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

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

Thyroid. 2016 Oct 5;:

Authors: Wichman J, Winther KH, Bonnema SJ, Hegedus L

Abstract
BACKGROUND: Selenium supplementation may decrease circulating thyroid autoantibodies in patients with chronic autoimmune thyroiditis (AIT), but the previous trials are heterogenous. Here, we expand and critically reappraise the knowledge on this topic.
METHODS: A literature search identified 3366 records. Controlled trials in adults (≥ 18 years) with AIT, comparing selenium with or without levothyroxine (LT4), versus placebo and/or LT4, were eligible. Assessed outcomes were serum thyroid peroxidase (TPO-Ab), thyroglobulin (Tg-Ab) autoantibody levels, and immunomodulatory effects. After screening and full-text assessment, sixteen controlled trials were included in the systematic review. Random effects meta-analyses in weighted mean difference (WMD) were performed for three, six, and twelve months of supplementation in two different populations: one receiving LT4-therapy and one newly diagnosed and untreated. Heterogeneity was estimated using I2 and quality of evidence was assessed per outcome, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines.
RESULTS: In LT4-treated populations, the selenium group had significantly lower TPO-Ab levels after three months (seven studies, WMD: -271, 95% CI: -366 to -175, p<0.0001, I2 = 45.4%), which was consistent at six months (three studies) and twelve months (one study). Tg-Ab decreased at twelve months but not at three or six months. In untreated populations, the selenium group showed a decrease of TPO-Ab levels after three months (three studies, WMD: -512, 95% CI: -626 to -398, p <0.0001, I2 = 0.0%), but not after six or twelve months. Tg-Ab decreased at three months, but neither at six nor at twelve months. Quality of evidence was generally assessed as low. Study participants receiving selenium had a significantly higher risk than controls of reporting adverse effects (p = 0.036).
CONCLUSIONS: Selenium supplementation reduced serum TPO-Ab levels after three, six and twelve months in an LT4-treated AIT population and after three months in an untreated AIT population. Whether these effects correlate with clinically relevant measures remains to be demonstrated.

PMID: 27702392 [PubMed - as supplied by publisher]

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