G Mantovani1, A M Isidori2, C Moretti3, C Di Dato2, E Greco4, P Ciolli5, M Bonomi6, L Petrone7, A Fumarola2, G Campagna2, G Vannucchi1, S Di Sante2, C Pozza2, A Faggiano8, A Lenzi2, E Giannetta9. 1. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Endocrine Unit - Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 2. Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy. 3. Department of Internal Medicine, "Tor Vergata" University of Rome, Rome, Italy. 4. Reproductive Medicine and Biology Center, "European Hospital" of Rome, Rome, Italy. 5. Department of Gynecological Sciences - Obstetric and Urological Sciences, "Sapienza" University of Rome, Rome, Italy. 6. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 7. Department of Endocrinology, Careggi University Hospital, Florence, Italy. 8. Thyroid and Parathyroid Surgery Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy. 9. Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy. elisa.giannetta@uniroma1.it.
Abstract
PURPOSE: Selenium is frequently in nutraceuticals for pregnancy, given its role on fertility and thyroid metabolism. However, most evidence rise from non-controlled studies. We aimed to evaluate the protective effect of selenium against thyroid autoimmunity during and after pregnancy. METHODS: A multicenter, randomized, double-blind, placebo-controlled trial was performed and promoted by the Young Italian Endocrinologists Group (EnGioI)-Italian Society of Endocrinology. Forty-five women with thyroiditis in pregnancy were enrolled and randomly assigned to L-selenomethionine (L-Se-Met) 83 mcg/day or placebo (PLB) and evaluated at 10 ± 2 (T1), 36 ± 2 weeks of gestation (T2) and 6 months after delivery (postpartum, PP). RESULTS: We measured a significant reduction of autoantibodies after pregnancy in L-Se-Met group [at PP: TgAb 19.86 (11.59-52.60), p < 0.01; TPOAb 255.00 (79.00-292.00), p < 0.01], and an antibodies titer's rebound in PLB group (TgAb 151.03 ± 182.9, p < 0.01; TPOAb 441.28 ± 512.18, p < 0.01). A significant increase in selenemia was measured in L-Se-Met group at T2 (91.33 ± 25.49; p < 0.01) and PP (93.55 ± 23.53; p = 0.02). Two miscarriage occurred in PLB. No differences were found in thyroid volume, echogenicity, quality of life, maternal/fetal complications. CONCLUSIONS: SERENA study demonstrated a beneficial effect of L-Se-Met supplementation on autoantibody titer during pregnancy and on postpartum thyroiditis recurrence.
RCT Entities:
PURPOSE:Selenium is frequently in nutraceuticals for pregnancy, given its role on fertility and thyroid metabolism. However, most evidence rise from non-controlled studies. We aimed to evaluate the protective effect of selenium against thyroid autoimmunity during and after pregnancy. METHODS: A multicenter, randomized, double-blind, placebo-controlled trial was performed and promoted by the Young Italian Endocrinologists Group (EnGioI)-Italian Society of Endocrinology. Forty-five women with thyroiditis in pregnancy were enrolled and randomly assigned to L-selenomethionine (L-Se-Met) 83 mcg/day or placebo (PLB) and evaluated at 10 ± 2 (T1), 36 ± 2 weeks of gestation (T2) and 6 months after delivery (postpartum, PP). RESULTS: We measured a significant reduction of autoantibodies after pregnancy in L-Se-Met group [at PP: TgAb 19.86 (11.59-52.60), p < 0.01; TPOAb 255.00 (79.00-292.00), p < 0.01], and an antibodies titer's rebound in PLB group (TgAb 151.03 ± 182.9, p < 0.01; TPOAb 441.28 ± 512.18, p < 0.01). A significant increase in selenemia was measured in L-Se-Met group at T2 (91.33 ± 25.49; p < 0.01) and PP (93.55 ± 23.53; p = 0.02). Two miscarriage occurred in PLB. No differences were found in thyroid volume, echogenicity, quality of life, maternal/fetal complications. CONCLUSIONS: SERENA study demonstrated a beneficial effect of L-Se-Met supplementation on autoantibody titer during pregnancy and on postpartum thyroiditis recurrence.
Authors: Margaret P Rayman; Elizabeth Searle; Lynne Kelly; Sigurd Johnsen; Katherine Bodman-Smith; Sarah C Bath; Jinyuan Mao; Christopher W G Redman Journal: Br J Nutr Date: 2014-04-08 Impact factor: 3.718