补充L-硒代蛋氨酸对儿童和青少年自身免疫性甲状腺炎的影响：一项随机双盲安慰剂对照临床试验。

l-selenomethionine supplementation in children and adolescents with autoimmune thyroiditis: A randomized double-blind placebo-controlled clinical trial.

作者信息

Kyrgios Ioannis, Giza Styliani, Kotanidou Eleni P, Kleisarchaki Angeliki, Tsinopoulou Vasiliki Rengina, Papadopoulou Anastasia, Markantonatou Anthi-Marina, Kanellidou Eleni, Giannakou Anastasia, Galli-Tsinopoulou Assimina

机构信息

4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Department of Immunology, Papageorgiou General Hospital, Thessaloniki, Greece.

出版信息

J Clin Pharm Ther. 2019 Feb;44(1):102-108. doi: 10.1111/jcpt.12765. Epub 2018 Oct 10.

DOI:10.1111/jcpt.12765

PMID:30306604

Abstract

WHAT IS KNOWN AND OBJECTIVE

Although a beneficial effect of selenium (Se) administration has been proposed in adults with autoimmune thyroiditis (AT), there is a paucity of similar data in children and adolescents. The purpose of the study was to investigate whether administration of a high dose of organic Se (200 μg daily as l-selenomethionine) has an effect on antithyroid antibody titres in children and adolescents with AT.

METHODS

Seventy-one (71) children and adolescents, with a mean age of 11.3 ± 0.3 years (range 4.5-17.8), diagnosed with AT (antibodies against thyroid peroxidase [anti-TPO] and/or thyroglobulin [anti-Tg] ≥60 IU/mL, euthyroidism or treated hypothyroidism and goitre in thyroid gland ultrasonography) were randomized to receive 200 μg l-selenomethionine or placebo daily for 6 months. Blood samples were drawn for measurement of serum fT4, TSH, anti-TPO and anti-Tg levels, and thyroid gland ultrasonography was performed at the entry to the study and after 6 months of treatment.

RESULTS AND DISCUSSION

At the end of the study, a statistically significantly higher reduction in anti-Tg levels was observed in the Se group compared to the placebo group (Δ: -70.9 ± 22.1 vs -6.7 ± 60.6 IU/mL, P = 0.021). Although anti-TPO levels were also decreased in the Se group, this change was not statistically different from that of the control group (Δ: -116.2 ± 68.4 vs +262.8 ± 255.5 IU/mL, P = 0.219). No significant difference in thyroid gland volume was observed between the two study groups (P > 0.05).

WHAT IS NEW AND CONCLUSION

In this original study, organic Se supplementation appears to reduce anti-Tg levels in children and adolescents with AT.

摘要

已知信息与研究目的

尽管已提出补充硒（Se）对自身免疫性甲状腺炎（AT）成年患者有益，但儿童和青少年中类似的数据较少。本研究的目的是调查高剂量有机硒（每天200μg的L-硒代蛋氨酸）对患有AT的儿童和青少年抗甲状腺抗体滴度是否有影响。

方法

71名平均年龄为11.3±0.3岁（范围4.5 - 17.8岁）、被诊断为AT（抗甲状腺过氧化物酶[抗-TPO]和/或甲状腺球蛋白[抗-Tg]抗体≥60IU/mL，甲状腺功能正常或经治疗的甲状腺功能减退，且甲状腺超声检查有甲状腺肿）的儿童和青少年被随机分为两组，分别每天接受200μg的L-硒代蛋氨酸或安慰剂，持续6个月。在研究开始时和治疗6个月后采集血样，测定血清游离甲状腺素（fT4）、促甲状腺激素（TSH）、抗-TPO和抗-Tg水平，并进行甲状腺超声检查。

结果与讨论

研究结束时，与安慰剂组相比，硒组抗-Tg水平的降低在统计学上有显著差异（差值：-70.9±22.1 vs -6.7±60.6IU/mL，P = 0.021）。虽然硒组抗-TPO水平也有所下降，但与对照组相比，这种变化在统计学上无显著差异（差值：-116.2±68.4 vs +262.8±255.5IU/mL，P = 0.219）。两个研究组之间甲状腺体积无显著差异（P>0.05）。