Peng Bingcong, Wang Weiwei, Gu Qingling, Wang Ping, Teng Weiping, Shan Zhongyan
Department of Endocrinology and Metabolism, The Institute of Endocrinology, National Health Commision of the People's Repiublic of China (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China.
Front Endocrinol (Lausanne). 2024 Dec 4;15:1445878. doi: 10.3389/fendo.2024.1445878. eCollection 2024.
Clinicians often consider the use of dietary supplements to assist in lowering thyroid autoantibody titres in patients with Hashimoto's thyroiditis (HT). Currently, different supplements differ in their ability to reduce autoantibody levels. The purpose of this article is to compare the ability of different supplements to lower autoantibody titres and restore TSH levels through a systematic literature review. We obtained information from the PubMed, Web of Science, Embase, and Cochrane databases, as well as the China National Knowledge Infrastructure (CNKI). Selected studies included those using selenium, Vitamin D, Myo-inositol, and Myo-inositol in combination with selenium for the treatment of HT patients with euthyroidism. These data were combined using standardised mean differences (SMDs) and assessed using a random effects model. A total of 10 quantitative meta-analyses of case-control studies were selected for this meta-analysis. Compared to the placebo group, the use of selenium supplements was able to significantly reduce the levels of thyroid peroxidase autoantibodies (TPOAb) (SMD: -2.44, 95% CI: -4.19, -0.69) and thyroglobulin autoantibodies (TgAb) (SMD: -2.76, 95% CI: -4.50, -1.02). During a 6-month treatment, the use of Myo-inositol, Vitamin D alone, and the combination of selenium, and Myo-inositol did not effectively reduce TPOAb (Myo-inositol: SMD:-1.94, 95% CI: -6.75, 2.87; Vitamin D: SMD: -2.54, 95% CI: -6.51,1.42; Se+Myo-inositol: SMD: -3.01, 95% CI: -8.96,2.93) or TgAb (Myo-inositol: SMD:-2.02, 95% CI: -6.52, 2.48; Vitamin D: SMD: -2.73, 95% CI: -6.44,0.98; Se+Myo-inositol: SMD: -3.64, 95% CI: -9.20,1.92) levels. Therefore, we recommend that patients with HT(Hashimoto's Thyroiditis) be given an appropriate amount of selenium as an auxiliary treatment during standard-of-care treatment.
临床医生常常考虑使用膳食补充剂来帮助降低桥本甲状腺炎(HT)患者的甲状腺自身抗体滴度。目前,不同的补充剂在降低自身抗体水平的能力上存在差异。本文的目的是通过系统的文献综述来比较不同补充剂降低自身抗体滴度和恢复促甲状腺激素(TSH)水平的能力。我们从PubMed、科学网、Embase、Cochrane数据库以及中国知网获取了信息。选定的研究包括那些使用硒、维生素D、肌醇以及肌醇与硒联合用于治疗甲状腺功能正常的HT患者的研究。这些数据使用标准化均数差(SMD)进行合并,并采用随机效应模型进行评估。本荟萃分析共选择了10项病例对照研究的定量荟萃分析。与安慰剂组相比,使用硒补充剂能够显著降低甲状腺过氧化物酶自身抗体(TPOAb)水平(SMD:-2.44,95%置信区间:-4.19,-0.69)和甲状腺球蛋白自身抗体(TgAb)水平(SMD:-2.76,95%置信区间:-4.50,-1.02)。在为期6个月的治疗期间,单独使用肌醇、维生素D以及硒与肌醇联合使用均未有效降低TPOAb水平(肌醇:SMD:-1.94,95%置信区间:-6.75,2.87;维生素D:SMD:-2.54,95%置信区间:-6.51,1.42;硒+肌醇:SMD:-3.01,95%置信区间:-8.96,2.93)或TgAb水平(肌醇:SMD:-2.02,95%置信区间:-6.52,2.48;维生素D:SMD:-2.73,95%置信区间:-6.44,0.98;硒+肌醇:SMD:-3.64,95%置信区间:-9.20,1.92)。因此,我们建议HT(桥本甲状腺炎)患者在标准治疗期间给予适量的硒作为辅助治疗。