University of Khartoum

Evaluation of Serum Selenium Levels in Hypo and Hyperthyroid Patients Presenting to Khartoum Teaching Hospital (September 2010 - February 2011)

Evaluation of Serum Selenium Levels in Hypo and Hyperthyroid Patients Presenting to Khartoum Teaching Hospital (September 2010 - February 2011)

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Title: Evaluation of Serum Selenium Levels in Hypo and Hyperthyroid Patients Presenting to Khartoum Teaching Hospital (September 2010 - February 2011)
Author: Abdel Malik, Huda
Abstract: Background: Selenium deficiency has been implicated in the pathogenesis of many thyroid diseases, namely hypothyroidism, autoimmune thyroid disease (ATD), endemic cretinism and thyroid cancer. Objectives: The study is conducted to evaluate serum selenium status in hypo and hyperthyroid patients and to compare the pre and post treatment levels. Methods: This is a prospective hospital based case control study conducted in Khartoum Teaching Hospital (KTH) (September 2010 to February 2011). The studied subjects were divided into 3 groups. The 1st two groups were adult male and female patients diagnosed clinically and biochemically as having hypo or hyperthyroidism. The 3rd group was age and sex matched normal controls. Data about the disease were collected from patients through a questionnaire. Sera were tested for selenium by atomic absorption spectrophotometer AA6800 (Shimadzu), and for thyroid hormones (T3 and T4) and TSH using the principle of chemiluminescence by Elecsys 2010 (Roche). VI Results: The studied subjects were 60 (40 cases and 20 controls). The mean serum selenium level in the hypothyroid group of patients was 63.82 ppb (+26.2 SD), significantly low compared to controls (P value<0.05). It was found that the mean serum selenium level in the newly diagnosed hypothyroid cases was 30.54ppb (+24.68SD), significantly lower compared to those on thyroxine replacement (74.71ppb +17.57SD)( P value>0.05). The mean serum TSH of the hypothyroid patients (20.06μu/ml) and of the hyperthyroid patients (2.36μu/ml) was inversely related to serum selenium. The relation was statistically significant (P value <0.05). The mean serum T4 of the hypothyroid group (5.9μg/dl) was inversely related to serum selenium. The relation was statistically significant (P value<0.05). Conclusion: This is the first study conducted in Sudan to explore selenium status in hypo and hyperthyroidism. Significantly low serum selenium levels in hypothyroid patients confirm the possible implication of selenium deficiency in the causation of hypothyroidism as reported in the literature. Controlling hypothyroidism with thyroxine replacement may have a possible role in improving selenium deficiency; still this finding needs further exploration through longitudinal studies. VII Inverse relationships were found between: (serum selenium and serum TSH) and (serum selenium and serum T4) confirming the role of selenium in thyroid hormone metabolism. Further studies that determine the prevalence of autoimmune thyroid disease in Sudan and to specifically evaluate selenium status in autoimmune thyroid disease are more valuable and thus needed. Protocols for introducing selenomethionine supplements to patients with autoimmune thyroid disease and monitoring the response by following the level of thyroid antibodies are needed.
Description: 70 page
URI: http://khartoumspace.uofk.edu/handle/123456789/8970
Date: 2015-04-14


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