SELENIUM SUPPLY AND THYROID CONDITION IN GRAVES’ DISEASE IN THE REGION OF IODINE DEFICIENCY
Keywords:Graves’ disease, blood selenium, iodine excretion with urine, risk factors
The aim of the study was to investigate the level of selenium in the serum, the median urinary iodine excretion, relationship between selenium and ioduria levels in patients with Graves’ disease. 141 residents of Kyiv and Kyiv region were examined, 37 of them without thyroid pathology (control group) aged 39.7 ± 2.7 years, and 104 with Graves’ disease (experimental group), aged 43.25 ± 1.18 years. The level of selenium in the serum of patients was significantly reduced compared to control. Its median was 29.35 and 1–3 quartiles [6.85–58.77] мg/l, respectively. With age, selenium deficiency worsened. In the study of thyroid status, the group of patients with Graves’ disease differed from the control of elevated thyroid hormone levels, decreased TSH levels, increased thyroid volume. There was a significant increase in the level of antibodies to TSH receptors more than 100 times. Dependence of these indicators on sex and age of patients was not observed. The median urinary iodine excretion in the experimental group was significantly different (p < 0.05), its value in the control group was 78.9 мg/l, which indicated the presence of mild iodine deficiency, in the experimental group it was 177.05 мg/l. After 3 and after 6 months after methimazole treatment, the level of selenium in the blood increased, but remained reduced compared to control. There was a complete normalization of thyroid hormones levels and TSH. In the group of patients, a relationship between selenium and ioduria levels was registered (p < 0.05), there was a correlation between the titer of antibodies to the TSH receptor, and as in the control, a correlation between thyroid function (p < 0.05). Calculation of the risks of changes in antibody titers depending on the level of selenium and other studied factors showed that increasing the level of selenium in the blood helps to reduce the titer of antibodies to TSH receptors. The positive effect of reducing antibodies occurs with the normalization of inhibited low levels of TSH. High levels of fT4, fT3, increased thyroid volume and high levels of iodine increase the risk of antibodies to the thyroid-stimulating hormone receptor.
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