| ObjectiveAutoimmune thyroiditis (AIT) is an organ specific autoimmune diseases. When patients went into hypothyroidism, they had to receive LT4 replacement therapy to maitain their thyroid function normal. How to mitigate its inflammatory reaction, lack effective method. Se enzymes play important role in thyroid antioxidant systems. Recent studies propose that selenium as the adjuvant of LT4 therapy can lower serum thyroid peroxidase antibody (TPOAb) to alleviate AIT patients'thyroid inflammation. This study aims to explore the effect of selenium supplementation on AIT thyroid oxidation antioxidant systems and serum TPOAb titer.Methods1. SubjectsWe collected 156 AIT patients at out-patient clinic, First Hospital of China Medical University. The patients' serum TPOAb>300IU/ml. There are 105 cases of subclinical AIT patients (with normal thyroid function, or subclinical hypothyroidism on the period of AIT patients) and 51 cases of AIT patients with hypothyroidism.2. MethodsWe have conducted a random, double-blind intervention of selenium or placebo for a period of 6-month study on 51 cases of AIT patients with hypothyroidism and 105 cases of subclinical AIT patients. All the hypothyroidism patients receiving L-T4 replacement therapy to control serum TSH in the normal range. While the subclinical AIT patients were not given LT4 therapy. At the same time all the selected AIT patients receive selenium yeast or placebo 200μg/day.All patients were followed up at the start and after the 3 months and 6 months of the intervention. At the first visit,urine iodine were tested. The serum thyroid function (FT4, FT3, TSH), TPOAb, blood selenium, serum antioxidation GPx3, and serum oxidation H2O2 and MDA were tested at each follow-up.3. Statistical analysisAll data were analyzed using software SPSS 16.0. If the data does not fit the normal distribution, we will have the data converted. Comparisons in concentrations of serum Measurement Indicators between baseline and post-selenium were performed by the analysis of variance (ANOVA) for repeated measures. All tests were considered statistically significant when P< 0.05.ResultsThe results of urinary iodine were 182(75,496)μg/L.There is no moderate or severe iodine deficiency patients.After the intervention on AIT patients, blood selenium levels were significantly higher in selenium group, and there's no change in placebo group patients.In subclinical AIT patients selenium intervention group, TPOAb decreased significantly (p= 0.004, n= 52)after 3 months, and after 6 months the TPOAb decreased significantly compared with the third month's result(p= 0.023, n= 52). While TPOAb did not change(P=0.97,n=53) in patients with subclinical AIT of placebo group. In AIT patients with hypothyroidism of selenium intervention group, TPOAb decreased significantly (p= 0.005, n= 28)after 3 months. There is a slight downward trend in TPOAb at placebo group without statistically significance. There's no significant change in TPOAb at patients with hypothyroidism whether on selenium intervention group or the placebo group during 3-6 months.Serum antioxidant activity GP,x3 increased gradually during 6 months intervention in selenium group of AIT patients(P<0.001,n=80), while it decreased at placebo group(P<0.001,n=76). The amount of serum oxidant H2O2 decreased gradually during 6 months intervention in selenium group of AIT patients(P<0.001,n=80), while there is no change at placebo group(P=0.229,n=76). The amount of serum oxidant MDA decreased gradually during 6 months intervention in selenium group of AIT patients(P<0.001,n=80), while there is an increase at placebo group(P=0.026,n=76).After selenium supplementation on subclinical AIT patients, the thyroid function didn't changed.ConclusionsBoth purely Se intake and selenium joint LT4 treatment on AIT patients can decrease serum TPOAb.After selenium supplementation on AIT patients, Antioxidant capacity increased, while Oxidation capacity decreased.
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