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硒蛋氨酸对甲状腺功能正常桥本甲状腺炎合并睾丸酮缺乏症男性甲状腺自身免疫的影响。

The Effect of Selenomethionine on Thyroid Autoimmunity in Euthyroid Men With Hashimoto Thyroiditis and Testosterone Deficiency.

机构信息

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

Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.

出版信息

J Clin Pharmacol. 2019 Nov;59(11):1477-1484. doi: 10.1002/jcph.1447. Epub 2019 May 20.

Abstract

Hashimoto (autoimmune) thyroiditis develops much less frequently in men than in women, suggesting that androgens have a protective effect against thyroid autoimmunity. The current study was aimed at investigating whether the effect of selenomethionine on thyroid antibody titers and thyroid function tests in euthyroid men with autoimmune thyroid disease depends on testosterone levels. The study population consisted of 2 age-matched, weight-matched, and thyroid antibody titer-matched groups of euthyroid men with Hashimoto thyroiditis and testosterone deficiency: 18 patients receiving intramuscular testosterone enanthate (100 mg once weekly) and 19 testosterone-naive men. All subjects were than treated with selenomethionine (200 µg daily) for 6 months. Serum titers of thyroid antibodies, thyrotropin, free thyroid hormones, and testosterone as well as calculated parameters of thyroid homeostasis were assessed at the beginning and at the end of the study. At baseline, except for testosterone, there were no differences between the 2 treatment arms in thyroid antibody titers, serum hormone levels, or values of all calculated indices. Although selenomethionine reduced thyroid peroxidase and thyroglobulin antibody titers in both treatment arms, these effects were stronger in testosterone-treated than in testosterone-untreated men. Only in men receiving testosterone, selenomethionine altered the free thyroxine/free triiodothyronine ratio, testosterone levels, and structure parameter interference approach-GT and structure parameter interference approach-GD. Selenomethionine-induced changes in thyroid antibody titers correlated with the effect of treatment on structure parameter interference approach-GT and testosterone. The obtained results suggest that testosterone determines the strength of selenomethionine action in euthyroid men with autoimmune thyroiditis.

摘要

桥本(自身免疫性)甲状腺炎在男性中的发病频率明显低于女性,这表明雄激素对甲状腺自身免疫具有保护作用。本研究旨在探讨硒代蛋氨酸对甲状腺自身免疫性疾病的甲状腺功能正常男性甲状腺抗体滴度和甲状腺功能测试的影响是否取决于睾酮水平。研究人群包括 2 组年龄、体重和甲状腺抗体滴度匹配的甲状腺功能正常的桥本甲状腺炎和睾酮缺乏的男性:18 名接受肌内注射睾酮庚酸(每周 100mg)和 19 名睾酮未治疗的男性。所有患者均接受硒代蛋氨酸(200μg 每日)治疗 6 个月。在研究开始和结束时评估甲状腺抗体、促甲状腺激素、游离甲状腺激素和睾酮的血清浓度以及甲状腺稳态的计算参数。在基线时,除了睾酮,两种治疗组之间的甲状腺抗体滴度、血清激素水平或所有计算指数的值均无差异。尽管硒代蛋氨酸降低了两种治疗组的甲状腺过氧化物酶和甲状腺球蛋白抗体滴度,但在接受睾酮治疗的男性中效果更强。仅在接受睾酮的男性中,硒代蛋氨酸改变了游离甲状腺素/游离三碘甲状腺原氨酸比值、睾酮水平以及结构参数干扰方法-GT 和结构参数干扰方法-GD。硒代蛋氨酸引起的甲状腺抗体滴度变化与治疗对结构参数干扰方法-GT 和睾酮的影响相关。研究结果表明,在甲状腺自身免疫性疾病的甲状腺功能正常男性中,睾酮决定了硒代蛋氨酸作用的强度。

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