Selenium and rubidium changes in subjects with pathologically altered thyroid

Correlation between systemic inflammatory response index and thyroid function: 2009-2012 NHANES results

Aims

This study investigates the relationship between the Systemic Inflammatory Response Index (SIRI) and thyroid function.

Methods

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012, we excluded participants lacking SIRI or thyroid function data, those under 20 years, and pregnant individuals. SIRI was determined using blood samples. We conducted weighted multivariate regression and subgroup analyses to discern the independent relationship between SIRI and thyroid function.

Results

The study included 1,641 subjects, with an average age of 47.26±16.77 years, including 48.65% males and 51.35% females. The population was divided into three SIRI-based groups (Q1-Q3). Q3, compared to Q1, exhibited higher age-at-onset, greater male prevalence, and increased levels of FT3, FT4, TT4, leukocytes, and triglycerides. This group also showed a higher incidence of diabetes, hypertension, and smoking. Notably, Q1 had lower LDL and HDL levels. SIRI maintained a positive association with FT4 (β = 0.01, 95% CI = 0.00-0.03, P for trend = 0.0071), TT4 (β = 0.20, 95% CI = 0.10, 0.31, P for trend=0.0001), and TPOAb (β = 8.0, 95% CI = 1.77-14.30, P for trend = 0.0120), indicating that each quartile increase in SIRI corresponded to a 0.01 ng/dL increase in FT4, a 0.2 g/dL increase in TT4, and an 8.03 IU/mL rise in TPOAb. The subgroup analysis suggested the SIRI-thyroid function correlation was influenced by hypertension.

Conclusion

Inflammation may impact the development and progression of thyroid function disorders. Proactive anti-inflammatory treatment might mitigate thyroid abnormalities.

Selenium and thyroid diseases

Selenium, a non-metallic element, is a micronutrient essential for the biosynthesis of selenoproteins containing selenocysteine. In adults, the thyroid contains the highest amount of selenium per gram of tissue. Most known selenoproteins, such as glutathione peroxidase, are expressed in the thyroid and are involved in thyroid hormone metabolism, redox state regulation, and maintenance of cellular homeostasis. Some clinical studies have shown that lack of selenium will increase the prevalence of several kinds of thyroid diseases. Selenium treatment in patients with Graves' orbitopathy has been shown to delay disease progression and improve the quality of life. Selenium supplementation in Hashimoto's thyroiditis was associated with the decreased levels of anti-thyroid peroxidase antibody and improved thyroid ultrasound structure. In thyroid cancer, various selenium supplements have shown variable anticancer activity. However, published results remain the conflicting and more clinical evidence is still needed to determine the clinical significance of selenium. This article reviews the strong association between selenium and thyroid disease and provides new ideas for the clinical management of selenium in thyroid disease.

The role of heavy metals in thyroid cancer: A meta-analysis

INTRODUCTION

Metal ions are known to accumulate in the thyroid and some play an important role in the function and homeostatic mechanisms of the thyroid gland. Certain metal ions are known endocrine disruptors while others are classified to be carcinogenic. Although higher thyroid cancer incidence rates have been reported in regions with high metal levels in soil and drinking water, including volcanic regions, the effect of heavy metals on the thyroid is still poorly understood. To investigate the association between heavy metals and thyroid cancer, a comprehensive meta-analysis was performed to draw a more evidence-based conclusion for individual metal ions.

MATERIAL AND METHODS

Nineteen studies were included in this meta-analysis, of which 9 studies reported blood metal ion levels, 8 studies reported tissue metal ion levels and 2 studies reported blood and tissue metal ion levels. The standardized mean difference (SMD) was calculated between thyroid cancer patients group and a control group (benign thyroid patients group or healthy controls group) per study.

RESULTS

A significant positive SMD in manganese tissue levels between thyroid cancer patients and benign thyroid patients (SMD: 0.56 (95 % CI: 0.16, 0.95)) and a significant negative SMD in cobalt blood levels between thyroid cancer patients and healthy controls (SMD: -2.03 (95 % CI: -3.95, -0.10)) was found. No difference in levels of other metals in blood or thyroid tissue between thyroid cancer patients and non-thyroid cancer patients was noted.

DISCUSSION AND CONCLUSION

The present meta-analysis therefore demonstrates the urgent need for future studies, especially given the increasing exposure of the general population to various environmental pollutants, including metal ions, and the thyroid cancer burden worldwide.

Non-Essential Trace Elements Dietary Exposure in French Polynesia: Intake Assessment, Nail Bio Monitoring and Thyroid Cancer Risk

Background:

In French Polynesia, thyroid cancer mortality and incidence is reported to be the highest in the world. Excessive levels of non-essential trace elements (nETE) in the body are associated with several types of cancer.

Objective:

The present study aims to provide quantitative information on food contamination by mercury (Hg), lead (Pb), arsenic (As) and cadmium (Cd) in French Polynesia and its potential correlation with measurements performed in fingernails of Polynesians, and then to investigate the potential association between these nETE and different thyroid cancer risks.

Methods:

The study population included 229 interviewed cases and 373 interviewed controls We performed a descriptive analysis of Polynesian food and examined the association between thyroid cancer risk and daily intake levels of nETE and with fingernail nETE levels.

Results:

Hg contamination was mainly present in sea products, Pb contamination was present in almost all samples, Cd was detectable in starchy food and As was detectable in all sea products. No patient exceeded dietary contamination WHO limits for Pb, 2 participants exceeded it for Hg and 3 individuals (0.5%) for cadmium. In fingernail clippings, the most detectable pollutant was Pb (553 participants), then Hg (543 participants) then Cd (only in 130 participants). Thyroid cancer risk was increased more than 4 times by Pb daily intake in patients with a history of cancer in first-degree relatives than in ones without (p for interaction =0.01), and 2 times more in women with more than 3 pregnancies than in those with none or less (p for interaction =0.005); it was also increased following As intake by more than 30% in patients with a history of cancer in first-degree relatives than in ones without (p for interaction =0.05).

Conclusion:

Locally produced foods are not a source of nETE exposure in French Polynesia. Dieatry nETE exposure and fingernail nETE concentration are not associated to differentiated thyroid cancer risk. No correlation found between nETE dietary exposure and fingernail nETE concentration.

Selenoenzymes, laboratory parameters, and trace elements in different types of thyroid tumor

This study was performed to investigate selenoenzyme activities and trace element concentrations in thyroid tissues, with reference to other parameters routinely used to characterize thyroid function. This was to reveal relevant parameters as possible additional markers of tumor grade, clinical course, and prognosis of thyroid disorders. The tissue samples were obtained during surgical treatment (total or near total thyroidectomy) of 122 patients with different types of thyroid tumor. For most of the investigated parameters in different groups of patients, we did not find statistically significant differences. In the majority of cases, thyroid benign or malignant tumors were not accompanied by significant derangement of the gland selenoenzymes and of either intrathyroidal or plasma concentration of selenium. Nevertheless, types I and II iodothyronine deiodinases were the most promising (among selenoenzymes) targets for diagnoses and possibly therapy of thyroid tumors. Higher activities of both enzymes in cases with Graves' disease, as compared with other thyroid lesions, suggest their involvement in the pathogenesis of this condition. Patients with struna nodosa had higher levels of thyroid Zn, Cu, and Pb as compared with papillary carcinoma subjects and also a higher level of Cu than follicular carcinoma cases. The above diagnostics may play a similar role to some of the general thyroid function indices, TSH, anti-TG, anti-TPO, and calcitonin, which can partially distinguish between various thyroid tumors. In conclusion, some of selenium status markers, when accompanied with general parameters, and trace elements can serve as factors with pathophysiologic relevance and be helpful in the identification of malignant disease. Multivariate statistical methods should be employed to tackle a broad array of thyroid tumor diagnostic data in a short time. Partial least squares model and other pattern recognition methods seem to be the most appropriate methods for that task. The miniaturization of all the steps of complex analytical procedure should be developed in a way to allow its completion as sensitive, robust, and efficient for use of the small quantity of material provided by fine-needle biopsy.

Selenium, the thyroid, and the endocrine system

Recent identification of new selenocysteine-containing proteins has revealed relationships between the two trace elements selenium (Se) and iodine and the hormone network. Several selenoproteins participate in the protection of thyrocytes from damage by H(2)O(2) produced for thyroid hormone biosynthesis. Iodothyronine deiodinases are selenoproteins contributing to systemic or local thyroid hormone homeostasis. The Se content in endocrine tissues (thyroid, adrenals, pituitary, testes, ovary) is higher than in many other organs. Nutritional Se depletion results in retention, whereas Se repletion is followed by a rapid accumulation of Se in endocrine tissues, reproductive organs, and the brain. Selenoproteins such as thioredoxin reductases constitute the link between the Se metabolism and the regulation of transcription by redox sensitive ligand-modulated nuclear hormone receptors. Hormones and growth factors regulate the expression of selenoproteins and, conversely, Se supply modulates hormone actions. Selenoproteins are involved in bone metabolism as well as functions of the endocrine pancreas and adrenal glands. Furthermore, spermatogenesis depends on adequate Se supply, whereas Se excess may impair ovarian function. Comparative analysis of the genomes of several life forms reveals that higher mammals contain a limited number of identical genes encoding newly detected selenocysteine-containing proteins.

The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health

Several minerals and trace elements are essential for normal thyroid hormone metabolism, e.g., iodine, iron, selenium, and zinc. Coexisting deficiencies of these elements can impair thyroid function. Iron deficiency impairs thyroid hormone synthesis by reducing activity of heme-dependent thyroid peroxidase. Iron-deficiency anemia blunts and iron supplementation improves the efficacy of iodine supplementation. Combined selenium and iodine deficiency leads to myxedematous cretinism. The normal thyroid gland retains high selenium concentrations even under conditions of inadequate selenium supply and expresses many of the known selenocysteine-containing proteins. Among these selenoproteins are the glutathione peroxidase, deiodinase, and thioredoxine reductase families of enzymes. Adequate selenium nutrition supports efficient thyroid hormone synthesis and metabolism and protects the thyroid gland from damage by excessive iodide exposure. In regions of combined severe iodine and selenium deficiency, normalization of iodine supply is mandatory before initiation of selenium supplementation in order to prevent hypothyroidism. Selenium deficiency and disturbed thyroid hormone economy may develop under conditions of special dietary regimens such as long-term total parenteral nutrition, phenylketonuria diet, cystic fibrosis, or may be the result of imbalanced nutrition in children, elderly people, or sick patients.

Serum selenium levels in multinodular goitre

Serum selenium levels were measured in 22 patients with a multinodular goitre and compared to 15 normal controls using atomic absorption spectrophotometry. The serum selenium was significantly low in these patients (patients' mean = 9.6 +/- 1.24 mcg/l, versus control mean = 11.7 +/- 1.64 mcg/l and P < 0.005). Serum T4 and T3 were within the normal range in all patients and controls. Their levels correlated positively, though weakly, with the serum selenium levels (r = 0.4 and 0.36, respectively). The control selenium levels in this study were lower than the reported figures from some European countries, but they were close to those from other studies in Egypt. It seems that Egypt is a low selenium area. A wide-scale epidemiological study is recommended, together with the examination of the possible preventive role of selenium supplementation in areas of endemic goitre.

The TSH-dependent variation of the essential elements iodine, selenium and zinc within human thyroid tissues

Instrumental Neutron Activation Analysis was used in order to measure iodine, selenium and zinc concentration in thyroid samples. A pair of samples of normal and nodular tissue were collected from the thyroid gland from 72 patients selected on the basis of pathological criteria (44 cases of multinodular goiter, 12 of chronic lymphocytic thyroiditis (CLT), 6 of thyroid adenoma (TA) and 12 of thyroid cancer (TC)). The check for tissue homogeneity and sampling error was performed by means of the coefficient of variation (CV%) of the elements in replicate samples of normal and altered tissues. High CV% values (> 15%) for iodine reflected a functional variability in thyroid follicles, while low CV% values (< 10%) for selenium and zinc indicated that the composition of selected tissues was rather homogeneous. The variation of the element's concentration was compared in normal and altered tissues. The mean element concentrations had values close to those already reported in the literature; furthermore, our patients had marginal iodine and selenium deficiency. Both normal and nodular tissues in CLT showed statistically significant lower zinc values as compared with the other thyroid diseases. To evaluate the thyroid function, thyroid stimulating hormone (TSH) and thyroxine (T4) levels were measured in the serum of patients. Two arbitrary serum-TSH threshold levels (TSH < 1.0 and > 4.0 mU/L) were introduced in order to classify, respectively, hyperthyroidism and hypothyroidism, as well as euthyroid conditions (1.0 < TSH < 4.0 mU/L), and each patient was assigned to one of these groups. The influence of TSH in the variation of the concentration of iodine, selenium and zinc in normal and altered human thyroid tissues was significant.