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Esposito D, Rotondi M, Accardo G, Vallone G, Conzo G, Docimo G, Selvaggi F, Cappelli C, Chiovato L, Giugliano D, Pasquali D. Influence of short-term selenium supplementation on the natural course of Hashimoto's thyroiditis: clinical results of a blinded placebo-controlled randomized prospective trial. J Endocrinol Invest 2017; 40:83-89. [PMID: 27572248 DOI: 10.1007/s40618-016-0535-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/16/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The real efficacy of selenium supplementation in Hashimoto's thyroiditis (HT) is still an unresolved issue. OBJECTIVES We studied the short-term effect of L-selenomethionine on the thyroid function in euthyroid patients with HT. Our primary outcome measures were TSH, thyroid hormones, thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb) levels and thyroid echogenicity after 6 months of L-selenomethionine treatment. The secondary outcome measure was serum CXCL10 levels. METHODS In a placebo-controlled randomized prospective study, we have enrolled untreated euthyroid patients with HT. Seventy-six patients were randomly assigned to receive L-selenomethionine 166 µg/die (SE n = 38) or placebo (controls n = 38) for 6 months. TSH, free T4 (FT4), free T3 (FT3), TPOAb and CXCL10 serum levels were assayed at time 0, after 3 and 6 months. An ultrasound examination of the left and right thyroid lobe in transverse and longitudinal sections was performed. A rectangular region, the region of interest, was selected for analysis. RESULTS TSH, FT4, FT3, TPOAb, thyroid echogenicity and CXCL10 were not statistically different between SE and control groups at time 0, after 3 and 6 months. In the SE group, FT4 levels were significantly decreased (P < 0.03) after 3 months, while FT3 increased (P < 0.04) after 3 and 6 months versus baseline values. In the control group, the FT3 decreased after 3 and 6 months (P < 0.02) compared to baseline. CONCLUSION The short-term L-selenomethionine supplementation has a limited impact on the natural course in euthyroid HT. Our results tip the balance toward the ineffectiveness of short-term L-selenomethionine supplementation in HT.
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Affiliation(s)
- D Esposito
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Piazza Miraglia n 2, 80100, Naples, Italy
| | - M Rotondi
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri IRCCS, University of Pavia, Pavia, Italy
| | - G Accardo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Piazza Miraglia n 2, 80100, Naples, Italy
| | - G Vallone
- Department of Pediatric Radiology, University Hospital Federico II, Naples, Italy
| | - G Conzo
- Division of General and Oncologic Surgery, Department of Anesthesiology, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy
| | - G Docimo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Piazza Miraglia n 2, 80100, Naples, Italy
| | - F Selvaggi
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Piazza Miraglia n 2, 80100, Naples, Italy
| | - C Cappelli
- Endocrine and Metabolic Unit, Department of Medical and Surgical Sciences, Clinica Medica, 2nd Medicina, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - L Chiovato
- Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri IRCCS, University of Pavia, Pavia, Italy
| | - D Giugliano
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Piazza Miraglia n 2, 80100, Naples, Italy
| | - D Pasquali
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Piazza Miraglia n 2, 80100, Naples, Italy.
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