Selenium supplementation in the management of thyroid autoimmunity during pregnancy

results of the “SERENA study”, a randomized, double-blind, placebo-controlled trial

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalEndocrine
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Selenium
Autoimmunity
Thyroid Gland
Placebos
Pregnancy
Postpartum Period
Autoantibodies
Postpartum Thyroiditis
Selenomethionine
Thyroiditis
Endocrinology
Spontaneous Abortion
Dietary Supplements
Fertility
Mothers
Quality of Life
Recurrence
Antibodies

Keywords

  • Autoimmune thyroiditis
  • Fetal risk
  • L-selenomethionine
  • Maternal complications

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Selenium supplementation in the management of thyroid autoimmunity during pregnancy : results of the “SERENA study”, a randomized, double-blind, placebo-controlled trial. / Mantovani, G.; Isidori, A. M.; Moretti, C.; Di Dato, C.; Greco, E.; Ciolli, P.; Bonomi, M.; Petrone, L.; Fumarola, A.; Campagna, G.; Vannucchi, G.; Di Sante, S.; Pozza, C.; Faggiano, A.; Lenzi, A.; Giannetta, E.

In: Endocrine, 01.01.2019.

Research output: Contribution to journalArticle

Mantovani, G. ; Isidori, A. M. ; Moretti, C. ; Di Dato, C. ; Greco, E. ; Ciolli, P. ; Bonomi, M. ; Petrone, L. ; Fumarola, A. ; Campagna, G. ; Vannucchi, G. ; Di Sante, S. ; Pozza, C. ; Faggiano, A. ; Lenzi, A. ; Giannetta, E. / Selenium supplementation in the management of thyroid autoimmunity during pregnancy : results of the “SERENA study”, a randomized, double-blind, placebo-controlled trial. In: Endocrine. 2019.
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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.",
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author = "G. Mantovani and Isidori, {A. M.} and C. Moretti and {Di Dato}, C. and E. Greco and P. Ciolli and M. Bonomi and L. Petrone and A. Fumarola and G. Campagna and G. Vannucchi and {Di Sante}, S. and C. Pozza and A. Faggiano and A. Lenzi and E. Giannetta",
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AU - Mantovani, G.

AU - Isidori, A. M.

AU - Moretti, C.

AU - Di Dato, C.

AU - Greco, E.

AU - Ciolli, P.

AU - Bonomi, M.

AU - Petrone, L.

AU - Fumarola, A.

AU - Campagna, G.

AU - Vannucchi, G.

AU - Di Sante, S.

AU - Pozza, C.

AU - Faggiano, A.

AU - Lenzi, A.

AU - Giannetta, E.

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N2 - 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.

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KW - Fetal risk

KW - L-selenomethionine

KW - Maternal complications

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