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自身免疫性甲状腺炎女性患者补充硒——对甲状腺和卵巢功能的影响(病例研究)

Selenium supplementation in autoimmune thyroiditis female patient--effects on thyroid and ovarian functions (case study).

作者信息

Zagrodzki Paweł, Ratajczak Ryszard

机构信息

Department of Food Chemistry and Nutrition, Collegium Medicum Jagiellonian University, Medyczna 9, 30-688 Krakow, Poland.

出版信息

Biol Trace Elem Res. 2008 Winter;126(1-3):76-82. doi: 10.1007/s12011-008-8188-6. Epub 2008 Aug 6.

Abstract

Recently published biochemical data suggest the significant role of selenium compounds as the adjuvants combined with L: -thyroxine therapy, which can reduce antithyroid peroxidase antibodies' (TPOAb) levels in patients with Hashimoto disease. The study was undertaken to document in a more detailed way the changes in parameters expressing the thyroid and ovarian function brought about by selenium supplementation (50-100 microg/day) in a woman undergoing autoimmune thyroiditis (AIT) therapy. This prospective observational case study lasted for 14 months plus additional 5 months as a follow-up period. Parameters reflecting selenium status, thyroid metabolism, and sex hormones secretion were determined at the onset and end of the study period, as well as in some of its middle points. During the supplementation trial, serum selenium (Se) increased by 45% and plasma glutathione peroxidase (GPX3) by 21%. TPOAb decreased by 76%. All other parameters also fluctuated during the supplementation period, but all results were always within normal physiological ranges. After withdrawal of the supplementation, the sharp fall of Se and GPX3 promptly occurred, and this phenomenon was accompanied with a marked increase in TPOAb. This report stresses the importance of selenium supplementation in AIT treatment. However, the efficiency and durability of the effect of Se supplementation on the TPOAb titer remain an open question. The clarification of mechanism(s) underlying Se interaction with autoimmune processes should throw new light on this issue.

摘要

最近发表的生化数据表明,硒化合物作为佐剂与左旋甲状腺素联合治疗具有重要作用,可降低桥本氏病患者的抗甲状腺过氧化物酶抗体(TPOAb)水平。本研究旨在更详细地记录在接受自身免疫性甲状腺炎(AIT)治疗的女性中,补充硒(50 - 100微克/天)所引起的甲状腺和卵巢功能相关参数的变化。这项前瞻性观察性病例研究持续了14个月,并额外设置了5个月的随访期。在研究期开始和结束时,以及在其中间的一些时间点,测定反映硒状态、甲状腺代谢和性激素分泌的参数。在补充试验期间,血清硒(Se)增加了45%,血浆谷胱甘肽过氧化物酶(GPX3)增加了21%。TPOAb降低了76%。在补充期间所有其他参数也有波动,但所有结果始终在正常生理范围内。停止补充后,Se和GPX3迅速大幅下降,并且这一现象伴随着TPOAb的显著增加。本报告强调了补充硒在AIT治疗中的重要性。然而,补充硒对TPOAb滴度影响的有效性和持久性仍是一个悬而未决的问题。阐明硒与自身免疫过程相互作用的潜在机制应能为这个问题带来新的启示。

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