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阿托伐他汀增强蛋氨酸硒对甲状腺功能正常桥本甲状腺炎妇女甲状腺自身免疫的作用。

Atorvastatin potentiates the effect of selenomethionine on thyroid autoimmunity in euthyroid women with Hashimoto's thyroiditis.

机构信息

a Department of Internal Medicine and Clinical Pharmacology , Medical University of Silesia , Katowice , Poland.

出版信息

Curr Med Res Opin. 2019 Apr;35(4):675-681. doi: 10.1080/03007995.2018.1541314. Epub 2018 Nov 27.

Abstract

OBJECTIVE

In many studies, selenium supplementation decreased serum titers of thyroid antibodies. The aim of the study was to investigate whether statin therapy determines selenium action on thyroid autoimmunity.

METHODS

This prospective case-control study enrolled 42 euthyroid women with Hashimoto's thyroiditis and normal vitamin D status, 20 of whom had been treated with atorvastatin (40 mg daily) for at least 6 months. All patients received selenomethionine (200 µg daily) for 6 months. Plasma levels of lipids, serum titers of thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) antibodies, as well as serum levels of thyrotropin, free thyroid hormones, and 25-hydroxyvitamin D were determined at the beginning and at the end of the study.

RESULTS

At baseline, there were no differences between both treatment arms in plasma lipids, titers of thyroid antibodies, serum levels of thyrotropin, free thyroid hormones, and 25-hydroxyvitamin D. Selenometionine decreased titers of TPOAb (from 843 ± 228 to 562 ± 189 U/mL) and TgAb (from 795 ± 286 to 501 ± 216 U/mL) in atorvastatin-treated women, as well as titers of TPOAb (from 892 ± 247 to 705 ± 205 U/mL) and TgAb (from 810 ± 301 to 645 ± 224 U/mL) in statin-naive women. The changes in antibody titers were more pronounced in women receiving atorvastatin (between-group difference: 94 [32-156] [TPOAb]; 129 [52-206] [TgAb]). Treatment-induced changes in TPOAb and TgAb correlated positively with baseline thyroid antibody titers. Circulating levels of lipids, free thyroxine, free triiodothyronine, and 25-hydroxyvitamin D remained at similar levels throughout the study.

CONCLUSIONS

The obtained results indicate that the decrease in titers of thyroid antibodies was potentiated by atorvastatin use.

摘要

目的

在许多研究中,硒补充剂降低了甲状腺抗体的血清滴度。本研究旨在探讨他汀类药物治疗是否决定了硒对甲状腺自身免疫的作用。

方法

这项前瞻性病例对照研究纳入了 42 名甲状腺功能正常的桥本甲状腺炎且维生素 D 状态正常的女性,其中 20 名接受阿托伐他汀(40mg/d)治疗至少 6 个月。所有患者均接受硒代蛋氨酸(200μg/d)治疗 6 个月。在研究开始和结束时,测定血脂水平、甲状腺过氧化物酶(TPOAb)和甲状腺球蛋白(TgAb)抗体的血清滴度,以及促甲状腺激素、游离甲状腺激素和 25-羟维生素 D 的血清水平。

结果

在基线时,两种治疗组之间的血脂、甲状腺抗体滴度、促甲状腺激素、游离甲状腺激素和 25-羟维生素 D 水平均无差异。硒代蛋氨酸降低了阿托伐他汀治疗女性的 TPOAb(从 843±228 降至 562±189U/mL)和 TgAb(从 795±286 降至 501±216U/mL),以及他汀类药物治疗女性的 TPOAb(从 892±247 降至 705±205U/mL)和 TgAb(从 810±301 降至 645±224U/mL)。在接受阿托伐他汀治疗的女性中,抗体滴度的变化更为明显(组间差异:94[32-156] [TPOAb];129[52-206] [TgAb])。TPOAb 和 TgAb 的治疗诱导变化与基线甲状腺抗体滴度呈正相关。血脂、游离甲状腺素、游离三碘甲状腺原氨酸和 25-羟维生素 D 的循环水平在整个研究过程中保持相似水平。

结论

研究结果表明,阿托伐他汀的使用增强了甲状腺抗体滴度的降低。

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