Köhrle Josef
Institute of Experimental Endocrinology, Charité University Medicine Berlin, Berlin, Germany.
Curr Opin Endocrinol Diabetes Obes. 2015 Oct;22(5):392-401. doi: 10.1097/MED.0000000000000190.
This article provides an update on the role of the essential trace element selenium and its interaction with the other trace elements iodine and iron that together contribute to adequate thyroid hormone status. Synthesis, secretion, metabolism and action of thyroid hormone in target tissues depend on a balanced nutritional availability or supplementation of these elements. Selenium status is altered in benign and malignant thyroid diseases and various selenium compounds have been used to prevent or treat widespread diseases such as goiter, autoimmune thyroid disease or thyroid cancer.
Several studies, most with still too low numbers of cases, indicate that selenium administration in both autoimmune thyroiditis (Hashimoto thyroiditis) and mild Graves' disease improves clinical scores and well-being of patients and reduces thyroperoxidase antibody titers. However, published results are still conflicting depending on basal selenium status, dose, time and form of selenium used for intervention. Evidence for sex-specific selenium action, lack of beneficial effects in pregnancy and contribution of genetic polymorphisms (selenoprotein S) has been presented.
Adequate nutritional supply of selenium that saturates expression of circulating selenoprotein P, together with optimal iodine and iron intake, is required for a healthy and functional thyroid during development, adolescence, adulthood and aging.
本文提供了关于必需微量元素硒的作用及其与其他微量元素碘和铁的相互作用的最新信息，这些元素共同作用有助于维持甲状腺激素水平正常。甲状腺激素在靶组织中的合成、分泌、代谢和作用取决于这些元素的营养供应平衡或补充情况。在良性和恶性甲状腺疾病中，硒的状态会发生改变，各种硒化合物已被用于预防或治疗诸如甲状腺肿、自身免疫性甲状腺疾病或甲状腺癌等广泛疾病。
多项研究（大多数病例数仍然较少）表明，在自身免疫性甲状腺炎（桥本甲状腺炎）和轻度格雷夫斯病中补充硒可改善患者的临床评分和健康状况，并降低甲状腺过氧化物酶抗体滴度。然而，根据基础硒状态、剂量、时间以及用于干预的硒的形式不同，已发表的结果仍存在矛盾。已有研究表明硒的作用存在性别差异，在孕期缺乏有益作用以及遗传多态性（硒蛋白S）的影响。
在发育、青春期、成年期和老年期，为维持甲状腺健康和正常功能，需要充足的硒营养供应以饱和循环硒蛋白P的表达，同时还需要最佳的碘和铁摄入量。
