Department of Endocrinology and Metabolic diseases, Hôpital du Cluzeau, Limoges Cedex, France.
Clin Endocrinol (Oxf). 2013 Feb;78(2):155-64. doi: 10.1111/cen.12066.
The thyroid is the organ with the highest selenium content per gram of tissue because it expresses specific selenoproteins. Since the discovery of myxoedematous cretinism and thyroid destruction following selenium repletion in iodine- and selenium-deficient children, data on links between thyroid metabolism and selenium have multiplied. Although very minor amounts of selenium appear sufficient for adequate activity of deiodinases, thus limiting the impact of its potential deficiency on synthesis of thyroid hormones, selenium status appears to have an impact on the development of thyroid pathologies. The value of selenium supplementation in autoimmune thyroid disorders has been emphasized. Most authors attribute the effect of supplementation on the immune system to the regulation of the production of reactive oxygen species and their metabolites. In patients with Hashimoto's disease and in pregnant women with anti-TPO antibodies, selenium supplementation decreases anti-thyroid antibody levels and improves the ultrasound structure of the thyroid gland. Although clinical applications still need to be defined for Hashimoto's disease, they are very interesting for pregnant women given that supplementation significantly decreases the percentage of postpartum thyroiditis and definitive hypothyroidism. In Graves' disease, selenium supplementation results in euthyroidism being achieved more rapidly and appears to have a beneficial effect on mild inflammatory orbitopathy. A risk of diabetes has been reported following long-term selenium supplementation, but few data are available on the side effects associated with such supplementation and further studies are required.
甲状腺是每克组织中硒含量最高的器官，因为它表达特定的硒蛋白。自从在碘和硒缺乏的儿童中发现补硒后黏液水肿性呆小病和甲状腺破坏以来，关于甲状腺代谢与硒之间联系的数据已经大量增加。尽管极少量的硒似乎足以使脱碘酶充分发挥活性，从而限制了其潜在缺乏对甲状腺激素合成的影响，但硒的状态似乎对甲状腺病理的发展有影响。硒补充在自身免疫性甲状腺疾病中的价值已得到强调。大多数作者将补充剂对免疫系统的影响归因于调节活性氧及其代谢物的产生。在桥本氏病患者和抗 TPO 抗体阳性的孕妇中，硒补充可降低甲状腺抗体水平并改善甲状腺的超声结构。尽管桥本氏病的临床应用仍需进一步明确，但对于孕妇来说非常有趣，因为补充剂可显著降低产后甲状腺炎和永久性甲状腺功能减退症的发生率。在 Graves 病中，硒补充可使甲状腺功能正常化更快实现，并且似乎对轻度炎症性眼眶病有有益影响。长期硒补充后报告了发生糖尿病的风险，但关于这种补充相关的副作用的资料很少，需要进一步研究。
