在患有唐氏综合征的儿童中，硒水平与抗体呈负相关，与甲状腺功能呈正相关：一项印度尼西亚的研究。

Selenium level correlates negatively with antibodies but positively with thyroid function in children with down syndrome: an Indonesian study.

机构信息

Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.

Faculty of Medicine, Department of Child Health, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia.

出版信息

Front Endocrinol (Lausanne). 2023 May 10;14:1177373. doi: 10.3389/fendo.2023.1177373. eCollection 2023.

DOI:10.3389/fendo.2023.1177373

PMID:37234806

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10206332/

Abstract

BACKGROUND

Children with Down syndrome (DS) are prone to developing autoimmune thyroid disease (AITD). Previous studies found lower selenium (Se) levels in children with AITD. Glutathione peroxidase-3 (GPx3) and selenoprotein-P (SePP) are widely used to measure Se levels. DS children tend to have lower Se levels, the main contributor to hypothyroidism in this population. This study aimed to analyze the Se's role in AITD in Indonesian children with DS.

METHODS

This cross-sectional study was conducted between February 2021-June 2022 at the Pediatric Outpatient Clinic of Dr Soetomo Hospital. DS children aged 1 month to 18 years were enrolled using consecutive sampling. Thyroid-stimulating hormone, free thyroxine, thyroid peroxidase (TPO-Ab) and thyroglobulin (Tg-Ab) autoantibody, GPx3, and SePP levels were measured in plasma samples using enzyme-linked immunosorbent assays. Statistical analyses used Chi-square, Mann-Whitney, and Spearman's rank correlation ( ). All results with <0.05 were considered statistically significant.

RESULTS

Among 62 children with DS, SePP and GPx3 levels were significantly lower in those with AITD than those without AITD (=0.013 and =0.018, respectively). SePP and GPx3 levels correlated significantly with lower TPO-Ab ( =-0.439 with =1×10 and =-0.396 with =0.001, respectively) and Tg-Ab ( =-0.474 with =1×10 and =-0.410 with =0.001, respectively) levels. SePP levels correlated significantly with lower thyroid dysfunction incidence ( =-0.252, =0.048) in the AITD group.

CONCLUSION

Selenium deficiency contributes to autoimmune process in the thyroid and to thyroid dysfunction in children with Down syndrome. Our findings recommend increasing Se levels through Se-containing foods to reduce the risks of AITD and thyroid dysfunction in DS children with AITD.

摘要

背景

唐氏综合征（Down syndrome，DS）患儿易发生自身免疫性甲状腺疾病（autoimmune thyroid disease，AITD）。既往研究发现 AITD 患儿硒（selenium，Se）水平较低。谷胱甘肽过氧化物酶 3（glutathione peroxidase-3，GPx3）和硒蛋白 P（selenoprotein-P，SePP）被广泛用于检测 Se 水平。DS 患儿 Se 水平往往较低，是该人群发生甲状腺功能减退症的主要原因。本研究旨在分析印度尼西亚 DS 患儿 AITD 中 Se 的作用。

方法

本横断面研究于 2021 年 2 月至 2022 年 6 月在苏托莫医院儿科门诊进行。采用连续抽样法纳入 1 个月至 18 岁的 DS 患儿。使用酶联免疫吸附试验测量血浆样本中的促甲状腺激素、游离甲状腺素、甲状腺过氧化物酶（thyroid peroxidase，TPO）抗体、甲状腺球蛋白（thyroglobulin，Tg）抗体、GPx3 和 SePP 水平。采用卡方检验、Mann-Whitney 检验和 Spearman 秩相关（Spearman's rank correlation，）进行统计学分析。所有 <0.05 的结果均被认为具有统计学意义。

结果

在 62 例 DS 患儿中，AITD 患儿的 SePP 和 GPx3 水平明显低于无 AITD 患儿（=0.013 和 =0.018）。SePP 和 GPx3 水平与较低的 TPO-Ab（ =-0.439， =1×10-5， =-0.396， =0.001）和 Tg-Ab（ =-0.474， =1×10-5， =-0.410， =0.001）水平显著相关。在 AITD 组中，SePP 水平与较低的甲状腺功能障碍发生率（ =-0.252， =0.048）显著相关。