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Selenium in thyroid disorders - essential knowledge for clinicians.
Nature Reviews Endocrinology ( IF 31.0 ) Pub Date : 2020-01-30 , DOI: 10.1038/s41574-019-0311-6
Kristian Hillert Winther 1 , Margaret Philomena Rayman 2 , Steen Joop Bonnema 1 , Laszlo Hegedüs 1
Affiliation  

In the 1990s, selenium was identified as a component of an enzyme that activates thyroid hormone; since this discovery, the relevance of selenium to thyroid health has been widely studied. Selenium, known primarily for the antioxidant properties of selenoenzymes, is obtained mainly from meat, seafood and grains. Intake levels vary across the world owing largely to differences in soil content and factors affecting its bioavailability to plants. Adverse health effects have been observed at both extremes of intake, with a narrow optimum range. Epidemiological studies have linked an increased risk of autoimmune thyroiditis, Graves disease and goitre to low selenium status. Trials of selenium supplementation in patients with chronic autoimmune thyroiditis have generally resulted in reduced thyroid autoantibody titre without apparent improvements in the clinical course of the disease. In Graves disease, selenium supplementation might lead to faster remission of hyperthyroidism and improved quality of life and eye involvement in patients with mild thyroid eye disease. Despite recommendations only extending to patients with Graves ophthalmopathy, selenium supplementation is widely used by clinicians for other thyroid phenotypes. Ongoing and future trials might help identify individuals who can benefit from selenium supplementation, based, for instance, on individual selenium status or genetic profile.

中文翻译:

甲状腺疾病中的硒-临床医生必不可少的知识。

在1990年代,硒被认为是激活甲状腺激素的酶的一种成分。自从发现以来,硒与甲状腺健康的相关性得到了广泛的研究。硒主要以硒酵素的抗氧化特性着称,主要从肉,海鲜和谷物中获得。全世界的摄入量水平各不相同,这在很大程度上是由于土壤含量的差异以及影响其对植物生物利用度的因素。在摄入量的两个极端情况下均观察到不利的健康影响,最佳范围狭窄。流行病学研究表明自身免疫性甲状腺炎,格雷夫斯病和甲状腺肿的风险增加与硒水平低有关。慢性自身免疫性甲状腺炎患者补充硒的试验通常会导致甲状腺自身抗体滴度降低,而对该病的临床病程没有明显改善。在Graves病中,对于患有轻度甲状腺眼病的患者,补充硒可能会导致甲状腺功能亢进症的更快缓解以及生活质量和眼部受累的改善。尽管建议仅适用于Graves眼病患者,但硒补充已被临床医生广泛用于其他甲状腺表型。正在进行的试验和将来的试验可能有助于根据个体硒的状况或遗传状况,从硒补充中受益。补充硒可能会导致甲状腺功能减退症的甲状腺功能亢进症的更快缓解,并改善生活质量和眼部受累。尽管建议仅适用于Graves眼病患者,但硒补充已被临床医生广泛用于其他甲状腺表型。正在进行的试验和将来的试验可能有助于根据个体硒的状况或遗传状况,从硒补充中受益。补充硒可能会导致甲状腺功能减退症的甲状腺功能亢进症的更快缓解,并改善生活质量和眼部受累。尽管建议仅适用于Graves眼病患者,但硒补充已被临床医生广泛用于其他甲状腺表型。正在进行的试验和将来的试验可能有助于例如根据个体硒的状况或遗传状况,从硒补充中受益的个体。
更新日期:2020-01-30
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