Endocrinology Unit, Department of Medical and Surgical Sciences, University of Padua Veneto Institute of Oncology Department of Laboratory Medicine, Padua, Italy.
Clin Endocrinol (Oxf). 2010 Oct;73(4):535-9. doi: 10.1111/j.1365-2265.2009.03758.x.
Our study aimed to investigate whether physiological doses of selenium (Se) influence the natural course of autoimmune thyroiditis (AIT).
A total of 76 consecutive patients (65 F, 11 M, median 43, range 15-75 years) with AIT, normal or slightly elevated TSH and fT4 within the normal range were divided into two groups: Group 0 (30 cases) was given no treatment while Group 1 (46 cases) was treated with sodium selenite 80 μg/day as a single oral dose for 12 months. Thyroperoxidase and thyroglobulin autoantibodies (TPO-Ab; Tg-Ab), TSH, fT4 and urine iodine concentrations (UIC) were measured at baseline and after 6 and 12 months of follow-up. Thyroid ultrasonography (US) was performed at each follow-up point. Echogenicity was measured by histographic analysis of gray-scale pixels (gsp) ranging from 0 = black to 255 = white.
Thyroid echogenicity decreased significantly in both groups after 6 months, but after 12 months, it had changed no more in Group 1, whereas it had dropped further in Group 0. No significant variation in TPO-Ab or Tg-Ab levels was observed between the two groups after 6 months, but both values decreased significantly after 12 months in Group 1, and five patients in this group became negative for TPO-Ab. TSH and FT4 showed no significant variations in either group.
Dietary supplementation with physiological doses of Se seems to be effective in preventing a reduction in thyroid echogenicity after 6 months of treatment and in reducing TPO-Ab and Tg-Ab after 12 months, but does not modify TSH or FT4.
本研究旨在探讨生理剂量的硒（Se）是否会影响自身免疫性甲状腺炎（AIT）的自然病程。
共纳入 76 例连续就诊的 AIT 患者（65 例女性，11 例男性；中位年龄 43 岁，范围 15-75 岁），甲状腺刺激素（TSH）和游离甲状腺素（fT4）均处于正常或轻度升高范围，游离甲状腺素在正常范围内。将患者分为两组：0 组（30 例）未接受治疗，1 组（46 例）接受亚硒酸钠 80μg/天的单一口服剂量治疗，疗程为 12 个月。在基线、6 个月和 12 个月随访时检测甲状腺过氧化物酶和甲状腺球蛋白自身抗体（TPO-Ab；Tg-Ab）、TSH、fT4 和尿碘浓度（UIC）。在每次随访时进行甲状腺超声检查。通过对灰度像素（gsp）进行直方图分析来测量甲状腺回声强度，gsp 范围从 0（黑色）到 255（白色）。
两组患者在治疗 6 个月后甲状腺回声强度均显著降低，但在治疗 12 个月时，1 组的回声强度无进一步变化，而 0 组的回声强度进一步降低。两组患者在治疗 6 个月后 TPO-Ab 或 Tg-Ab 水平无显著变化，但在治疗 12 个月后，1 组的这两项指标均显著降低，其中 5 例患者 TPO-Ab 转为阴性。TSH 和 fT4 在两组患者中均无显著变化。
饮食补充生理剂量的 Se 似乎能有效预防治疗 6 个月后甲状腺回声强度降低，并能在 12 个月时降低 TPO-Ab 和 Tg-Ab，但不会改变 TSH 或 fT4。
