Mao Jinyuan, Pop Victor J, Bath Sarah C, Vader Huib L, Redman Christopher W G, Rayman Margaret P
Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK.
Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China.
Eur J Nutr. 2016 Feb;55(1):55-61. doi: 10.1007/s00394-014-0822-9. Epub 2014 Dec 19.
Selenium is an essential trace mineral and a component of selenoproteins that are involved in the production of thyroid hormones and in regulating the immune response. We aimed to explore the effect of low-dose selenium supplementation on thyroid peroxidase antibody (TPO-Ab) concentration and thyroid function in pregnant women from a mild-to-moderate iodine-deficient population.
Samples and data were from a secondary analysis of Selenium in PRegnancy INTervention (SPRINT), a double-blind, randomized, placebo-controlled study that recruited 230 women with singleton pregnancies from a UK antenatal clinic at 12 weeks of gestation. Women were randomized to receive 60 µg/day selenium or placebo until delivery. Serum thyroid peroxidase antibodies (TPO-Ab), thyrotropin (TSH) and free thyroxine (FT4) were measured at 12, 20 and 35 weeks and thyroglobulin antibodies (Tg-Ab) at 12 weeks.
93.5% of participants completed the study. Se supplementation had no more effect than placebo in decreasing TPO-Ab concentration or the prevalence of TPO-Ab positivity during the course of pregnancy. In women who were either TPO-Ab or Tg-Ab negative at baseline (Thy-Ab(-ve)), TSH increased and FT4 decreased significantly throughout gestation (P < 0.001), with no difference between treatment groups. In women who were Thy-Ab(+ve) at baseline, TSH tended to decrease and was lower than placebo at 35 weeks (P = 0.050). FT4 fell more on Se than placebo supplementation and was significantly lower at 35 weeks (P = 0.029).
Low-dose selenium supplementation in pregnant women with mild-to-moderate deficiency had no effect on TPO-Ab concentration, but tended to change thyroid function in Thy-Ab(+ve) women.
硒是一种必需的微量矿物质，是硒蛋白的组成成分，参与甲状腺激素的产生及免疫反应的调节。我们旨在探讨低剂量补充硒对轻度至中度碘缺乏人群中孕妇甲状腺过氧化物酶抗体（TPO-Ab）浓度及甲状腺功能的影响。
样本和数据来自孕期硒干预（SPRINT）的二次分析，这是一项双盲、随机、安慰剂对照研究，从英国一家产前诊所招募了230名单胎妊娠妇女，妊娠12周时入组。妇女被随机分为接受60μg/天硒或安慰剂直至分娩。在妊娠12、20和35周时测量血清甲状腺过氧化物酶抗体（TPO-Ab）、促甲状腺激素（TSH）和游离甲状腺素（FT4），在12周时测量甲状腺球蛋白抗体（Tg-Ab）。
93.5%的参与者完成了研究。在孕期过程中，补充硒在降低TPO-Ab浓度或TPO-Ab阳性率方面与安慰剂相比没有更多效果。在基线时TPO-Ab或Tg-Ab阴性（甲状腺抗体阴性（Thy-Ab(-ve)））的妇女中，整个孕期TSH显著升高，FT4显著降低（P<0.001），治疗组之间无差异。在基线时甲状腺抗体阳性（Thy-Ab(+ve)）的妇女中，TSH有降低趋势，在35周时低于安慰剂组（P = 0.050）。补充硒组的FT4下降幅度大于安慰剂组，在35周时显著更低（P = 0.029）。
轻度至中度缺乏的孕妇补充低剂量硒对TPO-Ab浓度没有影响，但在甲状腺抗体阳性（Thy-Ab(+ve)）的妇女中倾向于改变甲状腺功能。
