ECE2017 Guided Posters Thyroid 1 (9 abstracts)
Cognitive functions in primary hypothyroidism on selenium supplementation
Marina Nikolic-Djurovic 1 , Alberto Pereira 2 , Johannes Smit 3 , Olga Vasovic 4 , Zvezdana Jemuovic 1 , Svetozar Damjanovic 1 , Milika Asanin 5 , Dragan Pavlovic 6 , Dragana Jankovic 1 , Sandra Pekic 1 , Dragana Miljic 1 , Marko Stojanovic 1 & Milan Petakov 1
1Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia; 2Department of Endocrinology and Metabolic Diseases Leiden University Medical Center, Leiden, The Netherlands; 3Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands; 4Institute for Gerontology and Palliative Care, Belgrade, Serbia; 5Clinic for Cardiology, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia; 6Faculty of Philosophy, University of Belgrade, Belgrade, Serbia.
Introduction: Selenium (Se) is a trace element that plays key roles in thyroid pathology. In patients with Hashimoto thyroiditis (HT), Se supplementation might reduce antibody levels and may provide additional beneficial effects, such as on cognition.
Aim: To evaluate cognitive function (cognitive decline) in patients on long-term levothyroxine replacement for primary hypothyroidism with and without selenium supplementation.
Design: Cross-sectional, case-control study.
Patients and methods: Sixty nine patients with HT (mean age 43.52±14.33 yrs) on long-term levothyroxine replacement and 57 euthyroid healthy controls, matched for age, sex, and educational level, were included. HT patients were divided into 2 groups, 25pts with (Se+) and 44pts without selenium supplementation(Se-). Neuropsychological evaluation assessed general cognitive function(cognitive screening: MMSE, Visual- and Digit Span), attention span in visual and verbal modality (Numbers from WAIS and Visual span from WMS-R), conceptual tracking (TMT A and B), verbal divergent thinking (Phonemic fluency test, Listing of animals from BDEA, TMT B, Verbal fluency test).
Results: Selenium levels were within the normal range in all groups, but significantly higher in HT(Se+)vs controls (94.88±20.63 vs 86.95±14.95 mcg/l, P<0.05). TSH concentrations were higher in patients (both HT(Se+) and HT(Se-)) when compared to controls: (3.01±1.66 and 3.01±1.90 vs 1.77±0.88 mU/l, P<0.000), but FT4 concentrations were not different: (12.81±4.01 vs 12.46±2.64 vs 12.93±2.88 ng/l, P>0.05). TPOab concentrations were different, both between HT(Se+) and HT(Se-), as well as between patients and controls (1399.25±1968.30 vs 4290.96±3177.13 vs 20.48±30.73 U/ml, P<0.001). Global cognitive function (MMSE) was not different between groups (29.16±1.31 vs 29.16±1.61 vs 29.54±0.93, P>0.05), but conceptual tracking and verbal divergent thinking was different between all groups (TMTA:36.40±12.85 vs 40.89±21.89 vs 29.81±11.57, P<0.001, TMTB:89.00±27.88 vs 103.93±48.81 vs 73.02±24.10, P<0.001, KF:21.88±5.61 vs 19.07±5.65 vs 21.44±5.11, P<0.05, FF:11.28±3.37 vs 9.22±3.69 vs 11.05±3.44, P<0.05).
Conclusion: Patients treated for primary hypothyroidism according to routine clinical care guidelines show persistent impairments in cognitive functioning which were, in certain domains, improved with selenium supplementation. Future studies are still needed in order to provide reliable evidence to support selenium supplementation in a clinical practice.
Volume 49
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