Bonfig W, Gärtner R, Schmidt H
1Pediatric Endocrinology, Dr. von Haunersches Children's Hospital and 2Endocrinology, Internal Medicine, Medical Department-Innenstadt, Ludwig Maximilians University, Munich.
ScientificWorldJournal. 2010 Jun 1;10:990-6. doi: 10.1100/tsw.2010.91.
In adults, selenium supplementation decreases thyroid peroxidase antibody (TPO Ab) concentrations in patients with autoimmune thyroiditis (AIT). Our aim in this study was to investigate if selenium supplementation decreased TPO Ab and thyroglobulin antibody (Tg Ab) concentrations in children with AIT. Forty-nine patients (33 females) with newly diagnosed AIT and hypothyroidism were randomized to daily oral therapy with levothyroxine alone (group A, n=18), levothyroxine plus 100 microg sodium-selenite (group B, n=13), or levothyroxine plus 200 microg sodium-selenite (group C, n=18). Mean age at diagnosis was 12.2+/-2.2 years. All 49 patients needed a mean levothyroxine dose of 1.6+/-0.5 microg/kg body weight to lower TSH to the treatment goal of 1-2 microU/ml, with no significant difference between groups. At study entry and after 12 months, TPO Ab concentrations were comparable in all three groups. Tg Ab concentrations decreased significantly after 12 months in group A and group C (p=0.03 and p=0.01), but not in group B (p=0.06). It is our conclusion that selenium supplementation with sodium-selenite does not decrease TPO Ab concentrations in children and adolescents, neither given in the reduced dose of 100 microg daily nor given in the "adult" supplementation dose of 200 microg daily.
在成人中，补充硒可降低自身免疫性甲状腺炎（AIT）患者的甲状腺过氧化物酶抗体（TPO Ab）浓度。本研究的目的是调查补充硒是否能降低AIT患儿的TPO Ab和甲状腺球蛋白抗体（Tg Ab）浓度。49例新诊断为AIT和甲状腺功能减退的患者（33例女性）被随机分为三组，分别接受每日仅口服左甲状腺素治疗（A组，n = 18）、左甲状腺素加100μg亚硒酸钠治疗（B组，n = 13）或左甲状腺素加200μg亚硒酸钠治疗（C组，n = 18）。诊断时的平均年龄为12.2±2.2岁。所有49例患者将促甲状腺激素（TSH）降至1 - 2μU/ml的治疗目标所需的左甲状腺素平均剂量为1.6±0.5μg/kg体重，各组之间无显著差异。在研究开始时和12个月后，三组的TPO Ab浓度相当。12个月后，A组和C组的Tg Ab浓度显著降低（p = 0.03和p = 0.01），但B组未降低（p = 0.06）。我们的结论是，补充亚硒酸钠对儿童和青少年的TPO Ab浓度没有降低作用，无论是每日100μg的低剂量还是每日200μg的“成人”补充剂量。
