Zuo Ying, Li Yaling, Gu Xiaoqin, Lei Zhen
Department of Endocrinology and Metabolism, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Internal Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Ann Palliat Med. 2021 Apr;10(4):4398-4408. doi: 10.21037/apm-21-449. Epub 2021 Apr 16.
This investigation systematically evaluated the selenium levels and the effects of selenium supplementation in patients with autoimmune thyroid disease (AITD).
Randomized controlled trials (RCTs) related to selenium supplementation in patients with AITD were selected from the PubMed, Medline, Web of Sciences, Embase, Cochrane Library, and Spring databases. All related literature published between January 2000 and November 2020 were included. The RCT bias risk assessment was conducted according to the Cochrane Handbook 5.0.2. The Review Manager 5.3 software was applied for meta-analysis of the included literature.
A total of 17 articles meeting the requirements were selected, including a total of 1,911 subjects. Meta-analysis results showed that the serum free triiodothyronine (FT3) levels in patients was greatly reduced after selenium supplementation compared to placebo treatment (MD =-0.40; 95% confidential interval (CI): -0.70--0.10; Z=2.61; P=0.009). Serum free thyroxine (FT4) levels and anti-thyroid peroxidase antibody (TPOAb) levels were also significantly reduced (MD = -0.76; 95% CI: -1.58--0.07; Z=1.79; P=0.07), and anti-thyroid peroxidase antibody (TPOAb) level was decreased observably (MD =-150.25; 95% CI: -04.06--96.43; Z=5.47; P<0.00001). The thyroid stimulating hormone (TSH) levels (MD =0.06; 95% CI: -0.53-0.66; Z=0.21; P=0.83) and anti-thyroglobulin antibody (TGAb) levels (MD =17.19; 95% CI: -254.86-289.25; Z=0.12; P=0.90) were not significantly different between the experimental group and the control group.
Selenium-containing drugs were effective in treating AITD patients, and greatly reduced the levels of FT3, FT4, and TPOAb in AITD patients. These results suggested that selenium level had a great effect on AITD and selenium supplementation showed a very important effect on AITD.
本研究系统评估了自身免疫性甲状腺疾病（AITD）患者的硒水平及补充硒的效果。
从PubMed、Medline、Web of Sciences、Embase、Cochrane图书馆和Spring数据库中筛选与AITD患者补充硒相关的随机对照试验（RCT）。纳入2000年1月至2020年11月期间发表的所有相关文献。根据Cochrane手册5.0.2进行RCT偏倚风险评估。应用Review Manager 5.3软件对纳入文献进行荟萃分析。
共筛选出17篇符合要求的文章，共1911名受试者。荟萃分析结果显示，与安慰剂治疗相比，补充硒后患者血清游离三碘甲状腺原氨酸（FT3）水平显著降低（MD = -0.40；95%置信区间（CI）：-0.70--0.10；Z = 2.61；P = 0.009）。血清游离甲状腺素（FT4）水平和抗甲状腺过氧化物酶抗体（TPOAb）水平也显著降低（MD = -0.76；95% CI：-1.58--0.07；Z = 1.79；P = 0.07），抗甲状腺过氧化物酶抗体（TPOAb）水平明显下降（MD = -150.25；95% CI：-04.06--96.43；Z = 5.47；P < 0.00001）。实验组和对照组的促甲状腺激素（TSH）水平（MD = 0.06；95% CI：-0.53 - 0.66；Z = 0.21；P = 0.83）和抗甲状腺球蛋白抗体（TGAb）水平（MD = 17.19；95% CI：-254.86 - 289.25；Z = 0.12；P = 0.90）无显著差异。
含硒药物对治疗AITD患者有效，可显著降低AITD患者的FT3、FT4和TPOAb水平。这些结果表明硒水平对AITD有很大影响，补充硒对AITD显示出非常重要的作用。
