Effects of Antioxidant Supplementation on Graves’ Disease: A Meta-Analysis

IF 2.1 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of Clinical Pharmacy and Therapeutics Pub Date : 2023-06-03 DOI:10.1155/2023/5587361

Qi Song, Xiaoxue Ji, Ying Xie

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引用次数: 0

Abstract

Objective. The main objective of this study is to evaluate the clinical efficacy of antithyroid drugs combined with antioxidant supplementation represented by selenium in the treatment of Graves’ disease. Methods. Relevant randomized controlled trials (RCTs) were searched in PubMed, MEDLINE, Embase, the Cochrane Library databases, and the Chinese Medical Association. The search was conducted from the time of library construction to December 20, 2022. Three writers gradually examined, evaluated, and graded the literature and then used RevMan 5.3 to analyze the data and develop conclusions. Results. A total of seven papers were screened according to the search requirements. The results showed that free triiodothyronine (FT3) (WMD = −2.29, 95% CI: −3.55 to −1.02, P = 0.0004 ), free thyroxine (FT4) (WMD = −0.62, 95% CI: −1.05 to −0.18, P = 0.0005 ), thyrotropin receptor antibody (TRAb) (WMD = −1.31, 95% CI: −1.63 to −0.99, P < 0.00001 ), and thyroid peroxidase antibody (TPOAb) (WMD = −9.8, 95% CI: −16.57 to −3.03, P = 0.005 ) in the observation group (selenium supplementation combined with antithyroid drugs) were significantly lower than those in the control group (antithyroid drugs combined with or without placebo). In addition, selenium supplementation can increase serum selenium (WMD = 33.29, 95% CI: 30.7 to 35.87, P < 0.00001 ), selenoprotein levels (WMD = 1.3, 95% CI: 0.8 to 1.8, P < 0.00001 ), and blood lipid levels (WMD = 32.3, 95% CI: 17.87 to 46.74, P < 0.0001 ). It cannot be excluded that the process of selenium supplementation treatment will affect the patient’s lipid levels. Conclusion. Selenium is a trace mineral that is crucial for human health. In patients with Graves’ disease, the use of antithyroid medications along with selenium supplementation can considerably enhance thyroid function. It has the potential to drastically lower TPOAb and TRAb levels as well as FT3 and FT4 levels, which is crucial for the treatment, recovery, and prognosis of hyperthyroid patients. Further research is required to determine whether the impact of antioxidant supplementation on blood lipids will restrict the use of this medication.

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抗氧化剂补充对Graves病的影响:一项荟萃分析

目标。本研究的主要目的是评价抗甲状腺药物联合以硒为代表的抗氧化剂补充剂治疗Graves病的临床疗效。方法。在PubMed、MEDLINE、Embase、Cochrane图书馆数据库和中华医学会检索相关随机对照试验(RCTs)。搜索从图书馆建设时间开始，一直进行到2022年12月20日。三位作者逐步对文献进行检查、评价和评分，然后使用RevMan 5.3对数据进行分析并得出结论。结果。根据检索要求，共筛选了7篇论文。结果显示，游离三碘甲状腺原氨酸(FT3) (WMD =−2.29,95% CI:−3.55 ~−1.02,P = 0.0004)、游离甲状腺素(FT4) (WMD =−0.62,95% CI:−1.05 ~−0.18,P = 0.0005)、促甲状腺素受体抗体(TRAb) (WMD =−1.31,95% CI:−1.63 ~−0.99,P < 0.00001)、甲状腺过氧化物酶抗体(TPOAb) (WMD =−9.8,95% CI:−16.57 ~−3.03,P = 0.005)，观察组(硒补充联合抗甲状腺药物)显著低于对照组(抗甲状腺药物联合或不联合安慰剂)。此外，添加硒可提高血清硒(WMD = 33.29, 95% CI: 30.7 ~ 35.87, P < 0.00001)、硒蛋白水平(WMD = 1.3, 95% CI: 0.8 ~ 1.8, P < 0.00001)和血脂水平(WMD = 32.3, 95% CI: 17.87 ~ 46.74, P < 0.0001)。不能排除补硒治疗过程中会影响患者血脂水平。结论。硒是一种对人体健康至关重要的微量矿物质。在Graves病患者中，使用抗甲状腺药物和补充硒可以显著增强甲状腺功能。它有可能大幅降低TPOAb和TRAb水平以及FT3和FT4水平，这对甲状腺功能亢进患者的治疗、恢复和预后至关重要。需要进一步的研究来确定补充抗氧化剂对血脂的影响是否会限制这种药物的使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Pharmacy and Therapeutics 医学-药学

CiteScore

4.10

自引率

5.00%

发文量

226

审稿时长

6 months

期刊介绍： The Journal of Clinical Pharmacy and Therapeutics provides a forum for clinicians, pharmacists and pharmacologists to explore and report on issues of common interest. Reports and commentaries on current issues in medical and pharmaceutical practice are encouraged. Papers on evidence-based clinical practice and multidisciplinary collaborative work are particularly welcome. Regular sections in the journal include: editorials, commentaries, reviews (including systematic overviews and meta-analyses), original research and reports, and book reviews. Its scope embraces all aspects of clinical drug development and therapeutics, including: Rational therapeutics Evidence-based practice Safety, cost-effectiveness and clinical efficacy of drugs Drug interactions Clinical impact of drug formulations Pharmacogenetics Personalised, stratified and translational medicine Clinical pharmacokinetics.