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植物雌激素对亚临床甲状腺功能减退症患者甲状腺的影响:随机、双盲、交叉研究

The Effect of Phytoestrogen on Thyroid in Subclinical Hypothyroidism: Randomized, Double Blind, Crossover Study.

作者信息

Sathyapalan Thozhukat, Dawson Alison J, Rigby Alan S, Thatcher Natalie J, Kilpatrick Eric S, Atkin Stephen L

机构信息

Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, United Kingdom.

Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom.

出版信息

Front Endocrinol (Lausanne). 2018 Sep 11;9:531. doi: 10.3389/fendo.2018.00531. eCollection 2018.

Abstract

Soy phytoestrogens are suggested to impair thyroid function but the effects of pharmacological doses of soy phytoestrogens are unknown; therefore, this study was performed to determine the effect of high dose soy phytoestrogens (66 mg) on thyroid function in subclinical hypothyroidism. Randomized, double-blind, crossover study. Forty four patients with subclinical hypothyroidism. Participants were randomly allocated to either 66 mg phytoestrogen with 30 g soy protein (active) or 0 mg phytoestrogen with 30 g soy protein (placebo) supplementation for 8 weeks, washed out for 8 weeks and then crossed over for another 8 week period. The primary outcome was progression to overt hypothyroidism with the secondary outcome measures were changes in thyroid function tests. Two patients in this trial progressed into overt hypothyroidism after high dose phytoestrogen supplementation. TSH, free thyroxine and triiodothyronine did not differ between groups. A pharmacological dose of 66 mg of soy phytoestrogens did not increase the overt thyroid failure rate or alter thyroid function tests in patients with subclinical hypothyroidism.

摘要

大豆植物雌激素被认为会损害甲状腺功能,但药理剂量的大豆植物雌激素的作用尚不清楚;因此,本研究旨在确定高剂量大豆植物雌激素(66毫克)对亚临床甲状腺功能减退患者甲状腺功能的影响。随机、双盲、交叉研究。44例亚临床甲状腺功能减退患者。参与者被随机分配到补充66毫克植物雌激素加30克大豆蛋白(活性组)或补充0毫克植物雌激素加30克大豆蛋白(安慰剂组),为期8周,洗脱8周,然后交叉进行另外8周。主要结局是进展为显性甲状腺功能减退,次要结局指标是甲状腺功能检查的变化。本试验中有两名患者在高剂量植物雌激素补充后进展为显性甲状腺功能减退。两组之间促甲状腺激素、游离甲状腺素和三碘甲状腺原氨酸没有差异。66毫克的药理剂量大豆植物雌激素不会增加亚临床甲状腺功能减退患者的显性甲状腺功能减退发生率,也不会改变甲状腺功能检查结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/143d/6141627/462e15905a5b/fendo-09-00531-g0001.jpg

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