The content of selenium, antibodies to TSH receptor and their correlation in patients with Graves’ disease complicated by autoimmune ophthalmopathy

Abstract

Background. Despite the large number of studies devoted to the role of selenium in the pathogenesis of autoimmune thyroid diseases, this issue remains relevant today. So, according to a survey of endocrinologists in Ukraine, conducted in 2019, 33 % of doctors would like to have more information about this problem. The influence of selenium deficiency on the course of autoimmune ophthalmopathy (AO) in Graves’ disease (GD) has also attracted the attention of researchers and medical practitioners in the last decade. There are reports of a negative correlative relationship between selenium levels and the concentration of antibodies to the pituitary TSH receptor (TSHR-Ab) and more rapid recovery of euthyroidism when combining antithyroid therapy with selenium preparations. At the same time, other studies do not confirm this connection and indicate that there is no decrease in the level of antithyroid antibodies during treatment with selenium-containing drugs. Such contradictions became the basis for our research. The purpose of the study was to investigate the content of selenium, TSH, and TSHR-Ab, as well as the correlation links between them in patients with Graves’ disease complicated by autoimmune ophthalmopathy. Materials and methods. The study included 124 patients with Graves’ disease (110 women and 14 men), the average age was 48.62 ± 10.26 years, and the average duration of the disease was 3.1 ± 2.2 years. All patients were divided into 2 groups: the first group — 47 patients with GD without AO; the second group — 77 patients with GD and AO. The control group consisted of 30 healthy women aged 28 to 56 years (mean age 45.90 ± 3.42 years). The blood content of selenium, TSH, TSHR-Ab was studied in all patients. Results. The selenium level in the blood of 124 patients with GD was 48.00 ± 3.64 μg/l versus 76.09 ± 4.81 μg/l in the control group (P 0.05). When comparing selenium levels between the groups of patients with and without AO, as well as with the results of the control group, the following results were obtained: selenium levels were reduced in patients with GD and AO to 42.92 ± 5.58 μg/l and up to 51.11 ± 4.77 μg/l in the group without AO (P > 0.05). Both in the group of patients with AO and in the group without AO, a significant decrease in selenium level was observed in comparison with the indicator of the control group (P 0.05), and there was established no correlation between the blood levels of selenium and the level of TSH and TSHR-Ab. Normal selenium levels were found in 23.40 % of patients without AO and in 29.87 % of AO patients. Considering these results, it is inexpedient to prescribe selenium-containing drugs without individual monitoring of selenium levels in the blood.

Keywords

• graves’ disease
• autoimmune ophthalmopathy
• selenium