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Коморбідний ендокринологічний пацієнт
Міжнародний ендокринологічний журнал 2 (74) 2016
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Effect of Selenium on Thyroid Hormones Metabolism in Patients with Metabolic Syndrome
Автори: Abramova N.O., Pashkovska N.V. - Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Chernivtsi, Ukraine
Рубрики: Ендокринологія
Розділи: Медичні форуми
Версія для друку
The article was published on p. 181-182
Microelements, such as selenium and iodine, play important role in thyroid hormones metabolism. Violation of thyroid homeostasis caused by inhibition of thyroid hormones convertion in peripheral organs as a result of decreased deiodinases activity is called «euthyroid sick syndrome» (ESS). Humans and animals require selenium for the function of a number of selenium-dependent enzymes, also known as selenoproteins. Deiodinases also refer to selenoproteins. Selenium deficiency causes inhibition of deiodinases activity as well as increased cytokines expression in patients with metabolic syndrome (MS) and is the trigger factor of ESS development.
The aim of the study. To establish impact of selenium and on thyroid homeostasis parameters in patients with metabolic syndrome.
Material and methods. We have examined 42 patients with MS, 10 healthy individuals formed control group. We determined selenium level in blood plasma by atomic absorption method.
To study thyroid homeostasis characteristics we determined free thyroxine (fT4) and free triiodothyronine (fT3) levels and calculated fT3/fT4 ratio to estimate activity of peripheral convetion of thyroid hormones.
Examined patients were divided into two groups in order to assess the impact of sodium selenite on thyroid hormones metabolism: 20 people received sodium selenite at a dose equivalent to 50 µg of selenium per day plus basic treatment of MS, 16 people received only basic therapy of MS and made control group.
Results. In previous studies we found increased fT4, decreased fT3 concentratoins and fT3/fT4 ratio in patients with MS compared to the control group.
Selenium level in the blood of patients with MS was by 16.7 % reliably lower than in control group (P < 0.05). Positive correlation between selenium level in blood and fT3 level, fT3/fT4 ratio was revealed. So selenium may have positive influence on thyroid hormones metabolism.
After patients have been divided into main and control group to assess the effectiveness of the treatment by sodium selenite, such changes remained significant in relation to control group without probable inter-group differences.
After sodium selenite administration fT4 level bacame 32.2 % lower (P < 0.05), while in the control group it was only 5 % lower (P < 0.05), than before treatment. FT3 level became 33.9 % higher in main group after treatment (P < 0.05), whilst in control group it’s changes weren’t significant. Reliable increase of fT3/fT4 ratio in both groups after treatment has been obtained: by 39.2 % in main group and by 8.4 % in control group (P < 0.05).
Conclusions:
1. There is a direct correlation between selenium content and activity of peripheral conversion of thyroid hormones.
2. The results indicate the improvement of peripheral conversion of thyroid hormones activity after sodium selenite intake in patients with metabolic syndrome by deiodinases activity balancing.