Selenium supplementation in the management of thyroid autoimmunity during pregnancy: results of the "SERENA study", a randomized, double-blind, placebo-controlled trial.

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.

• Authors: G Mantovani, A M Isidori, C Moretti, C Di Dato, E Greco, P Ciolli, M Bonomi, L Petrone, A Fumarola, G Campagna, G Vannucchi, S Di Sante, C Pozza, A Faggiano, A Lenzi, E Giannetta
• Journal: Endocrine (Endocrine) Vol. 66 Issue 3 Pg. 542-550 (12 2019) ISSN: 1559-0100 [Electronic] United States
• PMID: 31129812 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Autoantibodies
• Trace Elements
• Selenium

Topics

• Adult
• Autoantibodies (blood)
• Autoimmune Diseases (prevention & control)
• Dietary Supplements
• Double-Blind Method
• Female
• Humans
• Pregnancy
• Pregnancy Complications (prevention & control)
• Selenium (blood, therapeutic use)
• Thyroid Diseases (prevention & control)
• Trace Elements (therapeutic use)