Effect of selenium yeast combined with vitamin D on thyroid-associated antibody levels in patients with Hashimoto thyroiditis at different ages

doi:10.16138/j.1673-6087.2021.06.005

Abstract

Abstract:

Objective To investigate the effect of selenium yeast combined with vitamin D on thyroid related antibody levels in Hashimoto thyroiditis (HT) patients at different ages. Method In this study, 148 patients with HT (96 adults and 52 minors) were selected from December 2017 to December 2019. The patients were divided into control group and observation group. The patients in the control group were treated with routine methods and the observation group of patients used selenium yeast and vitamin D besides routine treatment. After 6 months, the levels of thyroid peroxidase autoantibody (TPOAb) and thyroglobulin antibody (TgAb) before and after treatment were compared between two groups. Results Serum 25-hydroxyvitamin D₃ [25(OH) D₃] levels were detected in both adults and minors before combined treatment. The average 25(OH) D₃ level in 2 groups before treatment was lower than normal, while the 25(OH) D₃ level in minors was higher than that in adults (P<0.05). There was no significant difference in TPOAb and TgAb in control group and the observation group before treatment(P>0.05). The levels of TPOAb and TgAb in the observation group were significantly lower than those in the control group(P<0.05), in addition, the treatment effect of the observation group was significantly higher than that of the control group(P<0.05). Conclusions The treatment of HT with selenium yeast combined with vitamin D on the basis of routine treatment can effectively reduce the TPOAb and TgAb level in adult and minor patients. The therapeutic effect is remarkable and has application value in the clinic.

Key words: Selenium yeast, Vitamin D, Age stratification, Hashimoto thyroiditis, Thyroid peroxidase autoantibody, Thyroglobulin antibody

CLC Number:

R581.4

GU Wei, HOU Liping, LI Xiaolong, GENG Jianlin. Effect of selenium yeast combined with vitamin D on thyroid-associated antibody levels in patients with Hashimoto thyroiditis at different ages[J]. Journal of Internal Medicine Concepts & Practice, 2021, 16(06): 392-396.

Figures/Tables 5

References 22

[1]	Zaletel K, Gaberšôcek S. Hashimoto’s thyroiditis: from genes to the disease[J]. Curr Genomics, 2011, 12(8): 576-588. doi: 10.2174/138920211798120763 pmid: 22654557
[2]	Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria[J]. Autoimmun Rev, 2014, 13(4-5): 391-397. doi: 10.1016/j.autrev.2014.01.007 pmid: 24434360
[3]	Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders[J]. Lancet Diabetes Endocrinol, 2015, 3(4): 286-295. doi: 10.1016/S2213-8587(14)70225-6 URL
[4]	Wang W, Mao J, Zhao J, et al. Decreased thyroid peroxidase antibody titer in response to selenium supplementation in autoimmune thyroiditis and the influence of a selenoprotein P gene polymorphism: a prospective, multicenter study in China[J]. Thyroid, 2018, 28(12): 1674-1681. doi: 10.1089/thy.2017.0230 URL
[5]	刘杉, 熊丰, 刘恩梅, 等. 1,25(OH)₂D₃干预实验性自身免疫性甲状腺炎TH1/TH2细胞失衡的研究[J]. 南方医科大学学报, 2010, 30(7): 1573-1576.
[6]	郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002: 226-233.
[7]	中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组. 中国甲状腺疾病诊治指南——甲状腺炎[J]. 中华内科杂志, 2008, 47(9): 784-788.
[8]	方露, 朱武飞, 廖翔宇, 等. 桥本氏甲状腺炎患者年龄、性别分布及自身免疫抗体水平分析[J]. 微循环学杂志, 2020, 30(1): 69-72.
[9]	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 甲状腺功能减退症基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2019, 18(11): 1022-1028.
[10]	汪岛, 王曙. 硒与甲状腺:密不可分的联系[J]. 内科理论与实践, 2011, 6(5): 397-400.
[11]	王清华, 余霄龙, 王娈, 等. 亚硒酸钠对桥本甲状腺炎患者血清甲状腺过氧化物酶抗体滴度及氧化应激水平的影响[J]. 中华内分泌代谢杂志, 2017, 33(8): 668.
[12]	Rostami R, Nourooz-Zadeh S, Mohammadi A, et al. Serum selenium status and its interrelationship with serum biomarkers of thyroid function and antioxidant defense in Hashimoto’s thyroiditis[J]. Antioxidants (Basel), 2020, 9(11): 1070.
[13]	任珍, 张薇, 王晓光. 左甲状腺素钠联合硒酵母对桥本甲状腺炎甲状腺功能减退的疗效分析[J]. 中国慢性病预防与控制, 2017, 25(1): 60-62.
[14]	de Farias CR, Cardoso BR, de Oliveira GM, et al. A randomized-controlled, double-blind study of the impact of selenium supplementation on thyroid autoimmunity and inflammation with focus on the GPx1 genotypes[J]. J Endocrinol Invest, 2015, 38(10): 1065-1074. doi: 10.1007/s40618-015-0285-8 pmid: 25894865
[15]	Wichman J, Winther KH, Bonnema SJ, et al. Selenium supplementation significantly reduces thyroid autoantibody levels in patients with chronic autoimmune thyroiditis[J]. Thyroid, 2016, 26(12): 1681-1692. doi: 10.1089/thy.2016.0256 URL
[16]	王清华, 余霄龙, 王娈, 等. 亚硒酸钠对桥本甲状腺炎患者血清甲状腺过氧化物酶抗体滴度及氧化应激水平的影响[J]. 中华内分泌代谢杂志, 2017, 33(8): 668.
[17]	高莹, 刘明明, 修瑞娟. 桥本甲状腺炎的免疫学发病机制进展[J]. 内科理论与实践, 2013, 8(6): 392-396.
[18]	Krysiak R, Szkróbka W, Okopień B. The effect of vitamin D on thyroid autoimmunity in levothyroxine-treated women with Hashimoto’s thyroiditis and normal vitamin D status[J]. Exp Clin Endocrinol Diabetes, 2017, 125(4): 229-233. doi: 10.1055/s-0042-123038 URL
[19]	侯丽萍, 耿建林, 谷巍, 等. 维生素D₃对实验性自身免疫性甲状腺炎Th1/Th2细胞平衡和MCP-1/CCR2信号的影响[J]. 重庆医科大学学报, 2021, 46(08): 921-926.
[20]	D’Aurizio F, Villalta D, Metus P, et al. Is vitamin D a player or not in the pathophysiology of autoimmune thyroid diseases?[J]. Autoimmun Rev, 2015, 14(5): 363-369. doi: 10.1016/j.autrev.2014.10.008 URL
[21]	Bozkurt NC, Karbek B, Ucan B, et al. The association between severity of vitamin D deficiency and Hashimoto’s thyroiditis[J]. Endocr Pract, 2013, 19 (3): 479-484. doi: 10.4158/EP12376.OR pmid: 23337162
[22]	Liontiris MI, Mazokopakis EE. A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation[J]. Hell J Nucl Med, 2017, 20(1): 51-56. doi: 10.1967/s002449910507 pmid: 28315909

组别	对照组	观察组
成年	n=47	n=45
治疗前	15.12±3.98	14.32±4.28
治疗后	16.39±2.99	31.61±5.12^2）
t	1.24	9.86
P	>0.05	<0.05
未成年	n=24	n=24
治疗前	22.28±5.21^1）	22.85±4.90^1）
治疗后	24.15±2.01	39.04±3.89^2）
t	0.98	8.23
P	>0.05	<0.05

项目	治疗前				治疗后
	成年患者		未成年患者		成年患者		未成年患者
	对照组（n=47）	观察组（n=45）	对照组（n=24）	观察组（n=24）	对照组（n=47）	观察组（n=45）	对照组（n=24）	观察组（n=24）
FT₃（pmol/L）	4.07±0.89	4.89±0.91	5.29±0.78	5.39±1.02	5.59±1.29	5.01±1.22	5.32±1.09	5.67±1.89
FT₄（pmol/L）	12.79±4.91	12.29±5.12	13.21±4.71	13.29±4.98	13.92±5.01	13.02±4.98	13.99±4.29	14.32±5.03
TSH（mU/L）	3.22±1.38	3.29±1.29	3.09±0.57	2.99±1.93	3.91±0.29	3.01±0.98	2.98±0.47	3.05±0.95

项目	对照组（n=47）	观察组（n=45）
TPOAb（U/mL）
治疗前	1 411±206	1 390±242^1）
治疗后6个月	1 391±194	684±259^2）
TgAb（U/mL）
治疗前	808±300	837±274^1）
治疗后6个月	789±276	403±188^2）
t^*	10.236	11.372
P^*	<0.05	<0.05

项目	对照组（n=24）	观察组（n=24）
TPOAb
治疗前	1 790±216	1 586±219^1）
治疗后6个月	1 469±197	706±230^2）
TgAb
治疗前	907±290	958±224^1）
治疗后6个月	899±266	489±200^2）
t^*	10.236	11.372
P^*	<0.05	<0.05

组别	显效	有效	无效	总有效率
成年
观察组（n=45）	13（28.9）	22（48.9）	10（22.2）	（77.8）
对照组（n=47）	5（10.6）	8（17.0）	32（72.3）	（27.7）
未成年
观察组（n=24）	8（33.3）	11（45.8）	6（20.8）	（79.2）
对照组（n=24）	3（12.5）	3（12.5）	18（75.0）	（25.0）