BACKGROUND The synthesis of thyroid hormone depends on a set of trace elements, most importantly selenium and iodine. The dietary supply with certain micronutrients is limited in many areas of the world, including central Europe and large parts of Asia and Africa. Moreover, both thyroid disease risk and therapy effects are modulated by trace element supply and status. OBJECTIVE Assessment of trace element status in thyroid patients in a European metropolis. MATERIAL AND METHODS Adult patients visiting a medical praxis in Berlin, Germany, were enrolled into a cross-sectional analysis, and serum samples were obtained from thyroid patients (n = 323) with different conditions including goitre, hypothyroidism, malignancy or autoimmune thyroid disease. Trace elements (iodine, selenium, copper and zinc) were assessed by ICP-MS/MS or total reflection X-ray analysis, along with two protein biomarkers of selenium status (selenoprotein P, glutathione peroxidase), and compared to the clinical phenotype. RESULTS The patients displayed relatively low serum zinc and selenium concentrations as compared to a set (n = 200) of healthy subjects (zinc; 1025+/-233 vs. 1068+/-230 μg/L, p < 0.01, selenium; 76.9+/18.8 vs. 85.1+/-17.4 μg/L, p < 0.0001). A high fraction of patients (37.5%) was classified as selenium-deficient (serum selenium concentrations <70 μg/L), in particular the patients with thyroid malignancy (59%). Serum copper was not different between the groups, and total serum iodine concentrations were unrelated to thyroid disease. Explorative statistical analyses yielded no significant interactions between the trace elements and disease parameters, except for free thyroxine inversely correlating to the copper/selenium ratio. CONCLUSIONS In adult thyroid patients, there is no relation of circulating copper, iodine, selenium or zinc concentrations to thyroid hormone. However, a large fraction of German thyroid patients displays a considerable selenium deficit, known to constitute a disease risk potentially impairing convalescence and aggravating autoimmune disease processes. It appears advisable to testing thyroid patients for selenium deficiency, and once diagnosed, an increased supply via dietary counselling or active supplementation should be considered.

中文翻译：

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甲状腺疾病中微量元素状况的横断面分析。

背景技术甲状腺激素的合成取决于一系列微量元素，最重要的是硒和碘。在世界许多地区，包括中欧以及亚洲和非洲的大部分地区，某些微量营养素的饮食供应受到限制。此外，甲状腺疾病的风险和治疗效果均受微量元素供应和状态的调节。目的评估欧洲大都市甲状腺患者的微量元素状况。材料与方法纳入在德国柏林就诊的成年患者，进行横断面分析，并从甲状腺疾病（n = 323）患有甲状腺肿，甲状腺功能减退，恶性肿瘤或自身免疫性甲状腺疾病的不同患者中获取血清样本。微量元素（碘，硒，铜和锌）通过ICP-MS / MS或全反射X射线分析以及硒状态的两种蛋白质生物标记（硒蛋白P，谷胱甘肽过氧化物酶）进行了评估，并与临床表型进行了比较。结果与一组健康受试者（锌= 1025 +/- 233与1068 +/- 230μg/ L，p <0.01，硒； 76.9）相比，该患者的血清锌和硒浓度相对较低（n = 200） + / 18.8与85.1 +/- 17.4μg/ L，p <0.0001）。很大一部分患者（37.5％）被归为硒缺乏（血清硒浓度<70μg/ L），特别是甲状腺恶性肿瘤患者（59％）。两组之间的血清铜无差异，血清总碘浓度与甲状腺疾病无关。探索性统计分析表明，微量元素与疾病参数之间没有显着的相互作用，除了游离的甲状腺素与铜/硒比成反比外。结论在成年甲状腺患者中，循环中的铜，碘，硒或锌的浓度与甲状腺激素没有关系。但是，大部分德国甲状腺患者显示出大量的硒缺乏症，已知会构成疾病风险，有可能损害康复和加重自身免疫疾病的进程。似乎建议对甲状腺患者进行硒缺乏检测，一旦确诊，应考虑通过饮食咨询或积极补充而增加供应。结论在成年甲状腺患者中，循环中的铜，碘，硒或锌的浓度与甲状腺激素没有关系。但是，大部分德国甲状腺患者显示出大量的硒缺乏症，已知会构成疾病风险，有可能损害康复和加重自身免疫疾病的进程。似乎建议对甲状腺患者进行硒缺乏检测，一旦确诊，应考虑通过饮食咨询或积极补充而增加供应。结论在成年甲状腺患者中，循环中的铜，碘，硒或锌的浓度与甲状腺激素没有关系。但是，大部分德国甲状腺患者显示出大量的硒缺乏症，已知会构成疾病风险，有可能损害康复和加重自身免疫疾病的进程。似乎建议对甲状腺患者进行硒缺乏检测，一旦确诊，应考虑通过饮食咨询或积极补充而增加供应。已知会构成疾病风险，可能会损害康复和加重自身免疫疾病的进程。似乎建议对甲状腺患者进行硒缺乏检测，一旦确诊，应考虑通过饮食咨询或积极补充而增加供应。已知会构成疾病风险，有可能损害疗养和加重自身免疫性疾病的进程。似乎建议对甲状腺患者进行硒缺乏检测，一旦确诊，应考虑通过饮食咨询或积极补充而增加供应。