Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
J Clin Pharm Ther. 2020 Dec;45(6):1334-1341. doi: 10.1111/jcpt.13214. Epub 2020 Jul 10.
Vitamin D administered together with selenomethionine has been reported to markedly reduce thyroid antibody titres in patients with autoimmune thyroiditis. Hyperprolactinaemia exerts a complex pro-inflammatory effect. This study was aimed at investigating whether prolactin excess determines the effect of vitamin D/selenomethionine combination therapy on thyroid autoimmunity.
The study included two age-, body mass index-, hormone- and thyroid antibody-matched groups of young euthyroid women with Hashimoto's thyroiditis: 19 women with mild-to-moderate hyperprolactinaemia and 19 individuals with prolactin levels within the reference range. All participants were then treated with vitamin D (4000 IU daily) and selenomethionine (200 µg daily). Serum titres of thyroid peroxidase and thyroglobulin (TgAb) antibodies, serum levels of thyrotropin, free thyroxine, free triiodothyronine, prolactin and 25-hydroxyvitamin D, as well as the calculated parameters of thyroid homeostasis, were determined at baseline and 6 months later.
All women completed the study. With the exception of prolactin and 25-hydroxyvitamin D levels, there were no differences between the study groups in the investigated parameters. In both study groups, vitamin D/selenomethionine combination therapy reduced thyroid peroxidase and TgAb antibody titres, decreased the free thyroxine:free triiodothyronine ratio and increased 25-hydroxyvitamin D levels and SPINA-GD. The decrease in antibody titres, as well as the improvement in vitamin D status, was more pronounced in subjects with prolactin levels within the reference range than in subjects with hyperprolactinaemia and was inversely correlated with prolactin levels. Moreover, only in normoprolactinaemic women, the treatment reduced thyrotropin levels and increased SPINA-GT.
The obtained results suggest that hyperprolactinaemia attenuates the impact of vitamin D/selenomethionine combination on thyroid autoimmunity.
已有报道称，维生素 D 与硒代蛋氨酸联合使用可显著降低自身免疫性甲状腺炎患者的甲状腺抗体滴度。高催乳素血症具有复杂的促炎作用。本研究旨在探讨催乳素过多是否决定了维生素 D/硒代蛋氨酸联合治疗对甲状腺自身免疫的影响。
该研究纳入了两组年龄、体重指数、激素和甲状腺抗体匹配的桥本甲状腺炎年轻甲状腺功能正常女性：19 名催乳素轻度至中度升高的女性和 19 名催乳素水平在参考范围内的个体。所有参与者随后接受维生素 D（4000IU/天）和硒代蛋氨酸（200μg/天）治疗。在基线和 6 个月后，测定甲状腺过氧化物酶和甲状腺球蛋白（TgAb）抗体的血清滴度、促甲状腺激素、游离甲状腺素、游离三碘甲状腺原氨酸、催乳素和 25-羟维生素 D 的血清水平，以及甲状腺稳态的计算参数。
所有女性均完成了研究。除催乳素和 25-羟维生素 D 水平外，两组在研究参数上无差异。在两组中，维生素 D/硒代蛋氨酸联合治疗均降低了甲状腺过氧化物酶和 TgAb 抗体滴度，降低了游离甲状腺素/游离三碘甲状腺原氨酸比值，增加了 25-羟维生素 D 水平和 SPINA-GD。抗体滴度下降以及维生素 D 状态改善在催乳素水平在参考范围内的受试者中比在高催乳素血症患者中更为明显，并且与催乳素水平呈负相关。此外，仅在正常催乳素血症的女性中，治疗降低了促甲状腺激素水平并增加了 SPINA-GT。
研究结果表明，高催乳素血症减弱了维生素 D/硒代蛋氨酸联合治疗对甲状腺自身免疫的影响。
