Rol selenium onduidelijk bij TPO-antistoffen

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laura
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Lid geworden op: 11 sep 2013, 22:42
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Rol selenium onduidelijk bij TPO-antistoffen

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Of we nu werkelijk zitten te wachten op weer zo'n onderzoek? En wel grappig hoe verschillend de conclusies zijn.

Medscape: Selenium supplement role unclear in autoimmune thyroiditis

Selenium supplementation significantly reduces thyroid autoantibody levels in patients with chronic autoimmune thyroiditis:
A systematic review and meta-analysis


Johanna Wichman, Hillert Winther Kristian, Joop Bonnema Steen, Laszlo Hegedüs.
Thyroid. December 2016, 26(12): 1681-1692. doi:10.1089/thy.2016.0256.

Summarizing the evidence of this study and previous systematic reviews and meta-analyses, selenium supplementation may decrease TPOAb levels in AIT patients. However, TPOAb is rated as a non-important outcome for patients and decision makers according to GRADE (21). Rather, it is a surrogate marker of disease activity, rendering it suboptimal when investigating the clinical efficacy of selenium supplementation in this patient group. In ongoing trials, such as CATALYST (62), attempts are made to shift the focus to more clinically relevant outcomes. The importance of this is emphasized by recent reports questioning the safety of current upper tolerable intake limits, which may be lower than hitherto recommended (63). On the other hand, there is circumstantial evidence for low selenium status being associated with a number of health issues (10), including a higher risk of developing thyroid disease (12).

In conclusion, the present results do not provide the evidence to warrant routine use of selenium supplementation in the treatment of patients with AIT because a decrease in circulating thyroid autoantibodies per se should not be the foundation of clinical decision making. The emerging use of selenium in AIT (64), without adequate evidence of clinical relevance, should thus be discouraged (65). However, correction of selenium deficiency seems rational in order to avoid negative health effects due to shortage of this important element. Future well-powered randomized controlled trials with long-term follow-up, reporting baseline selenium status and disease stage, will help clarify efficacy.
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