Analysis Of The Efficacy Of Selenium Yeast In The Treatment Of TPOAb And TgAb In Patients With Normal Thyroid Function Hashimoto Thyroiditis

Background:Hashimoto thyroiditis（HT）is an autoimmune thyroid disease characterized by elevated thyroid peroxidase antibody（TPOAb）and/or thyroglobulin antibody（TgAb）,goiter,and a large number of lymphocyte infiltrates in the thyroid gland.In the early stage,only serum TPOAb is positive,most of them have no clinical symptoms,and symptoms of hypothyroidism may occur in the later stage,but symptoms of hyperthyroidism can also occur.At present,clinical treatment is mainly aimed at hypothyroidism and goiter compression symptoms,and there are no effective treatment measures for high concentration of antibodies.Therefore,finding a treatment method that effectively reduces the concentration of antibodies has become the focus of current clinical work.In recent years,selenium supplementation therapy has become a research hotspot for HT treatment.Many clinical studies on the use of selenium supplementation in HT patients have been carried out at home and abroad,but there is still some controversy about the effect of selenium supplementation on antibodies,and the relevant factors affecting the treatment effect of selenium supplementation are not clear.Therefore,it is of important guiding significance for the clinical treatment of HT patients to explore the influence of selenium supplement therapy on antibody and analyze the related factors that may affect the effect of selenium supplement therapy.Objective:To observe the changes of TPOAb and TgAb concentrations before and after selenium supplement therapy,analyze the effects of selenium supplement therapy on TPOAb and TgAb,and explore the related factors that may affect the effect of selenium supplement therapy,so as to provide reference for the clinical treatment of HT patients.Methods:According to the inclusion and exclusion criteria,171 HT patients who visited the outpatient and inpatient department of the Department of Endocrinology of Huaihe Hospital of Henan University from March 2021 to September 2022 were selected.All patients were treated with selenium yeast at 200μg/d for at least 6 months.General data and laboratory examination results of the patients before treatment with selenium yeast were collected,and free triiodothyronine（FT₃）,free thyroxine（FT₄）,thyroid-stimulating hormone（TSH）,TPOAb,TgAb and other indicators were collected for re-examination at the 3rd and 6th months after receiving selenium yeast treatment.Statistical methods were used to compare the changes of the above indicators before and after treatment,and to analyze the influence of selenium supplementation on each index.The decline of antibodies in different time periods was compared,and the relationship between the therapeutic effect of selenium supplementation and the treatment time was analyzed.Then,according to the degree of antibody decline at 6 months of treatment compared with before treatment,the antibody decline group and the non-decline group were divided,and the differences of factors between the two groups were compared,and the relevant factors that may affect the treatment effect of selenium supplementation and their correlation were analyzed.Results:1.There was no significant difference in FT₃,FT₄and TSH at 3 months and 6 months of treatment compared with before treatment（p>0.05）.2.The concentrations of TPOAb and TgAb at 3 and 6 months of treatment were lower than those before treatment,and the difference was statistically significant（p<0.05）.The decreases of TPOAb and TgAb at 6 months of treatment were greater than those at 3 months of treatment,and the difference was statistically significant（p<0.05）.The decrease of TPOAb and TgAb during 3 to 6 months of treatment was not statistically significant compared with 3 months of treatment（p>0.05）.Compared with the decline of TPOAb in the same time period,the decline of TgAb was small,and the difference was statistically significant（p<0.05）.3.At 6 months of treatment,there were statistically significant differences in gender,age and initial TPOAb concentration between the decreased and non-decreased TPOAb groups（p<0.05）,but there were no statistically significant differences in disease course and BMI（p>0.05）.At 6 months of treatment,there were statistically significant differences in gender and initial TgAb concentration between the decreased and non-decreased TgAb groups（p<0.05）,but there were no statistically significant differences in age,disease course and BMI（p>0.05）.4.The initial TPOAb concentration was positively correlated with the decrease of TPOAb at 6 months of treatment（r=0.694,p<0.001）,and the initial TgAb concentration was positively correlated with the decrease of TgAb at 6 months of treatment（r=0.361,p<0.001）.Conclusion:1.Selenium supplementation therapy can reduce the concentration of TPOAb and TgAb in patients with normal thyroid function HT,and the longer the treatment time,the more obvious the decrease of TPOAb and TgAb concentrations,especially the most significant reduction of TPOAb concentration.But the levels of FT₃,FT₄and TSH were not affected by selenium supplementation.2.The decrease of TPOAb and TgAb concentrations was affected by gender,age,and initial TPOAb and TgAb concentrations,among which the initial TPOAb concentration was positively correlated with the decrease of TPOAb after treatment,and the initial TgAb concentration was positively correlated with the decrease of TgAb after treatment.