types 0.248 0.093 0.206 2.669 0.008 Age 0.008 0.004 0.156 1.013 0.105 BMI 0.062 0.023 0.201 1.673 0.077 Thyroid Function Status 0.175 0.081 0.156 2.167 0.031 Gender (Female = 1) 0.124 0.065 0.132 1.913 0.057 TSH -0.011 0.021 -0.039 -0.513 0.608 FT3 0.106 0.094 0.078 1.081 0.281 FT4 -0.217 0.131 -0.113 -1.642 0.098 TPOAb 0.001 0.000 0.214 2.492 0.013 TGAb 0.001 0.000 0.153 1.752 0.076 hs-CRP Food Antibody Positive Types 0.293 0.098 0.227 2.982 0.003 Age 0.013 0.004 0.189 0.812 0.152 BMI 0.084 0.025 0.241 0.773 0.201 Thyroid Function Status 0.198 0.087 0.158 2.279 0.023 Gender (Female = 1) 0.136 0.070 0.139 1.945 0.053 TSH -0.022 0.022 -0.067 -1.005 0.316 FT3 0.123 0.103 0.086 1.193 0.234 FT4 -0.247 0.138 -0.124 -1.789 0.075 TPOAb 0.001 0.000 0.231 2.699 0.007 TGAb 0.001 0.000 0.172 2.004 0.046 ESR Food Antibody Positive Types 0.362 0.105 0.251 3.453 0.001 Age 0.015 0.004 0.213 1.511 0.101 BMI 0.091 0.027 0.233 0.364 0.401 Thyroid Function Status 0.254 0.093 0.172 2.515 0.012 Gender (Female = 1) 0.182 0.077 0.157 0.397 0.217 TSH -0.027 0.024 -0.073 -1.134 0.258 FT3 0.162 0.108 0.094 1.502 0.134 FT4 -0.284 0.143 -0.136 -2.056 0.041 TPOAb 0.001 0.000 0.264 3.061 0.002 TGAb 0.001 0.000 0.191 2.218 0.027 4. Discussion This study aimed to explore the correlation between food intolerance and inflammatory factors in patients with Hashimoto’s thyroiditis (HT) to provide a theoretical basis for clinical intervention[ 24 – 26 ]. Hashimoto’s thyroiditis is a common autoimmune disease characterized by the presence of thyroid-specific antibodies (such as TPOAb and TGAb), accompanied by varying degrees of thyroid dysfunction and chronic inflammatory response [ 27 , 28 ]. In recent years, studies have found that the rate of multiple food intolerances is high in HT patients, which may induce or exacerbate systemic inflammatory responses by activating the immune system and destroying intestinal barrier function, thereby affecting disease progression [ 29 ]. This finding suggests that food antibody positivity may more reflect individual dietary exposure history rather than an HT-specific immune intolerance phenomenon. Compared with existing studies, this study not only focused on the universality of food intolerance but also further analyzed its relationship with inflammatory factors (such as IL-6, TNF-α, hs-CRP, ESR) and explored its potential as an independent influencing factor of inflammatory response. Dean Kaličanin et al. [ 9 ] found that the positive rates of food intolerance such as eggs and milk were high in HT patients and were closely related to thyroid autoantibody levels. On this basis, this study further revealed that the more types of food antibody positivity, the higher the level of inflammatory factors, suggesting its potential role in immune regulation. In addition, Manli Yan et al. [ 11 ] also pointed out that HT patients generally have elevated multiple food-specific IgG antibodies, especially eggs and milk. The results of this study are highly consistent with this, further supporting the universality and clinical relevance of food intolerance in HT. The results of this study show that the most common food intolerance in Hashimoto’s thyroiditis patients is milk (positive rate 38%-51%), followed by eggs, wheat, soybeans, etc., which is consistent with multiple study results. Mehmet Asik et al.[ 30 ] found that the prevalence of lactose intolerance (LI) among Hashimoto's thyroiditis (HT) patients receiving levothyroxine (LT4) therapy was as high as 75.9%; following an 8-week lactose-restricted diet, serum TSH levels significantly decreased in LI patients with either euthyroidism or subclinical hypothyroidism (from 2.06 ± 1.02 to 1.51 ± 1.1 IU/mL and from 5.45 ± 1.88 to 0.74 ± 2.25 IU/mL, respectively; both P 0.05), suggesting that LI screening and dietary lactose restriction may benefit HT patients with suboptimal TSH control despite LT4 treatment. Manli Yan et al. [ 11 ] found 85 patients with Hashimoto's thyroiditis, 97.65% exhibited food intolerances, with an average of 15.76 ± 10.61 food intolerances. The most common intolerances were eggs (75.29%), cabbage (71.76%), and milk (65.88%), all exceeding 60% intolerance rates. Although the specific values were slightly different, the overall trend was consistent, indicating that these foods may be common IgG antibody positive objects for HT patients. In addition, this study also found that as the degree of hypothyroidism aggravated, the proportion of food antibody positivity showed an upward trend. Although the statistical difference was not significant, this trend was consistent with literature reports. This trend may be related to slowed metabolism, immune disorder, and impaired intestinal barrier function caused by low thyroid function. This study also showed that IL-6, TNF-α, hs-CRP, and ESR levels in Hashimoto’s thyroiditis patients were significantly higher than in the healthy control group, and reached the highest level in the hypothyroidism group, which is highly consistent with existing literature. For example, Kuna al. [ 31 ] found that serum CRP, ESR and IL-6levels in HT patients were significantly elevated and were closely related to thyroid dysfunction. In addition, Fen Feng et al. [ 32 ] also pointed out that serum MIP-1α and PD-1 levels in patients with type 2 diabetes combined with HT were significantly elevated and were positively correlated with TSH, TPOAb, and TGAb, further indicating the core position of inflammatory factors in the immune response of HT patients. It is worth noting that this study also found that thyroid function status had a significant impact on inflammatory factor levels. The inflammatory factor levels in the hypothyroidism group were the highest, followed by the euthyroid group, and the hyperthyroidism group was relatively low, suggesting that thyroid dysfunction may exacerbate inflammatory responses by affecting the immune system and metabolic levels. This result is consistent with the study by Yifang Hu et al. [ 14 ], They discovered that foods containing Se have the potential to lower thyroid antibody and TSH levels, promote hormone therapy, and for the first time improved Treg cells in hormone patients through se supplementation, laying the foundation for the treatment mechanism. Spearman correlation analysis showed that food antibody positive grade was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR, indicating that the more types of food antibody positivity and the more severe the reaction, the stronger the inflammatory response. This finding is consistent with the study by Ewa Tywanek et al. [ 33 ], who found that inflammatory factor levels in HT patients were closely related to thyroid autoantibodies and immune dysfunction. In addition, Farhangi et al. [ 34 ] also pointed out that inflammatory factors such as VCAM-1, MCP-1, IL-17, and IL-6 were significantly elevated in HT patients and were positively correlated with TPOAb and TGAb levels, further supporting the hypothesis that food intolerance affects inflammatory factors through immune activation mechanisms. This study further found through multiple linear regression analysis that the number of food antibody positive types is an independent predictor of IL-6, TNF-α, hs-CRP, and ESR, indicating that even after controlling for factors such as age, BMI, and thyroid function status, food intolerance still has a significant impact on inflammatory response. This result is consistent with the findings of Ai-Jing Chu et al. [ 35 ], who found that Buzhong Yiqi Pill combined with levothyroxine sodium tablets can significantly reduce the levels of IL-12, IFN-γ and other inflammatory factors in patients with Hashimoto's thyroiditis, suggesting that diet and immune regulation play an important role in controlling inflammation. Multiple linear regression analysis results showed that the number of food antibody positive types was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR (P < 0.05), confirming that food antibody positivity is an independent risk factor for elevated inflammatory factor levels. In addition, variables such as thyroid function status, TPOAb, and TGAb also had varying degrees of impact on inflammatory factors, indicating that the inflammatory response in HT patients is the result of the combined action of multiple factors. This result is consistent with the study by Huwiler et al. [ 36 ], who found that TPOAb levels were positively correlated with inflammatory factors, suggesting that elevated autoantibody levels may exacerbate immune responses. In addition, Sheng Huang et al. [ 37 ] also pointed out that traditional Chinese medicine can regulate immune responses and improve the inflammatory status of HT patients by intervening in inflammatory factors and signaling pathways. This study further illustrates that in addition to drug intervention, dietary intervention (such as avoiding positive antibody foods) may also become an important means of controlling inflammation. Despite the significant findings presented above, several limitations of this study warrant careful consideration. First, the clinical utility of food-specific IgG testing remains a subject of debate within the immunological community. While traditional guidelines, such as those from the European Academy of Allergy and Clinical Immunology (EAACI), suggest that elevated food-specific IgG may merely reflect exposure or immune tolerance rather than pathology [ 38 ], emerging evidence indicates that in the context of autoimmune conditions, these antibodies may form circulating immune complexes (CICs). These complexes can activate the complement system, potentially triggering chronic low-grade inflammation and tissue damage [ 39 ]. Therefore, while the clinical significance is still controversial, our data suggests that IgG levels should not be interpreted in isolation but must be judged in combination with clinical symptoms and inflammatory markers. Second, the absence of a healthy control group limits the external validity of our findings. This study did not detect food IgG antibody data in a matched healthy population, so it was impossible to compare the food IgG antibody profile between HT patients and healthy individuals. Consequently, we cannot definitively conclude whether the observed high prevalence of food intolerance is specific to the HT pathophysiology or reflects a broader population trend [ 40 ]. Future studies should establish age and gender-matched control groups to define specific reference ranges for this population. Third, the mechanistic pathways linking food intolerance to HT inflammation were not fully elucidated. In addition, this study did not deeply explore the association between food intolerance and gut microbiota, intestinal permeability, oxidative stress, and other factors. Recent literature highlights the “Gut-Thyroid Axis,” suggesting that dysbiosis and increased intestinal permeability (leaky gut) may allow food antigens to enter circulation, triggering autoimmune responses via molecular mimicry [ 41 ]. Furthermore, oxidative stress is a known contributor to thyroid tissue damage and may be exacerbated by chronic dietary inflammation [ 42 ]. Future research can further investigate these potential mechanisms to establish a causal link. Notwithstanding these limitations, this study offers significant strengths. In summary, this study shows that food intolerance is prevalent in Hashimoto’s thyroiditis patients, especially common foods such as dairy products, eggs, and wheat. Unlike previous studies that focused solely on thyroid antibodies, we quantified the dose-response relationship between food antigens and systemic inflammation. The more types of food positive antibodies and the more severe the reaction, the higher the level of inflammatory factors, suggesting its important role in HT inflammatory response. Multiple regression analysis further confirmed that food antibody positivity is an independent influencing factor for elevated inflammatory levels, strengthening the evidence for food antigens as environmental triggers in HT. Therefore, in clinical management, attention should be paid to the screening and intervention of food positive antibodies, but with a nuanced approach. Combined with dietary adjustment and immune regulation, it helps to improve the inflammatory status of HT patients and delay disease progression. We recommend that screening be followed by supervised elimination diets rather than blind long-term restriction to avoid nutritional deficiencies [ 43 ]. By integrating dietary strategies with standard immune regulation, clinicians may better manage the inflammatory burden in HT patients. 5. Conclusions This study demonstrates a significant correlation between the variety of food-specific IgG antibody positivity and systemic inflammatory levels in patients with Hashimoto's thyroiditis (HT). Multiple linear regression analysis confirmed that the number of positive food antibody types serves as an independent predictor for elevated inflammatory markers, including IL-6, TNF-α, hs-CRP, and ESR, even after adjusting for thyroid function status and autoantibody levels. While food-specific IgG antibodies primarily reflect immune exposure rather than definitive clinical intolerance, their strong association with inflammatory burden suggests a potential role in exacerbating the immune response in HT. Consequently, integrating food-specific IgG screening into clinical assessment may help identify patients with a higher inflammatory burden. We recommend that positive results be followed by personalized, supervised dietary elimination strategies rather than blind long-term restriction to avoid nutritional deficiencies. However, given the ongoing debate regarding the clinical utility of IgG testing, these findings should be interpreted cautiously and in conjunction with clinical symptoms. Future longitudinal studies are warranted to elucidate the underlying mechanistic pathways, particularly the gut-thyroid axis, and to validate the long-term therapeutic benefits of IgG-guided dietary interventions in the management of Hashimoto's thyroiditis. Abbreviations HT Hashimoto's thyroiditis IgG Immunoglobulin G IgE Immunoglobulin E TPOAb Anti-thyroid peroxidase antibody TGAb Anti-thyroglobulin antibody TSH Thyroid stimulating hormone FT3 Free triiodothyronine FT4 Free thyroxine IL-6 Interleukin-6 TNF-α Tumor necrosis factor-α hs-CRP High-sensitivity C-reactive protein ESR Erythrocyte sedimentation rate BMI Body mass index ELISA Enzyme-linked immunosorbent assay ANOVA Analysis of variance SPSS Statistical Package for the Social Sciences SLE Systemic lupus erythematosus Declarations Acknowledgements: We express our gratitude to Mr. Shusen Li for his invaluable guidance and support. His insights into my research topic were crucial in shaping my understanding and direction. Data availability statement The data that support the findings of this study are available from the corresponding author upon reasonable request. Consent for Publication: Not applicable. Funding: This study was supported by the Guangdong Famous Chinese Medicine Workshop: Shusen Li Workshop Foundation Program. Clinical trial number: Not applicable. Author contributions： Yingchao Chen: conceptualization, data curation, methodology, formal analysis, writing—original draft. Ping Gong: data curation, writing—original draft. Hua Wei: project administration, writing—review & editing. Ethics declarations： This study was conducted in strict accordance with the ethical principles of the Declaration of Helsinki. The study protocol was reviewed and approved by the Ethics Committee of Guangdong Provincial Hospital of Chinese Medicine (Approval No. ZE2026-125). All clinical data used in this retrospective cohort study were fully anonymized before being accessed and analyzed, with no possibility of identifying individual patients. References Cabibi D, Giannone AG, Bellavia S, Coco RL, Bianco AL, Formisano E, et al. Serum Anti-Thyroglobulin Autoantibodies Are Specific in Predicting the Presence of Papillary-like Nuclear Features and Lymphocytic Infiltrate in the Thyroid Gland. Diagnostics. 2023;13. https://doi.org/10.3390/diagnostics13122042 . Yamagami A, Iwama S, Kobayashi T, Zhou X, Yasuda Y, Okuji T, et al. Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade. Endocr J. 2024;71:515–26. https://doi.org/10.1507/endocrj.EJ23-0480 . Luo T, Zhao X, Jiang X, Li P, Gu X, Xie X, et al. Serum metabolomic analysis in patients with Hashimoto’s thyroiditis positive for TgAb or TPOAb: a preliminary study. Sci Rep. 2025;15:9945. https://doi.org/10.1038/s41598-025-90467-5 . Luo J, Wang X, Yuan L, Guo L. Iron Deficiency, a Risk Factor of Thyroid Disorders in Reproductive-Age and Pregnant Women: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2021;12:629831. https://doi.org/10.3389/fendo.2021.629831 . Morales-Martínez FA, Sordia-Hernández LH, Ruiz MM, Garcia-Luna S, Valdés-Martínez OH, Vidal-Gutierez O. Association between thyroid autoimmunity and ovarian reserve in women with hypothyroidism. Thyroid Res. 2021;14:6. https://doi.org/10.1186/s13044-021-00095-0 . Bajpai G, Nahrendorf M. Infectious and lifestyle modifiers of immunity and host resilience. Immunity. 2021;54:1110–22. https://doi.org/10.1016/j.immuni.2021.05.011 . Ralli M, Angeletti D, Fiore M, D’Aguanno V, Lambiase A, Artico M, et al. Hashimoto’s thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation. Autoimmun Rev. 2020;19:102649. https://doi.org/10.1016/j.autrev.2020.102649 . Hu X, Chen Y, Shen Y, Tian R, Sheng Y, Que H. Global prevalence and epidemiological trends of Hashimoto’s thyroiditis in adults: A systematic review and meta-analysis. Front Public Health. 2022;10:1020709. https://doi.org/10.3389/fpubh.2022.1020709 . Kaličanin D, Brčić L, Barić A, Zlodre S, Barbalić M, Torlak Lovrić V, et al. Evaluation of Correlations Between Food-Specific Antibodies and Clinical Aspects of Hashimoto’s Thyroiditis. J Am Coll Nutr. 2019;38:259–66. https://doi.org/10.1080/07315724.2018.1503103 . Ihnatowicz P, Gębski J, Drywień ME. Effects of Autoimmune Protocol (AIP) diet on changes in thyroid parameters in Hashimoto’s disease. Ann Agric Environ Med. 2023;30:513–21. https://doi.org/10.26444/aaem/166263 . Yan M, Wu H, Zhang K, Gong P, Wang Y, Wei H. Analysis of the correlation between Hashimoto’s thyroiditis and food intolerance. Front Nutr. 2024;11:1452371. https://doi.org/10.3389/fnut.2024.1452371 . Ruchała M, Bossowski A, Brzozka MM, Gietka-Czernel M, Hubalewska-Dydejczyk A, Kos-Kudła B, et al. Liquid levothyroxine improves thyroid control in patients with different hypothyroidism aetiology and variable adherence - case series and review. Endokrynol Pol. 2022;73:893–902. https://doi.org/10.5603/EP.a2022.0078 . Mikulska AA, Karaźniewicz-Łada M, Filipowicz D, Ruchała M, Główka FK. Metabolic Characteristics of Hashimoto’s Thyroiditis Patients and the Role of Microelements and Diet in the Disease Management-An Overview. Int J Mol Sci. 2022;23:6580. https://doi.org/10.3390/ijms23126580 . Szczuko M, Syrenicz A, Szymkowiak K, Przybylska A, Szczuko U, Pobłocki J, et al. Doubtful Justification of the Gluten-Free Diet in the Course of Hashimoto’s Disease. Nutrients. 2022;14:1727. https://doi.org/10.3390/nu14091727 . Wrońska K, Hałasa M, Szczuko M. The Role of the Immune System in the Course of Hashimoto’s Thyroiditis: The Current State of Knowledge. Int J Mol Sci. 2024;25:6883. https://doi.org/10.3390/ijms25136883 . Pan M, Qi Q, Li C, Wang J, Pan X, Zhou J, et al. Effect and mechanism of Hashimoto thyroiditis on female infertility: A clinical trial, bioinformatics analysis, and experiments-based study. Biosci Trends. 2024;18:356–69. https://doi.org/10.5582/bst.2024.01120 . Hepp M, Werion A, De Greef A, de Ville de Goyet C, de Bournonville M, Behets C, et al. Oxidative Stress-Induced Sirtuin1 Downregulation Correlates to HIF-1α, GLUT-1, and VEGF-A Upregulation in Th1 Autoimmune Hashimoto’s Thyroiditis. Int J Mol Sci. 2021;22:3806. https://doi.org/10.3390/ijms22083806 . Klobučar S, Kenđel Jovanović G, Kryczyk-Kozioł J, Cigrovski Berković M, Vučak Lončar J, Morić N, et al. Association of Dietary Inflammatory Index and Thyroid Function in Patients with Hashimoto’s Thyroiditis: An Observational Cross-Sectional Multicenter Study. Med (Kaunas). 2024;60:1454. https://doi.org/10.3390/medicina60091454 . Alijani S, Ghadir M, Gargari BP. The association between dietary inflammatory index and dietary total antioxidant capacity and Hashimoto’s thyroiditis: a case-control study. BMC Endocr Disord. 2024;24:177. https://doi.org/10.1186/s12902-024-01708-z . Ülker MT, Çolak GA, Baş M, Erdem MG. Evaluation of the effect of gluten-free diet and Mediterranean diet on autoimmune system in patients with Hashimoto’s thyroiditis. Food Sci Nutr. 2024;12:1180–8. https://doi.org/10.1002/fsn3.3833 . Laganà M, Piticchio T, Alibrandi A, Le Moli R, Pallotti F, Campennì A, et al. Effects of Dietary Habits on Markers of Oxidative Stress in Subjects with Hashimoto’s Thyroiditis: Comparison Between the Mediterranean Diet and a Gluten-Free Diet. Nutrients. 2025;17:363. https://doi.org/10.3390/nu17020363 . Vergatti A, Abate V, Garofano F, Fiore A, De Filippo G, Strazzullo P, et al. Are Dietary Habits the Missing Link Between Hashimoto’s Thyroiditis and Osteoporosis? Nutrients. 2025;17:2109. https://doi.org/10.3390/nu17132109 . Barbalace MC, Talotta R, Rapisarda F, D’Amico V, Laganà M, Malaguti M, et al. Unlocking the Power of the Mediterranean Diet: Two in One-Dual Benefits for Rheumatic and Thyroid Autoimmune Diseases. Nutrients. 2025;17:1383. https://doi.org/10.3390/nu17081383 . Klubo-Gwiezdzinska J, Wartofsky L. Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment. Pol Arch Intern Med. 2022;132:16222. https://doi.org/10.20452/pamw.16222 . Hu Y, Feng W, Chen H, Shi H, Jiang L, Zheng X, et al. Effect of selenium on thyroid autoimmunity and regulatory T cells in patients with Hashimoto’s thyroiditis: A prospective randomized-controlled trial. Clin Transl Sci. 2021;14:1390–402. https://doi.org/10.1111/cts.12993 . Dwivedi SN, Kalaria T, Buch H. Thyroid autoantibodies. J Clin Pathol. 2023;76:19–28. https://doi.org/10.1136/jcp-2022-208290 . Peng B, Wang W, Gu Q, Wang P, Teng W, Shan Z. Effects of different supplements on Hashimoto’s thyroiditis: a systematic review and network meta-analysis. Front Endocrinol (Lausanne). 2024;15:1445878. https://doi.org/10.3389/fendo.2024.1445878 . Kravchenko V, Zakharchenko T. Thyroid hormones and minerals in immunocorrection of disorders in autoimmune thyroid diseases. Front Endocrinol (Lausanne). 2023;14:1225494. https://doi.org/10.3389/fendo.2023.1225494 . Chaudhuri J, Mukherjee A, Chakravarty A. Hashimoto’s Encephalopathy: Case Series and Literature Review. Curr Neurol Neurosci Rep. 2023;23:167–75. https://doi.org/10.1007/s11910-023-01255-5 . Asik M, Gunes F, Binnetoglu E, Eroglu M, Bozkurt N, Sen H, et al. Decrease in TSH levels after lactose restriction in Hashimoto’s thyroiditis patients with lactose intolerance. Endocrine. 2014;46:279–84. https://doi.org/10.1007/s12020-013-0065-1 . Kuna M, Štefanović M, Barac E, Madunić FI, Hanžek M, Lugović-Mihić L Prospective Monitoring of Serum Values of CBC, Total IgE, Findings T, Vitamin D-D D, and, Molecules I. CRP, ESR, and IL-6 and Clinical Features of Chronic Spontaneous Urticaria Patients During Antihistamine Treatment. Int J Mol Sci. 2026;27:2503. https://doi.org/10.3390/ijms27052503 Feng F, Zhou B, Zhou C-L, Huang P, Wang G, Yao K, Vitamin D. selenium, and antidiabetic drugs in the treatment of type 2 diabetes mellitus with Hashimoto’s thyroiditis. World J Diabetes. 2024;15:209–19. https://doi.org/10.4239/wjd.v15.i2.209 . Tywanek E, Michalak A, Świrska J, Zwolak A, Autoimmunity. New Potential Biomarkers and the Thyroid Gland-The Perspective of Hashimoto’s Thyroiditis and Its Treatment. Int J Mol Sci. 2024;25:4703. https://doi.org/10.3390/ijms25094703 . Farhangi MA, Tajmiri S. The effects of powdered black cumin seeds on markers of oxidative stress, intracellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in patients with Hashimoto’s thyroiditis. Clin Nutr ESPEN. 2020;37:207–12. https://doi.org/10.1016/j.clnesp.2020.02.015 . Chu A-J, Lu Y-Y, Qiao J-J, Xia Z-Y. Effect of Buzhong Yiqi Decoction on Treg cells in rats with autoimmune thyroiditis through TGF-β/Smad signaling pathway. Zhongguo Zhong Yao Za Zhi. 2024;49:5288–96. https://doi.org/10.19540/j.cnki.cjcmm.20240712.702 . Huwiler VV, Maissen-Abgottspon S, Stanga Z, Mühlebach S, Trepp R, Bally L, et al. Selenium Supplementation in Patients with Hashimoto Thyroiditis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Thyroid. 2024;34:295–313. https://doi.org/10.1089/thy.2023.0556 . Huang S, Ziros PG, Chartoumpekis DV, Psarias G, Duntas L, Zuo X, et al. Traditional Chinese Medicine for Hashimoto’s Thyroiditis: Focus on Selenium and Antioxidant Phytochemicals. Antioxid (Basel). 2024;13:868. https://doi.org/10.3390/antiox13070868 . Santos AF, Riggioni C, Agache I, Akdis CA, Akdis M, Alvarez-Perea A, et al. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy. 2023;78:3057–76. https://doi.org/10.1111/all.15902 . Bajic G, Degn SE, Thiel S, Andersen GR. Complement activation, regulation, and molecular basis for complement-related diseases. EMBO J. 2015;34:2735–57. https://doi.org/10.15252/embj.201591881 . Feng H, Luo N, Xiong X, Wu Y. Prevalence of food allergy in the Chinese population: A systematic review and meta-analysis of population-based studies. Allergy Asthma Proc. 2023;44:315–25. https://doi.org/10.2500/aap.2023.44.230039 Kinashi Y, Hase K. Partners in Leaky Gut Syndrome: Intestinal Dysbiosis and Autoimmunity. Front Immunol. 2021;12:673708. https://doi.org/10.3389/fimmu.2021.673708 . Mancini A, Di Segni C, Raimondo S, Olivieri G, Silvestrini A, Meucci E, et al. Thyroid Hormones, Oxidative Stress, and Inflammation. Mediators Inflamm. 2016;2016:6757154. https://doi.org/10.1155/2016/6757154 . Munteanu C, Schwartz B. The relationship between nutrition and the immune system. Front Nutr. 2022;9:1082500. https://doi.org/10.3389/fnut.2022.1082500 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 06 May, 2026 Reviewers agreed at journal 05 May, 2026 Reviewers agreed at journal 30 Apr, 2026 Reviewers invited by journal 30 Apr, 2026 Editor invited by journal 08 Apr, 2026 Editor assigned by journal 01 Apr, 2026 Submission checks completed at journal 31 Mar, 2026 First submitted to journal 31 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9256069","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":635416546,"identity":"e2d3dffb-a118-4b6e-ab7a-3370226d6fc3","order_by":0,"name":"Yingchao Chen","email":"","orcid":"","institution":"The Second Clinical College of Guangzhou University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Yingchao","middleName":"","lastName":"Chen","suffix":""},{"id":635416548,"identity":"46adaf89-1c4b-4a96-bf41-91d44a44b8bd","order_by":1,"name":"Ping Gong","email":"","orcid":"","institution":"The Second Clinical College of Guangzhou University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Ping","middleName":"","lastName":"Gong","suffix":""},{"id":635416549,"identity":"1a32a601-189f-4729-8915-fb13f8e737ae","order_by":2,"name":"Hua Wei","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYDACCShtwN7Y+PADaVp4DjcbS+BViqFFIr1NgIcYHfKzm489/Np2OHG75MM2oH47Od0GAloY5xxLN5Y5czhx5+zEtgcFDMnGZgcIaGGWyDGTlqg4nLvhdmK7gQTDgcRthLSwgbUYALXcPNgmwUOMFh6gFskPIFtuMBKpRUIiLU2a4Ux6/YYzicBANiDCL/Izko9J/myzNjY4fvzhww8VdnIEtYAAMw9DM5RpQIRyEGD8wVBHpNJRMApGwSgYkQAAeaVD/nidZu0AAAAASUVORK5CYII=","orcid":"","institution":"Guangdong Provincial Hospital of Traditional Chinese Medicine","correspondingAuthor":true,"prefix":"","firstName":"Hua","middleName":"","lastName":"Wei","suffix":""}],"badges":[],"createdAt":"2026-03-29 03:08:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9256069/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9256069/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108972583,"identity":"154764b0-1e5c-4da5-bb60-1cfd5cf10af6","added_by":"auto","created_at":"2026-05-11 10:36:47","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":694909,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation Analysis Between Food Antibody Positive Grade and IL-6\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpearman correlation analysis between the number of food-specific IgG antibody-positive types and serum IL-6 levels in patients with Hashimoto's thyroiditis (n=184). Each dot represents an individual patient. The solid line indicates the linear regression fit. Spearman's rank correlation coefficient (r) and P-value are shown in the upper left corner. A positive correlation was observed (r = 0.584, P \u0026lt; 0.05), indicating that a greater variety of food-specific IgG antibody positivity is associated with elevated IL-6 levels. Abbreviations: IL-6, interleukin-6; IgG, immunoglobulin G.\u003c/p\u003e","description":"","filename":"figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-9256069/v1/3befc552ee36c3cb715e88dc.png"},{"id":108978085,"identity":"b29d7a3a-a747-4758-a742-67067c14c2f2","added_by":"auto","created_at":"2026-05-11 11:33:59","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":800339,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation Analysis Between Food Antibody Positive Grade and TNF-α\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpearman correlation analysis between the number of food-specific IgG antibody-positive types and serum TNF-α levels in patients with Hashimoto's thyroiditis (n=184). Each dot represents an individual patient. Spearman's r and P-value are displayed. Results demonstrate a significant positive association (r = 0.667, P \u0026lt; 0.05), suggesting that increased food antibody positivity correlates with higher TNF-α concentrations. Abbreviations: TNF-α, tumor necrosis factor-α; IgG, immunoglobulin G.\u003c/p\u003e","description":"","filename":"figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-9256069/v1/bf7bfd8a59f6e9d309e04c18.png"},{"id":108972585,"identity":"65f5e3dd-ecb6-4bd4-b45f-f6f4dfc5fbdb","added_by":"auto","created_at":"2026-05-11 10:36:47","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":747290,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation Analysis Between Food Antibody Positive Grade and hs-CRP\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpearman correlation analysis between the number of food-specific IgG antibody-positive types and serum hs-CRP levels in patients with Hashimoto's thyroiditis (n=184). Data points represent individual measurements. Spearman correlation analysis revealed a significant positive correlation (r = 0.431, P \u0026lt; 0.05), indicating that the variety of food-specific IgG antibody positivity is linked to elevated hs-CRP levels. Abbreviations: hs-CRP, high-sensitivity C-reactive protein; IgG, immunoglobulin G.\u003c/p\u003e","description":"","filename":"figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-9256069/v1/35a016a3ca4343c21cc72898.png"},{"id":108972586,"identity":"1238860f-6d43-4a33-947a-e9d082f0520c","added_by":"auto","created_at":"2026-05-11 10:36:47","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":655656,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCorrelation Analysis Between Food Antibody Positive Grade and ESR\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpearman correlation analysis between the number of food-specific IgG antibody-positive types and ESR in patients with Hashimoto's thyroiditis (n=184). Each point corresponds to one patient. The solid line denotes the fitted regression line. Spearman's r and P-value are provided. A significant positive correlation was identified (r = 0.397, P \u0026lt; 0.05), supporting the association between food antibody variety and systemic inflammatory burden. Abbreviations: ESR, erythrocyte sedimentation rate; IgG, immunoglobulin G.\u003c/p\u003e","description":"","filename":"figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-9256069/v1/69e06383bee541061d68772b.png"},{"id":108979872,"identity":"d666c5de-ddac-45e9-b064-78aab9cbdd32","added_by":"auto","created_at":"2026-05-11 12:02:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3303099,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9256069/v1/a6dd75ed-48d5-49ec-adf3-6098db7910aa.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical analysis of the correlation between food-specific IgG antibody positivity and inflammatory factors in patients with Hashimoto's thyroiditis","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eHashimoto\u0026rsquo;s thyroiditis (Hashimoto\u0026rsquo;s thyroiditis, HT) is a common autoimmune thyroid disease characterized by lymphocytic infiltration in thyroid tissue and elevated levels of serum anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibodies (TGAb) [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In recent years, the incidence of HT has been on the rise, especially in the female population, and it has become one of the main causes of hypothyroidism [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Although the exact etiology is not fully understood, genetic susceptibility, environmental factors, and immune imbalance are believed to play key roles in its pathogenesis [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn recent years, increasing attention has been paid to the relationship between HT, food intolerance, and inflammatory factors, hoping to provide new directions for disease prevention and treatment [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Food intolerance refers to a non-immunoglobulin E (IgE)-mediated immune response produced by the body against specific food components, often manifested as digestive discomfort, fatigue, skin reactions, and other symptoms [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Studies have found that food intolerance is prevalent in HT patients, especially with a higher proportion of intolerance to dairy products, eggs, wheat, and other foods [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. This may exacerbate immune disorder through chronic low-grade inflammation mechanisms, thereby affecting thyroid function [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn addition, inflammatory factors also play an important role in the pathogenesis of HT. Studies have confirmed that the levels of pro-inflammatory factors such as IL-6, IL-12, IL-17, and TNF-α are significantly elevated in HT patients and are positively correlated with disease activity [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Mendelian randomization studies have further revealed the potential causal relationship between factors such as VEGF, IL-12p70, and MIP-1β and HT [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], providing strong evidence for disease mechanism research. Diet, as an important factor affecting inflammatory status, has also received attention regarding its relationship with HT. Studies have shown that dietary patterns with a higher Dietary Inflammatory Index (DII) may exacerbate inflammatory responses and affect thyroid function [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In addition, gluten-free diets and Mediterranean diets have been proven to reduce autoantibody levels and improve the immune status of HT patients [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTherefore, the pathogenesis of HT is complex, and the interaction between food intolerance and inflammatory factors may play an important role in disease progression[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In-depth exploration of the correlation between food intolerance and inflammatory factors in HT not only helps to reveal the immune regulation mechanism of the disease but also provides a theoretical basis for clinicians to formulate individualized dietary intervention and anti-inflammatory treatment strategies.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study Design\u003c/h2\u003e \u003cp\u003eThis study was a retrospective study. Patients diagnosed with Hashimoto\u0026rsquo;s thyroiditis in the Department of Endocrinology of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2024 were included as the case group, and healthy volunteers from the physical examination center during the same period were selected as the control group.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Inclusion Criteria:\u003c/h2\u003e \u003cp\u003e(1) Case group: Diagnosis met the clinical and laboratory criteria for HT (TPOAb or TGAb positive, thyroid ultrasound suggested diffuse lesions);\u003c/p\u003e \u003cp\u003e(2) Control group: Normal thyroid function (TSH 0.4\u0026ndash;4.0 mIU/L, FT4 12\u0026ndash;22 pmol/L), no history of autoimmune diseases;\u003c/p\u003e \u003cp\u003e(3) Age 18\u0026ndash;60 years, gender unlimited;\u003c/p\u003e \u003cp\u003e (4) All patients signed informed consent;\u003c/p\u003e \u003cp\u003e(5) Complete data on thyroid function, autoantibodies, food intolerance, and inflammatory factors.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Exclusion Criteria:\u003c/h2\u003e \u003cp\u003e(1) Complicated with other autoimmune diseases (such as systemic lupus erythematosus, rheumatoid arthritis);\u003c/p\u003e \u003cp\u003e(2) Use of immunosuppressants or hormonal drugs within the last 3 months;\u003c/p\u003e \u003cp\u003e(3) Complicated with infectious diseases or malignant tumors;\u003c/p\u003e \u003cp\u003e(4) Pregnant or lactating women;\u003c/p\u003e \u003cp\u003e(5) Incomplete or missing data.\u003c/p\u003e \u003cp\u003eIn this study, the \u0026ldquo;food intolerance\u0026rdquo; detection was actually a food-specific IgG antibody test. The positive result reflects the immune system\u0026rsquo;s exposure response to food and is not directly equivalent to clinical food intolerance. Clinical diagnosis requires combination with dietary exclusion methods and symptom assessment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Study Subjects\u003c/h2\u003e \u003cp\u003eA total of 184 cases in the case group and 100 cases in the healthy control group were included in this study. The case group was further divided into the euthyroid group (TSH 0.4-4.0 mIU/L) with 52 cases, the subclinical hypothyroidism group (TSH\u0026thinsp;\u0026gt;\u0026thinsp;4.0 mIU/L and free thyroxine FT4 level normal) with 47 cases, the hypothyroidism group (TSH\u0026thinsp;\u0026gt;\u0026thinsp;4.0 mIU/L and FT4\u0026thinsp;\u0026lt;\u0026thinsp;12 pmol/L) with 49 cases, and the hyperthyroidism group (TSH\u0026thinsp;\u0026lt;\u0026thinsp;0.4 mIU/L and FT4\u0026thinsp;\u0026gt;\u0026thinsp;22 pmol/L) with 36 cases based on thyroid function status. Hyperthyroidism patients in the case group were all in the thyrotoxicosis phase caused by Hashimoto\u0026rsquo;s thyroiditis, excluding Graves\u0026rsquo; disease and other causes of hyperthyroidism. All patients did not receive levothyroxine, antithyroid drugs, or other immunomodulatory treatments during the study period to avoid interference from drugs on inflammatory indicators and antibody levels.\u003c/p\u003e \u003cp\u003eThe healthy control group consisted of 100 healthy people with normal thyroid function and no history of thyroid disease. All study subjects came from the same period of medical treatment or physical examination population. General data such as gender and age were balanced and comparable among groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Observation Indicators\u003c/h2\u003e \u003cp\u003eDemographic data included age, gender, and Body Mass Index (BMI).\u003c/p\u003e \u003cp\u003eThyroid function indicators included Thyroid Stimulating Hormone (TSH), Free Triiodothyronine (FT3), and Free Thyroxine (FT4), measured by chemiluminescence in a standardized laboratory after blood sample collection.\u003c/p\u003e \u003cp\u003eAutoantibody indicators included Anti-Thyroid Peroxidase Antibody (TPOAb) and Anti-Thyroglobulin Antibody (TGAb), used to assess the presence of autoimmune thyroid disease. Detected by blood sample testing, using chemiluminescence or ELISA methods.\u003c/p\u003e \u003cp\u003eFood-specific IgG antibody detection assessed whether individuals had food sensitivity reactions by detecting specific IgG antibody levels in serum against common foods. The food types tested included 14 common foods such as dairy products, wheat, corn, eggs, soybeans, beef, pork, fish, etc. According to antibody concentration, the reaction degree was divided into four grades: Negative (\u0026lt;\u0026thinsp;50 U/mL), Grade I (50\u0026ndash;100 U/mL), Grade II (101\u0026ndash;200 U/mL), and Grade III (\u0026gt;\u0026thinsp;200 U/mL). The test was performed using Enzyme-Linked Immunosorbent Assay (ELISA).\u003c/p\u003e \u003cp\u003eInflammatory factor levels included Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), High-sensitivity C-reactive protein (hs-CRP), and Erythrocyte Sedimentation Rate (ESR). IL-6 and TNF-α were detected by chemiluminescence, hs-CRP by immunoturbidimetry, and ESR by the Westergren method. All tests were completed in a standard laboratory.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Detection Methods\u003c/h2\u003e \u003cp\u003eBlood Sample Collection: Performed in the early morning fasting state of subjects, using sterile venipuncture technology, collected in vacuum blood collection tubes without anticoagulants for serum separation. After collection, samples were left at room temperature for 30 minutes to allow blood to coagulate fully, then centrifuged at 3000 rpm for 10 minutes, separated serum was aliquoted and stored in a -80℃ refrigerator to avoid repeated freeze-thaw cycles. All samples were uniformly numbered, registered, and collection time was recorded to ensure traceability and consistency of the subsequent detection process.\u003c/p\u003e \u003cp\u003eChemiluminescence: The substance to be tested is combined with its specific antibody or antigen to form an immune complex, and a light signal is generated through an enzyme or chemiluminescent substrate. The light intensity is proportional to the concentration of the substance to be tested. The sample to be tested is mixed with reagents labeled with luminescent substances in the reaction system, and a specific binding reaction occurs. After washing to remove unbound components, a trigger is added to cause the luminescent substrate to undergo an oxidation reaction, generating photon signals. The instrument detects the luminescence intensity and converts it into the concentration of the substance to be tested.\u003c/p\u003e \u003cp\u003eEnzyme-Linked Immunosorbent Assay (ELISA): Known antigens or antibodies are coated on the surface of microplates. After adding the sample to be tested, if the corresponding antibody or antigen exists in the sample, it will specifically bind to the coating. Then enzyme-labeled secondary antibodies are added to form an antigen-antibody-enzyme-labeled secondary antibody complex. After washing away unbound components, substrate solution is added, and the enzyme catalyzes the substrate reaction to produce a color change. The absorbance value is measured by a microplate reader, and the concentration of the substance to be tested is calculated according to the standard curve.\u003c/p\u003e \u003cp\u003eImmunoturbidimetry: The antigen to be tested (such as hs-CRP) and specific antibodies are added to the buffer solution. The two combine to form an immune complex, causing a turbidity change in the solution. The increase in solution turbidity is measured by a turbidimeter. The strength of the turbidity is proportional to the antigen concentration. This method uses standards to draw a standard curve to achieve quantitative analysis of antigens in samples.\u003c/p\u003e \u003cp\u003eWestergren Method: Anticoagulated venous blood is injected into a special Westergren erythrocyte sedimentation tube, placed vertically on a special stand, left at room temperature for 1 hour, and the distance of red blood cell sinking is observed, recorded in millimeters/hour (mm/h).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.7 Statistical Methods\u003c/h2\u003e \u003cp\u003eSPSS 26.0 statistical software was used for data analysis. For continuous variables conforming to normal distribution, independent sample t-test (two-group comparison) or one-way analysis of variance (ANOVA, multi-group comparison) was used; for data not conforming to normal distribution, non-parametric test methods were used, such as Mann-Whitney U test (two-group comparison) or Kruskal-Wallis test (multi-group comparison). To explore the correlation between variables, Spearman rank correlation analysis was used. In addition, to further analyze the potential causal relationship between food intolerance and inflammatory factors, multiple linear regression analysis was performed, with inflammatory factors (IL-6, TNF-α, hs-CRP, ESR) as dependent variables and the number of food intolerance types as independent variables to evaluate the independent impact of food intolerance on inflammatory response. All statistical analyses regarded P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 as the standard for statistical significance.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Comparison of Basic Characteristics of Study Subjects\u003c/h2\u003e \u003cp\u003eThere were no statistically significant differences in age, gender, and BMI among groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of General Data Among Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGender (Male/Female)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBMI (kg/m\u0026sup2;)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthy Control Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.42\u0026thinsp;\u0026plusmn;\u0026thinsp;9.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32/68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEuthyroid Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.81\u0026thinsp;\u0026plusmn;\u0026thinsp;8.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15/37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.45\u0026thinsp;\u0026plusmn;\u0026thinsp;2.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubclinical Hypothyroidism Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.12\u0026thinsp;\u0026plusmn;\u0026thinsp;9.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12/35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.67\u0026thinsp;\u0026plusmn;\u0026thinsp;2.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypothyroidism Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.35\u0026thinsp;\u0026plusmn;\u0026thinsp;8.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10/39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.82\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperthyroidism Group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.73\u0026thinsp;\u0026plusmn;\u0026thinsp;8.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8/28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eχ\u0026sup2;/t value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u0026sup2;=2.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eF\u0026thinsp;=\u0026thinsp;0.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.301\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.537\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.442\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Comparison of Thyroid Function and Autoantibody Levels\u003c/h2\u003e \u003cp\u003eTSH in the hypothyroidism group was significantly higher than in other groups, and the lowest in the hyperthyroidism group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). FT3 and FT4 were highest in the hyperthyroidism group and lowest in the hypothyroidism group, indicating that thyroid hormone levels were consistent with functional status (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eTPOAb and TGAb in all groups of Hashimoto\u0026rsquo;s thyroiditis were significantly higher than in the healthy control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and antibody levels increased with the aggravation of thyroid dysfunction (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Thyroid Function and Autoantibody Levels\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealthy Control (n\u0026thinsp;=\u0026thinsp;100)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEuthyroid (n\u0026thinsp;=\u0026thinsp;52)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSubclinical Hypo (n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHypothyroidism (n\u0026thinsp;=\u0026thinsp;49)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHyperthyroidism (n\u0026thinsp;=\u0026thinsp;36)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eF value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTSH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.37\u0026thinsp;\u0026plusmn;\u0026thinsp;0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e5.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e7.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e0.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e98.312\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFT3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e4.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e3.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e6.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e31.241\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFT4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e16.32\u0026thinsp;\u0026plusmn;\u0026thinsp;2.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e16.01\u0026thinsp;\u0026plusmn;\u0026thinsp;1.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e15.84\u0026thinsp;\u0026plusmn;\u0026thinsp;1.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e12.44\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e26.73\u0026thinsp;\u0026plusmn;\u0026thinsp;2.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e67.417\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTPOAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e15.24\u0026thinsp;\u0026plusmn;\u0026thinsp;8.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e58.32\u0026thinsp;\u0026plusmn;\u0026thinsp;21.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e89.42\u0026thinsp;\u0026plusmn;\u0026thinsp;28.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e112.71\u0026thinsp;\u0026plusmn;\u0026thinsp;35.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e61.27\u0026thinsp;\u0026plusmn;\u0026thinsp;24.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e48.731\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTGAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e12.13\u0026thinsp;\u0026plusmn;\u0026thinsp;6.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e47.84\u0026thinsp;\u0026plusmn;\u0026thinsp;19.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e73.57\u0026thinsp;\u0026plusmn;\u0026thinsp;26.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e98.30\u0026thinsp;\u0026plusmn;\u0026thinsp;31.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e51.23\u0026thinsp;\u0026plusmn;\u0026thinsp;22.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e39.627\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Distribution of Food-Specific IgG Antibodies\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e results show that milk was the most common positive food, with a positive rate exceeding 38% in all groups, and showing a trend of increasing IgG antibody positive proportion as the degree of hypothyroidism aggravated, but no significant difference was found among groups statistically (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Other foods such as wheat, eggs, soybeans, cheese, etc., also showed similar trends, suggesting that Hashimoto\u0026rsquo;s thyroiditis patients generally have food-specific IgG antibody positivity, but the differences between different food types and different functional status groups were not statistically significant. Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e further analyzed the distribution of food antibody positive grading. The results showed that the negative proportion was highest in the euthyroid group, and the Grade III (severe positive) proportion was highest in the hypothyroidism group. Although from the data trend it appears that hypothyroidism patients have more severe antibody positivity, it also did not reach a statistically significant level (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). There were no statistical differences in antibody positive rates and grading distribution among subgroups within the case group (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), suggesting that food antibody positivity may more reflect dietary exposure rather than pathological status.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eOccurrence of Antibody Positivity for Different Food Types\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFood Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEuthyroid Positive Cases (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSubclinical Hypo Positive Cases (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHypothyroidism Positive Cases (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHyperthyroidism Positive Cases (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eχ\u0026sup2; value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMilk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (38.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (46.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25 (51.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15 (41.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.743\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.236\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEggs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (23.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (29.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (32.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10 (27.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.715\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.372\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWheat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 (32.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (40.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23 (46.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13 (36.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.942\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.141\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSoybeans\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (19.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (25.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14 (28.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8 (22.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.401\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBeef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (15.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (21.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (24.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6 (16.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.681\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.317\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChicken\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (11.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (17.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (20.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5 (13.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.548\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.411\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCorn\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (13.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (19.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (22.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4 (11.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.785\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.367\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCrab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (9.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (14.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (18.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.641\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.467\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShrimp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (7.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (12.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (16.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2 (5.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.526\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFish (Salmon)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (5.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (10.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (14.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2 (5.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.438\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.574\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (7.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (10.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (12.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2 (5.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.442\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.571\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCitrus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (11.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (14.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (18.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4 (11.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.614\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.431\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChocolate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (9.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (12.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (16.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3 (8.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.485\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.524\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCheese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (23.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (31.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (36.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9 (25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.921\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.181\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of Food Positive Antibodies by Grade\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrading Distribution\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEuthyroid (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSubclinical Hypo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHypothyroidism (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHyperthyroidism (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eχ\u0026sup2; value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (34.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (27.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (22.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14 (38.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.099\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (28.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (29.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (26.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12 (33.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.814\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.208\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (23.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 (23.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14 (28.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6 (16.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.895\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.163\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrade III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (13.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (19.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (22.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4 (11.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.814\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.184\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Comparison of Inflammatory Factor Levels\u003c/h2\u003e \u003cp\u003eAll inflammatory factors (IL-6, TNF-α, hs-CRP, ESR) were significantly higher in all groups of Hashimoto\u0026rsquo;s thyroiditis than in the healthy control group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Among them, the inflammatory factor levels in the hypothyroidism group were the highest, followed by the subclinical hypothyroidism group and the hyperthyroidism group, and the euthyroid group was relatively low, but still significantly higher than the control group. See Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferences in IL-6, TNF-α, hs-CRP, ESR Among Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealthy Control\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEuthyroid\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSubclinical Hypo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHypothyroidism\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHyperthyroidism\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eF value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIL-6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.37\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2.74\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e3.23\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e2.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e23.857\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTNF-α\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.46\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.54\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e4.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e3.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e18.942\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ehs-CRP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e1.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e1.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e1.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e14.653\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eESR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e12.34\u0026thinsp;\u0026plusmn;\u0026thinsp;3.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e17.44\u0026thinsp;\u0026plusmn;\u0026thinsp;4.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e19.83\u0026thinsp;\u0026plusmn;\u0026thinsp;4.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e22.11\u0026thinsp;\u0026plusmn;\u0026thinsp;4.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e16.27\u0026thinsp;\u0026plusmn;\u0026thinsp;3.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e11.724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Correlation Analysis Between Number of Food Antibody Positive Types and Inflammatory Factors\u003c/h2\u003e \u003cp\u003eSpearman analysis showed that the number of food antibody positive types was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e4\u003c/span\u003e.)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Correlation Analysis Between Food Antibody Positive Grade and IL-6\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Correlation Analysis Between Food Antibody Positive Grade and TNF-α\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Correlation Analysis Between Food Antibody Positive Grade and hs-CRP\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Correlation Analysis Between Food Antibody Positive Grade and ESR\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Results of Multivariate Regression Analysis\u003c/h2\u003e \u003cp\u003eMultiple linear regression analysis results showed that the number of food antibody positive types was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR levels (P values were 0.002, 0.008, 0.003, 0.001 respectively), indicating that the more types of food antibody positivity, the stronger the inflammatory response. In addition, thyroid function status, TPOAb, and TGAb and other variables were also correlated with inflammatory factor levels to varying degrees. This indicates that food antibody positivity is one of the independent influencing factors of inflammatory response in Hashimoto\u0026rsquo;s thyroiditis patients. See Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultiple Linear Regression Analysis of the Impact of Food Antibody Positivity on Inflammatory Factors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDependent Variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndependent Variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eβ Coefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003et value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIL-6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFood Antibody Positive Types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.327\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.089\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.773\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.086\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.944\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.103\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThyroid Function Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.091\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender (Female\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.074\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.957\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.141\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTSH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.058\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.829\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.408\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFT3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFT4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.927\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTPOAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.256\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.941\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTGAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTNF-α\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFood Antibody Positive Types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.669\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.673\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.077\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThyroid Function Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender (Female\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.913\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.057\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTSH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.513\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.608\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFT3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.281\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFT4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.642\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTPOAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.492\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTGAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.752\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ehs-CRP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFood Antibody Positive Types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.812\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.152\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.241\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.773\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThyroid Function Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.023\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender (Female\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.945\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTSH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.316\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFT3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.234\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFT4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.789\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTPOAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.699\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTGAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eESR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFood Antibody Positive Types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.362\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.511\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.091\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.401\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThyroid Function Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender (Female\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.077\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.397\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.217\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTSH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.258\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFT3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.502\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.134\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFT4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-2.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTPOAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTGAb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study aimed to explore the correlation between food intolerance and inflammatory factors in patients with Hashimoto\u0026rsquo;s thyroiditis (HT) to provide a theoretical basis for clinical intervention[\u003cspan additionalcitationids=\"CR25\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Hashimoto\u0026rsquo;s thyroiditis is a common autoimmune disease characterized by the presence of thyroid-specific antibodies (such as TPOAb and TGAb), accompanied by varying degrees of thyroid dysfunction and chronic inflammatory response [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. In recent years, studies have found that the rate of multiple food intolerances is high in HT patients, which may induce or exacerbate systemic inflammatory responses by activating the immune system and destroying intestinal barrier function, thereby affecting disease progression [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. This finding suggests that food antibody positivity may more reflect individual dietary exposure history rather than an HT-specific immune intolerance phenomenon.\u003c/p\u003e \u003cp\u003eCompared with existing studies, this study not only focused on the universality of food intolerance but also further analyzed its relationship with inflammatory factors (such as IL-6, TNF-α, hs-CRP, ESR) and explored its potential as an independent influencing factor of inflammatory response. Dean Kaličanin et al. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] found that the positive rates of food intolerance such as eggs and milk were high in HT patients and were closely related to thyroid autoantibody levels. On this basis, this study further revealed that the more types of food antibody positivity, the higher the level of inflammatory factors, suggesting its potential role in immune regulation. In addition, Manli Yan et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] also pointed out that HT patients generally have elevated multiple food-specific IgG antibodies, especially eggs and milk. The results of this study are highly consistent with this, further supporting the universality and clinical relevance of food intolerance in HT.\u003c/p\u003e \u003cp\u003eThe results of this study show that the most common food intolerance in Hashimoto\u0026rsquo;s thyroiditis patients is milk (positive rate 38%-51%), followed by eggs, wheat, soybeans, etc., which is consistent with multiple study results. Mehmet Asik et al.[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] found that the prevalence of lactose intolerance (LI) among Hashimoto's thyroiditis (HT) patients receiving levothyroxine (LT4) therapy was as high as 75.9%; following an 8-week lactose-restricted diet, serum TSH levels significantly decreased in LI patients with either euthyroidism or subclinical hypothyroidism (from 2.06\u0026thinsp;\u0026plusmn;\u0026thinsp;1.02 to 1.51\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1 IU/mL and from 5.45\u0026thinsp;\u0026plusmn;\u0026thinsp;1.88 to 0.74\u0026thinsp;\u0026plusmn;\u0026thinsp;2.25 IU/mL, respectively; both P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), whereas no significant changes were observed in non-LI controls (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), suggesting that LI screening and dietary lactose restriction may benefit HT patients with suboptimal TSH control despite LT4 treatment. Manli Yan et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] found 85 patients with Hashimoto's thyroiditis, 97.65% exhibited food intolerances, with an average of 15.76\u0026thinsp;\u0026plusmn;\u0026thinsp;10.61 food intolerances. The most common intolerances were eggs (75.29%), cabbage (71.76%), and milk (65.88%), all exceeding 60% intolerance rates. Although the specific values were slightly different, the overall trend was consistent, indicating that these foods may be common IgG antibody positive objects for HT patients. In addition, this study also found that as the degree of hypothyroidism aggravated, the proportion of food antibody positivity showed an upward trend. Although the statistical difference was not significant, this trend was consistent with literature reports. This trend may be related to slowed metabolism, immune disorder, and impaired intestinal barrier function caused by low thyroid function. This study also showed that IL-6, TNF-α, hs-CRP, and ESR levels in Hashimoto\u0026rsquo;s thyroiditis patients were significantly higher than in the healthy control group, and reached the highest level in the hypothyroidism group, which is highly consistent with existing literature. For example, Kuna al. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] found that serum CRP, ESR and IL-6levels in HT patients were significantly elevated and were closely related to thyroid dysfunction. In addition, Fen Feng et al. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] also pointed out that serum MIP-1α and PD-1 levels in patients with type 2 diabetes combined with HT were significantly elevated and were positively correlated with TSH, TPOAb, and TGAb, further indicating the core position of inflammatory factors in the immune response of HT patients. It is worth noting that this study also found that thyroid function status had a significant impact on inflammatory factor levels. The inflammatory factor levels in the hypothyroidism group were the highest, followed by the euthyroid group, and the hyperthyroidism group was relatively low, suggesting that thyroid dysfunction may exacerbate inflammatory responses by affecting the immune system and metabolic levels. This result is consistent with the study by Yifang Hu et al. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], They discovered that foods containing Se have the potential to lower thyroid antibody and TSH levels, promote hormone therapy, and for the first time improved Treg cells in hormone patients through se supplementation, laying the foundation for the treatment mechanism.\u003c/p\u003e \u003cp\u003eSpearman correlation analysis showed that food antibody positive grade was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR, indicating that the more types of food antibody positivity and the more severe the reaction, the stronger the inflammatory response. This finding is consistent with the study by Ewa Tywanek et al. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], who found that inflammatory factor levels in HT patients were closely related to thyroid autoantibodies and immune dysfunction. In addition, Farhangi et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] also pointed out that inflammatory factors such as VCAM-1, MCP-1, IL-17, and IL-6 were significantly elevated in HT patients and were positively correlated with TPOAb and TGAb levels, further supporting the hypothesis that food intolerance affects inflammatory factors through immune activation mechanisms. This study further found through multiple linear regression analysis that the number of food antibody positive types is an independent predictor of IL-6, TNF-α, hs-CRP, and ESR, indicating that even after controlling for factors such as age, BMI, and thyroid function status, food intolerance still has a significant impact on inflammatory response. This result is consistent with the findings of Ai-Jing Chu et al. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], who found that Buzhong Yiqi Pill combined with levothyroxine sodium tablets can significantly reduce the levels of IL-12, IFN-γ and other inflammatory factors in patients with Hashimoto's thyroiditis, suggesting that diet and immune regulation play an important role in controlling inflammation.\u003c/p\u003e \u003cp\u003eMultiple linear regression analysis results showed that the number of food antibody positive types was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), confirming that food antibody positivity is an independent risk factor for elevated inflammatory factor levels. In addition, variables such as thyroid function status, TPOAb, and TGAb also had varying degrees of impact on inflammatory factors, indicating that the inflammatory response in HT patients is the result of the combined action of multiple factors. This result is consistent with the study by Huwiler et al. [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e], who found that TPOAb levels were positively correlated with inflammatory factors, suggesting that elevated autoantibody levels may exacerbate immune responses. In addition, Sheng Huang et al. [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] also pointed out that traditional Chinese medicine can regulate immune responses and improve the inflammatory status of HT patients by intervening in inflammatory factors and signaling pathways. This study further illustrates that in addition to drug intervention, dietary intervention (such as avoiding positive antibody foods) may also become an important means of controlling inflammation.\u003c/p\u003e \u003cp\u003eDespite the significant findings presented above, several limitations of this study warrant careful consideration. First, the clinical utility of food-specific IgG testing remains a subject of debate within the immunological community. While traditional guidelines, such as those from the European Academy of Allergy and Clinical Immunology (EAACI), suggest that elevated food-specific IgG may merely reflect exposure or immune tolerance rather than pathology [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e], emerging evidence indicates that in the context of autoimmune conditions, these antibodies may form circulating immune complexes (CICs). These complexes can activate the complement system, potentially triggering chronic low-grade inflammation and tissue damage [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Therefore, while the clinical significance is still controversial, our data suggests that IgG levels should not be interpreted in isolation but must be judged in combination with clinical symptoms and inflammatory markers. Second, the absence of a healthy control group limits the external validity of our findings. This study did not detect food IgG antibody data in a matched healthy population, so it was impossible to compare the food IgG antibody profile between HT patients and healthy individuals. Consequently, we cannot definitively conclude whether the observed high prevalence of food intolerance is specific to the HT pathophysiology or reflects a broader population trend [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Future studies should establish age and gender-matched control groups to define specific reference ranges for this population. Third, the mechanistic pathways linking food intolerance to HT inflammation were not fully elucidated. In addition, this study did not deeply explore the association between food intolerance and gut microbiota, intestinal permeability, oxidative stress, and other factors. Recent literature highlights the \u0026ldquo;Gut-Thyroid Axis,\u0026rdquo; suggesting that dysbiosis and increased intestinal permeability (leaky gut) may allow food antigens to enter circulation, triggering autoimmune responses via molecular mimicry [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Furthermore, oxidative stress is a known contributor to thyroid tissue damage and may be exacerbated by chronic dietary inflammation [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Future research can further investigate these potential mechanisms to establish a causal link.\u003c/p\u003e \u003cp\u003eNotwithstanding these limitations, this study offers significant strengths. In summary, this study shows that food intolerance is prevalent in Hashimoto\u0026rsquo;s thyroiditis patients, especially common foods such as dairy products, eggs, and wheat. Unlike previous studies that focused solely on thyroid antibodies, we quantified the dose-response relationship between food antigens and systemic inflammation. The more types of food positive antibodies and the more severe the reaction, the higher the level of inflammatory factors, suggesting its important role in HT inflammatory response. Multiple regression analysis further confirmed that food antibody positivity is an independent influencing factor for elevated inflammatory levels, strengthening the evidence for food antigens as environmental triggers in HT.\u003c/p\u003e \u003cp\u003eTherefore, in clinical management, attention should be paid to the screening and intervention of food positive antibodies, but with a nuanced approach. Combined with dietary adjustment and immune regulation, it helps to improve the inflammatory status of HT patients and delay disease progression. We recommend that screening be followed by supervised elimination diets rather than blind long-term restriction to avoid nutritional deficiencies [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. By integrating dietary strategies with standard immune regulation, clinicians may better manage the inflammatory burden in HT patients.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eThis study demonstrates a significant correlation between the variety of food-specific IgG antibody positivity and systemic inflammatory levels in patients with Hashimoto's thyroiditis (HT). Multiple linear regression analysis confirmed that the number of positive food antibody types serves as an independent predictor for elevated inflammatory markers, including IL-6, TNF-α, hs-CRP, and ESR, even after adjusting for thyroid function status and autoantibody levels. While food-specific IgG antibodies primarily reflect immune exposure rather than definitive clinical intolerance, their strong association with inflammatory burden suggests a potential role in exacerbating the immune response in HT.\u003c/p\u003e \u003cp\u003eConsequently, integrating food-specific IgG screening into clinical assessment may help identify patients with a higher inflammatory burden. We recommend that positive results be followed by personalized, supervised dietary elimination strategies rather than blind long-term restriction to avoid nutritional deficiencies. However, given the ongoing debate regarding the clinical utility of IgG testing, these findings should be interpreted cautiously and in conjunction with clinical symptoms. Future longitudinal studies are warranted to elucidate the underlying mechanistic pathways, particularly the gut-thyroid axis, and to validate the long-term therapeutic benefits of IgG-guided dietary interventions in the management of Hashimoto's thyroiditis.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHashimoto's thyroiditis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIgG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eImmunoglobulin G\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIgE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eImmunoglobulin E\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTPOAb\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAnti-thyroid peroxidase antibody\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTGAb\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAnti-thyroglobulin antibody\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTSH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThyroid stimulating hormone\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFT3\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFree triiodothyronine\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFT4\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFree thyroxine\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIL-6\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInterleukin-6\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTNF-α\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTumor necrosis factor-α\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ehs-CRP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHigh-sensitivity C-reactive protein\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eESR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eErythrocyte sedimentation rate\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBMI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBody mass index\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eELISA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEnzyme-linked immunosorbent assay\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eANOVA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAnalysis of variance\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSLE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSystemic lupus erythematosus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003eAcknowledgements:\u003c/p\u003e\n\u003cp\u003eWe express our gratitude to Mr. Shusen Li for his invaluable guidance and support. His insights into my research topic were crucial in shaping my understanding and direction.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData availability statement\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for Publication:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\n\u003cp\u003eFunding:\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Guangdong Famous Chinese Medicine Workshop: Shusen Li Workshop Foundation Program.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical trial number: \u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\n\u003cp\u003eAuthor contributions：\u003c/p\u003e\n\u003cp\u003eYingchao Chen: conceptualization, data curation, methodology, formal analysis, writing\u0026mdash;original draft. Ping Gong: data curation, writing\u0026mdash;original draft. Hua Wei: project administration, writing\u0026mdash;review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003eEthics declarations：\u003c/p\u003e\n\u003cp\u003eThis study was conducted in strict accordance with the ethical principles of the Declaration of Helsinki. The study protocol was reviewed and approved by the Ethics \u003c/p\u003e\n\u003cp\u003eCommittee of Guangdong Provincial Hospital of Chinese Medicine (Approval No. ZE2026-125). All clinical data used in this retrospective cohort study were fully anonymized before being accessed and analyzed, with no possibility of identifying individual patients.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCabibi D, Giannone AG, Bellavia S, Coco RL, Bianco AL, Formisano E, et al. Serum Anti-Thyroglobulin Autoantibodies Are Specific in Predicting the Presence of Papillary-like Nuclear Features and Lymphocytic Infiltrate in the Thyroid Gland. Diagnostics. 2023;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/diagnostics13122042\u003c/span\u003e\u003cspan address=\"10.3390/diagnostics13122042\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYamagami A, Iwama S, Kobayashi T, Zhou X, Yasuda Y, Okuji T, et al. Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade. Endocr J. 2024;71:515\u0026ndash;26. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1507/endocrj.EJ23-0480\u003c/span\u003e\u003cspan address=\"10.1507/endocrj.EJ23-0480\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuo T, Zhao X, Jiang X, Li P, Gu X, Xie X, et al. Serum metabolomic analysis in patients with Hashimoto\u0026rsquo;s thyroiditis positive for TgAb or TPOAb: a preliminary study. Sci Rep. 2025;15:9945. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/s41598-025-90467-5\u003c/span\u003e\u003cspan address=\"10.1038/s41598-025-90467-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuo J, Wang X, Yuan L, Guo L. Iron Deficiency, a Risk Factor of Thyroid Disorders in Reproductive-Age and Pregnant Women: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2021;12:629831. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fendo.2021.629831\u003c/span\u003e\u003cspan address=\"10.3389/fendo.2021.629831\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMorales-Mart\u0026iacute;nez FA, Sordia-Hern\u0026aacute;ndez LH, Ruiz MM, Garcia-Luna S, Vald\u0026eacute;s-Mart\u0026iacute;nez OH, Vidal-Gutierez O. Association between thyroid autoimmunity and ovarian reserve in women with hypothyroidism. Thyroid Res. 2021;14:6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s13044-021-00095-0\u003c/span\u003e\u003cspan address=\"10.1186/s13044-021-00095-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBajpai G, Nahrendorf M. Infectious and lifestyle modifiers of immunity and host resilience. Immunity. 2021;54:1110\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.immuni.2021.05.011\u003c/span\u003e\u003cspan address=\"10.1016/j.immuni.2021.05.011\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRalli M, Angeletti D, Fiore M, D\u0026rsquo;Aguanno V, Lambiase A, Artico M, et al. Hashimoto\u0026rsquo;s thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation. Autoimmun Rev. 2020;19:102649. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.autrev.2020.102649\u003c/span\u003e\u003cspan address=\"10.1016/j.autrev.2020.102649\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHu X, Chen Y, Shen Y, Tian R, Sheng Y, Que H. Global prevalence and epidemiological trends of Hashimoto\u0026rsquo;s thyroiditis in adults: A systematic review and meta-analysis. Front Public Health. 2022;10:1020709. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fpubh.2022.1020709\u003c/span\u003e\u003cspan address=\"10.3389/fpubh.2022.1020709\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKaličanin D, Brčić L, Barić A, Zlodre S, Barbalić M, Torlak Lovrić V, et al. Evaluation of Correlations Between Food-Specific Antibodies and Clinical Aspects of Hashimoto\u0026rsquo;s Thyroiditis. J Am Coll Nutr. 2019;38:259\u0026ndash;66. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/07315724.2018.1503103\u003c/span\u003e\u003cspan address=\"10.1080/07315724.2018.1503103\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIhnatowicz P, Gębski J, Drywień ME. Effects of Autoimmune Protocol (AIP) diet on changes in thyroid parameters in Hashimoto\u0026rsquo;s disease. Ann Agric Environ Med. 2023;30:513\u0026ndash;21. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.26444/aaem/166263\u003c/span\u003e\u003cspan address=\"10.26444/aaem/166263\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYan M, Wu H, Zhang K, Gong P, Wang Y, Wei H. Analysis of the correlation between Hashimoto\u0026rsquo;s thyroiditis and food intolerance. Front Nutr. 2024;11:1452371. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fnut.2024.1452371\u003c/span\u003e\u003cspan address=\"10.3389/fnut.2024.1452371\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRuchała M, Bossowski A, Brzozka MM, Gietka-Czernel M, Hubalewska-Dydejczyk A, Kos-Kudła B, et al. Liquid levothyroxine improves thyroid control in patients with different hypothyroidism aetiology and variable adherence - case series and review. Endokrynol Pol. 2022;73:893\u0026ndash;902. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5603/EP.a2022.0078\u003c/span\u003e\u003cspan address=\"10.5603/EP.a2022.0078\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMikulska AA, Karaźniewicz-Łada M, Filipowicz D, Ruchała M, Gł\u0026oacute;wka FK. Metabolic Characteristics of Hashimoto\u0026rsquo;s Thyroiditis Patients and the Role of Microelements and Diet in the Disease Management-An Overview. Int J Mol Sci. 2022;23:6580. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijms23126580\u003c/span\u003e\u003cspan address=\"10.3390/ijms23126580\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSzczuko M, Syrenicz A, Szymkowiak K, Przybylska A, Szczuko U, Pobłocki J, et al. Doubtful Justification of the Gluten-Free Diet in the Course of Hashimoto\u0026rsquo;s Disease. Nutrients. 2022;14:1727. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/nu14091727\u003c/span\u003e\u003cspan address=\"10.3390/nu14091727\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWrońska K, Hałasa M, Szczuko M. The Role of the Immune System in the Course of Hashimoto\u0026rsquo;s Thyroiditis: The Current State of Knowledge. Int J Mol Sci. 2024;25:6883. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijms25136883\u003c/span\u003e\u003cspan address=\"10.3390/ijms25136883\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePan M, Qi Q, Li C, Wang J, Pan X, Zhou J, et al. Effect and mechanism of Hashimoto thyroiditis on female infertility: A clinical trial, bioinformatics analysis, and experiments-based study. Biosci Trends. 2024;18:356\u0026ndash;69. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5582/bst.2024.01120\u003c/span\u003e\u003cspan address=\"10.5582/bst.2024.01120\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHepp M, Werion A, De Greef A, de Ville de Goyet C, de Bournonville M, Behets C, et al. Oxidative Stress-Induced Sirtuin1 Downregulation Correlates to HIF-1α, GLUT-1, and VEGF-A Upregulation in Th1 Autoimmune Hashimoto\u0026rsquo;s Thyroiditis. Int J Mol Sci. 2021;22:3806. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijms22083806\u003c/span\u003e\u003cspan address=\"10.3390/ijms22083806\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKlobučar S, Kenđel Jovanović G, Kryczyk-Kozioł J, Cigrovski Berković M, Vučak Lončar J, Morić N, et al. Association of Dietary Inflammatory Index and Thyroid Function in Patients with Hashimoto\u0026rsquo;s Thyroiditis: An Observational Cross-Sectional Multicenter Study. Med (Kaunas). 2024;60:1454. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/medicina60091454\u003c/span\u003e\u003cspan address=\"10.3390/medicina60091454\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlijani S, Ghadir M, Gargari BP. The association between dietary inflammatory index and dietary total antioxidant capacity and Hashimoto\u0026rsquo;s thyroiditis: a case-control study. BMC Endocr Disord. 2024;24:177. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12902-024-01708-z\u003c/span\u003e\u003cspan address=\"10.1186/s12902-024-01708-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u0026Uuml;lker MT, \u0026Ccedil;olak GA, Baş M, Erdem MG. Evaluation of the effect of gluten-free diet and Mediterranean diet on autoimmune system in patients with Hashimoto\u0026rsquo;s thyroiditis. Food Sci Nutr. 2024;12:1180\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/fsn3.3833\u003c/span\u003e\u003cspan address=\"10.1002/fsn3.3833\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLagan\u0026agrave; M, Piticchio T, Alibrandi A, Le Moli R, Pallotti F, Campenn\u0026igrave; A, et al. Effects of Dietary Habits on Markers of Oxidative Stress in Subjects with Hashimoto\u0026rsquo;s Thyroiditis: Comparison Between the Mediterranean Diet and a Gluten-Free Diet. Nutrients. 2025;17:363. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/nu17020363\u003c/span\u003e\u003cspan address=\"10.3390/nu17020363\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVergatti A, Abate V, Garofano F, Fiore A, De Filippo G, Strazzullo P, et al. Are Dietary Habits the Missing Link Between Hashimoto\u0026rsquo;s Thyroiditis and Osteoporosis? Nutrients. 2025;17:2109. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/nu17132109\u003c/span\u003e\u003cspan address=\"10.3390/nu17132109\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarbalace MC, Talotta R, Rapisarda F, D\u0026rsquo;Amico V, Lagan\u0026agrave; M, Malaguti M, et al. Unlocking the Power of the Mediterranean Diet: Two in One-Dual Benefits for Rheumatic and Thyroid Autoimmune Diseases. Nutrients. 2025;17:1383. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/nu17081383\u003c/span\u003e\u003cspan address=\"10.3390/nu17081383\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKlubo-Gwiezdzinska J, Wartofsky L. Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment. Pol Arch Intern Med. 2022;132:16222. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.20452/pamw.16222\u003c/span\u003e\u003cspan address=\"10.20452/pamw.16222\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHu Y, Feng W, Chen H, Shi H, Jiang L, Zheng X, et al. Effect of selenium on thyroid autoimmunity and regulatory T cells in patients with Hashimoto\u0026rsquo;s thyroiditis: A prospective randomized-controlled trial. Clin Transl Sci. 2021;14:1390\u0026ndash;402. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/cts.12993\u003c/span\u003e\u003cspan address=\"10.1111/cts.12993\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDwivedi SN, Kalaria T, Buch H. Thyroid autoantibodies. J Clin Pathol. 2023;76:19\u0026ndash;28. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1136/jcp-2022-208290\u003c/span\u003e\u003cspan address=\"10.1136/jcp-2022-208290\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeng B, Wang W, Gu Q, Wang P, Teng W, Shan Z. Effects of different supplements on Hashimoto\u0026rsquo;s thyroiditis: a systematic review and network meta-analysis. Front Endocrinol (Lausanne). 2024;15:1445878. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fendo.2024.1445878\u003c/span\u003e\u003cspan address=\"10.3389/fendo.2024.1445878\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKravchenko V, Zakharchenko T. Thyroid hormones and minerals in immunocorrection of disorders in autoimmune thyroid diseases. Front Endocrinol (Lausanne). 2023;14:1225494. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fendo.2023.1225494\u003c/span\u003e\u003cspan address=\"10.3389/fendo.2023.1225494\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChaudhuri J, Mukherjee A, Chakravarty A. Hashimoto\u0026rsquo;s Encephalopathy: Case Series and Literature Review. Curr Neurol Neurosci Rep. 2023;23:167\u0026ndash;75. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s11910-023-01255-5\u003c/span\u003e\u003cspan address=\"10.1007/s11910-023-01255-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAsik M, Gunes F, Binnetoglu E, Eroglu M, Bozkurt N, Sen H, et al. Decrease in TSH levels after lactose restriction in Hashimoto\u0026rsquo;s thyroiditis patients with lactose intolerance. Endocrine. 2014;46:279\u0026ndash;84. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s12020-013-0065-1\u003c/span\u003e\u003cspan address=\"10.1007/s12020-013-0065-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKuna M, Štefanović M, Barac E, Madunić FI, Hanžek M, Lugović-Mihić L Prospective Monitoring of Serum Values of CBC, Total IgE, Findings T, Vitamin D-D D, and, Molecules I. CRP, ESR, and IL-6 and Clinical Features of Chronic Spontaneous Urticaria Patients During Antihistamine Treatment. Int J Mol Sci. 2026;27:2503. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijms27052503\u003c/span\u003e\u003cspan address=\"10.3390/ijms27052503\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFeng F, Zhou B, Zhou C-L, Huang P, Wang G, Yao K, Vitamin D. selenium, and antidiabetic drugs in the treatment of type 2 diabetes mellitus with Hashimoto\u0026rsquo;s thyroiditis. World J Diabetes. 2024;15:209\u0026ndash;19. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4239/wjd.v15.i2.209\u003c/span\u003e\u003cspan address=\"10.4239/wjd.v15.i2.209\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTywanek E, Michalak A, Świrska J, Zwolak A, Autoimmunity. New Potential Biomarkers and the Thyroid Gland-The Perspective of Hashimoto\u0026rsquo;s Thyroiditis and Its Treatment. Int J Mol Sci. 2024;25:4703. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/ijms25094703\u003c/span\u003e\u003cspan address=\"10.3390/ijms25094703\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFarhangi MA, Tajmiri S. The effects of powdered black cumin seeds on markers of oxidative stress, intracellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in patients with Hashimoto\u0026rsquo;s thyroiditis. Clin Nutr ESPEN. 2020;37:207\u0026ndash;12. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.clnesp.2020.02.015\u003c/span\u003e\u003cspan address=\"10.1016/j.clnesp.2020.02.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChu A-J, Lu Y-Y, Qiao J-J, Xia Z-Y. Effect of Buzhong Yiqi Decoction on Treg cells in rats with autoimmune thyroiditis through TGF-β/Smad signaling pathway. Zhongguo Zhong Yao Za Zhi. 2024;49:5288\u0026ndash;96. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.19540/j.cnki.cjcmm.20240712.702\u003c/span\u003e\u003cspan address=\"10.19540/j.cnki.cjcmm.20240712.702\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuwiler VV, Maissen-Abgottspon S, Stanga Z, M\u0026uuml;hlebach S, Trepp R, Bally L, et al. Selenium Supplementation in Patients with Hashimoto Thyroiditis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Thyroid. 2024;34:295\u0026ndash;313. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1089/thy.2023.0556\u003c/span\u003e\u003cspan address=\"10.1089/thy.2023.0556\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang S, Ziros PG, Chartoumpekis DV, Psarias G, Duntas L, Zuo X, et al. Traditional Chinese Medicine for Hashimoto\u0026rsquo;s Thyroiditis: Focus on Selenium and Antioxidant Phytochemicals. Antioxid (Basel). 2024;13:868. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/antiox13070868\u003c/span\u003e\u003cspan address=\"10.3390/antiox13070868\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSantos AF, Riggioni C, Agache I, Akdis CA, Akdis M, Alvarez-Perea A, et al. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy. 2023;78:3057\u0026ndash;76. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/all.15902\u003c/span\u003e\u003cspan address=\"10.1111/all.15902\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBajic G, Degn SE, Thiel S, Andersen GR. Complement activation, regulation, and molecular basis for complement-related diseases. EMBO J. 2015;34:2735\u0026ndash;57. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.15252/embj.201591881\u003c/span\u003e\u003cspan address=\"10.15252/embj.201591881\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFeng H, Luo N, Xiong X, Wu Y. Prevalence of food allergy in the Chinese population: A systematic review and meta-analysis of population-based studies. Allergy Asthma Proc. 2023;44:315\u0026ndash;25. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2500/aap.2023.44.230039\u003c/span\u003e\u003cspan address=\"10.2500/aap.2023.44.230039\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKinashi Y, Hase K. Partners in Leaky Gut Syndrome: Intestinal Dysbiosis and Autoimmunity. Front Immunol. 2021;12:673708. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fimmu.2021.673708\u003c/span\u003e\u003cspan address=\"10.3389/fimmu.2021.673708\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMancini A, Di Segni C, Raimondo S, Olivieri G, Silvestrini A, Meucci E, et al. Thyroid Hormones, Oxidative Stress, and Inflammation. Mediators Inflamm. 2016;2016:6757154. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1155/2016/6757154\u003c/span\u003e\u003cspan address=\"10.1155/2016/6757154\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMunteanu C, Schwartz B. The relationship between nutrition and the immune system. Front Nutr. 2022;9:1082500. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fnut.2022.1082500\u003c/span\u003e\u003cspan address=\"10.3389/fnut.2022.1082500\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-endocrine-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bend","sideBox":"Learn more about [BMC Endocrine Disorders](http://bmcendocrdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bend/default.aspx","title":"BMC Endocrine Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Hashimoto’s thyroiditis, Food-specific IgG, Inflammatory factors, Autoantibodies, Immune response","lastPublishedDoi":"10.21203/rs.3.rs-9256069/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9256069/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eThe pathogenesis of Hashimoto’s thyroiditis (HT) involves immune dysregulation, where food sensitivity-mediated by food-specific IgG antibodies-may contribute to the disease progression by inducing chronic low-grade inflammation. Pro-inflammatory cytokines have been shown to be causally linked to the development of HT. This study aims to investigate the correlation between food-specific IgG antibody levels and inflammatory factors in HT patients to evaluate the impact of food exposure on the systemic inflammatory response.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAims: \u003c/strong\u003eThis study aims to investigate the correlation between food-specific IgG antibody positivity and systemic inflammatory factors (IL-6, TNF-α, hs-CRP, ESR) in patients with Hashimoto's thyroiditis. Specifically, we sought to evaluate whether the variety and severity of food-specific IgG antibodies serve as independent predictors of systemic inflammation levels across different thyroid functional statuses.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA retrospective analysis was conducted on clinical data from 184 HT patients (case group) and 100 healthy controls who were admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine between January 2021 and December 2024. The case group was categorized into euthyroid, subclinical hypothyroidism, hypothyroidism, and hyperthyroidism (thyrotoxicosis phase) groups based on thyroid function. Levels of 14 common food-specific IgG antibodies, thyroid-related autoantibodies (TPOAb, TGAb), and inflammatory markers (IL-6, TNF-α, hs-CRP, ESR) were measured. Spearman rank correlation and multiple linear regression analyses were performed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eHT patients exhibited high positivity rates for various food-specific IgG antibodies, with milk being the most prevalent (38.46%–51.02%). While antibody positivity was also detected in healthy controls with no significant inter-group difference (P \u0026gt; 0.05), inflammatory factor levels were significantly higher in all HT subgroups compared to controls (P \u0026lt; 0.001), peaking in the hypothyroidism group. Spearman analysis revealed that the number of positive food antibody types was significantly positively correlated with IL-6, TNF-α, hs-CRP, and ESR (P \u0026lt; 0.05). Multiple linear regression confirmed that the variety of food-specific IgG antibodies was an independent positive predictor of systemic inflammation levels (P \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eIn HT patients, the variety of food-specific IgG antibody positivity is significantly associated with systemic inflammatory levels. Although these antibodies primarily reflect food exposure rather than direct intolerance, monitoring and dietary intervention based on antibody profiles may help manage the inflammatory burden in HT patients.\u003c/p\u003e","manuscriptTitle":"Clinical analysis of the correlation between food-specific IgG antibody positivity and inflammatory factors in patients with Hashimoto's thyroiditis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-11 10:36:42","doi":"10.21203/rs.3.rs-9256069/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-06T10:36:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"272132167132112710992175025732715584536","date":"2026-05-05T11:36:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"161702731019968728961774098235571233347","date":"2026-05-01T02:57:36+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-30T19:10:57+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-08T09:00:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-01T04:49:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-01T02:08:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Endocrine Disorders","date":"2026-04-01T02:04:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-endocrine-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bend","sideBox":"Learn more about [BMC Endocrine Disorders](http://bmcendocrdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bend/default.aspx","title":"BMC Endocrine Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"430e7d6b-efa8-4dfb-aa8e-ced6907eddad","owner":[],"postedDate":"May 11th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-06T10:36:12+00:00","index":49,"fulltext":""},{"type":"reviewerAgreed","content":"272132167132112710992175025732715584536","date":"2026-05-05T11:36:43+00:00","index":48,"fulltext":""},{"type":"reviewerAgreed","content":"161702731019968728961774098235571233347","date":"2026-05-01T02:57:36+00:00","index":46,"fulltext":""},{"type":"reviewersInvited","content":"30","date":"2026-04-30T19:10:57+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-11T10:36:42+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-11 10:36:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9256069","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9256069","identity":"rs-9256069","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}