硒补充对甲状腺自身免疫和炎症的影响的随机对照、双盲研究，重点关注 GPx1 基因型。
A randomized-controlled, double-blind study of the impact of selenium supplementation on thyroid autoimmunity and inflammation with focus on the GPx1 genotypes.
机构信息
Thyroid Unit and Laboratory of Cellular and Molecular Biology (LIM-25), Division of Endocrinology and Metabolism, University of São Paulo Medical School, Hospital das Clínicas, Av. Dr. Enéas de Carvalho Aguiar, 155, 8th floor, bl 3, PAMB, São Paulo, SP, 05403-900, Brazil.
Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Science, University of São Paulo, Av. Prof. Lineu Prestes 580, bl 14, Cidade Universitária, São Paulo, SP, 05508-000, Brazil.
出版信息
J Endocrinol Invest. 2015 Oct;38(10):1065-74. doi: 10.1007/s40618-015-0285-8. Epub 2015 Apr 17.
PURPOSE
To analyze the impact of selenium supplementation on serum antiTPO levels and thyroid echogenicity in patients with CAT, evaluating the response in subgroups with different GPx1 genotypes.
METHODS
CAT patients (n = 55) with positive antiTPO were randomized to selenomethionine (SeMet) 200 μg daily (n = 28) or placebo (n = 27) for 3 months. Assessments included GPx1 genotyping at baseline and serum levels of plasma selenium, erythrocyte GPx1 activity, antiTPO and thyroid echogenicity at baseline, and 3 and 6 months.
RESULTS
In the SeMet group, the increase in plasma levels of selenium and erythrocyte GPx1 activity was similar among patients with different GPx1 genotypes. In the overall cohort, patients randomized to SeMet showed a 5 % decrease in antiTPO levels at 3 months (p = non-significant) and 20 % at 6 months (p < 0.001 versus 3 months). In contrast, patients in the placebo group did not show significant changes in antiTPO levels at any time point. Subgroup analysis showed that patients with different GPx1 genotypes presented comparable responses in antiTPO levels and echogenicity index to SeMet.
CONCLUSIONS
Selenium supplementation decreased serum antiTPO levels in CAT patients, with similar response among patients with different GPx1 genotypes.
目的
分析补充硒对桥本甲状腺炎（CAT）患者血清抗甲状腺过氧化物酶抗体（antiTPO）水平和甲状腺回声的影响，评估不同谷胱甘肽过氧化物酶 1（GPx1）基因型亚组的反应。
方法
将 55 例抗 TPO 阳性的 CAT 患者随机分为亚硒酸钠（SeMet）200μg 组（n=28）或安慰剂组（n=27），每天服用硒补充剂，疗程为 3 个月。基线时评估 GPx1 基因型，检测血清硒、红细胞 GPx1 活性、antiTPO 及甲状腺回声，随后在 3 个月和 6 个月时再次评估。
结果
在 SeMet 组中，不同 GPx1 基因型患者的血浆硒水平和红细胞 GPx1 活性升高情况相似。在总体队列中，随机接受 SeMet 治疗的患者在 3 个月时 antiTPO 水平降低了 5%（p=非显著），6 个月时降低了 20%（p<0.001，与 3 个月时相比）。相比之下，安慰剂组患者在任何时间点的 antiTPO 水平均无显著变化。亚组分析显示，不同 GPx1 基因型的患者对 SeMet 的抗 TPO 水平和回声指数的反应相似。
结论
硒补充剂降低了 CAT 患者的血清抗 TPO 水平，不同 GPx1 基因型患者的反应相似。
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