Pirola Ilenia, Gandossi Elena, Agosti Barbara, Delbarba Andrea, Cappelli Carlo
Department of Clinical and Experimental Sciences, Endocrine and Metabolic Unit, Clinica Medica, University of Brescia, Italy.
Endokrynol Pol. 2016;67(6):567-571. doi: 10.5603/EP.2016.0064.
The thyroid is an organ with one of the highest selenium concentrations, containing many selenoproteins implicated in thyroid hormone metabolism. Treatment with levothyroxine has been recommended for all subclinical hypothyroid patients with TSH levels > 10 mU/L, whereas for those with TSH< 10 mU/L treatment remains controversial.
A randomised controlled prospective study was performed to investigate the effects of Se treatment on patients with autoimmune thyroiditis and mild sub-clinical hypothyroidism (TSH < 10 mU/L).
A total of 196 patients with autoimmune thyroiditis were recruited in the study. Patients were assigned to receive (case) or not receive (control) an oral selenomethionine treatment. Cases received 83 mcg selenomethionine/day orally for four months. All the patient's charts were submitted to thyroid hormonal profile (TSH, fT4) and TPOAb evaluation upon enrolment and at the end of the study.
In total 192 patients completed the study. Cases and controls were superimposable for age, gender, thyroid hormonal profile, and TPOAb levels. At the end of the study, 33/192 (17.2%) participants restored euthyroidism (Responders). Responders were significantly more frequent among Cases than Controls (30/96 [31.3%] vs. 3/96 [3.1%], p < 0.0001).
Selenium supplementation could restore euthyroidism in one third of subclinical hypothyroidism patients with autoimmune thyroiditis. (Endokrynol Pol 2016; 67 (6): 567-571).
甲状腺是体内硒浓度最高的器官之一，含有许多与甲状腺激素代谢相关的硒蛋白。对于所有促甲状腺激素（TSH）水平>10 mU/L的亚临床甲状腺功能减退患者，推荐使用左甲状腺素进行治疗，而对于TSH<10 mU/L的患者，治疗仍存在争议。
进行一项随机对照前瞻性研究，以调查硒治疗对自身免疫性甲状腺炎和轻度亚临床甲状腺功能减退（TSH<10 mU/L）患者的影响。
本研究共招募了196例自身免疫性甲状腺炎患者。患者被分配接受（病例组）或不接受（对照组）口服硒代蛋氨酸治疗。病例组患者每天口服83微克硒代蛋氨酸，持续四个月。在入组时和研究结束时，所有患者的病历均进行甲状腺激素水平（TSH、游离甲状腺素fT4）和甲状腺过氧化物酶抗体（TPOAb）评估。
共有192例患者完成了研究。病例组和对照组在年龄、性别、甲状腺激素水平和TPOAb水平方面具有可比性。研究结束时，192例参与者中有33例（17.2%）恢复了甲状腺功能正常（反应者）。病例组中的反应者明显多于对照组（30/96 [31.3%] 对3/96 [3.1%]，p<0.0001）。
补充硒可使三分之一患有自身免疫性甲状腺炎的亚临床甲状腺功能减退患者恢复甲状腺功能正常。（《波兰内分泌学》2016年；67(6):567 - 571）
