Evidence-Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou 730000, China.
Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China.
Nutrients. 2023 Jul 19;15(14):3194. doi: 10.3390/nu15143194.
The available evidence on selenium supplementation in the treatment of autoimmune thyroiditis (AIT) was inconclusive. This research serves to assess the effects of selenium supplementation in the treatment of AIT.
Online databases including PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to 10 June 2022. The AMSTAR-2 tool was used to assess the methodological quality of included studies. The information on the randomized controlled trials of the included studies was extracted and synthesized. The GRADE system was used to assess the certainty of evidence.
A total of 6 systematic reviews with 75 RCTs were included. Only one study was rated as high quality. The meta-analysis showed that in the levothyroxine (LT4)-treated population, thyroid peroxidase antibody (TPO-Ab) levels decreased significantly in the selenium group at 3 months (SMD = -0.53, 95% CI: [-0.89, -0.17], < 0.05, very low certainty) and 6 months (SMD = -1.95, 95% CI: [-3.17, -0.74], < 0.05, very low certainty) and that thyroglobulin antibody (Tg-Ab) levels were not decreased. In the non-LT4-treated population, TPO-Ab levels decreased significantly in the selenium group at 3 and 6 months and did not decrease at 12 months. Tg-Ab levels decreased significantly in the selenium group at 3 and 6 months and did not decrease at 12 months. The adverse effects reported in the selenium group were not significantly different from those in the control group, and the certainty of evidence was low.
Although selenium supplementation might reduce TPO-Ab levels at 3 and 6 months and Tg-Ab levels at 3 and 6 months in the non-LT4-treated population, this was based on a low certainty of evidence.
关于硒补充剂治疗自身免疫性甲状腺炎（AIT）的现有证据尚无定论。本研究旨在评估硒补充剂治疗 AIT 的效果。
从建库至 2022 年 6 月 10 日，检索 PubMed、Web of Science、Embase 和 Cochrane Library 等在线数据库。采用 AMSTAR-2 工具评估纳入研究的方法学质量。提取并综合纳入研究的随机对照试验信息。采用 GRADE 系统评估证据确定性。
共纳入 6 篇系统评价，包含 75 项 RCT。仅有 1 项研究被评为高质量。Meta 分析显示，在左甲状腺素（LT4）治疗人群中，硒组在 3 个月（SMD=-0.53，95%CI：[-0.89，-0.17]，<0.05，极低确定性）和 6 个月（SMD=-1.95，95%CI：[-3.17，-0.74]，<0.05，极低确定性）时甲状腺过氧化物酶抗体（TPO-Ab）水平显著降低，而甲状腺球蛋白抗体（Tg-Ab）水平未降低。在非 LT4 治疗人群中，硒组在 3 个月和 6 个月时 TPO-Ab 水平显著降低，而在 12 个月时则未降低。3 个月和 6 个月时 Tg-Ab 水平显著降低，而在 12 个月时则未降低。硒组报告的不良反应与对照组无显著差异，证据确定性为低。
尽管硒补充剂可能会降低非 LT4 治疗人群中 3 个月和 6 个月时的 TPO-Ab 水平以及 3 个月和 6 个月时的 Tg-Ab 水平，但这一结论基于低确定性证据。
