Serum Selenium Levels in Patients with Graves Disease: Associations with Clinical Activity and Severity in a Retrospective Case-control Study

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Purpose: To compare serum selenium levels in Graves patients and non-Graves control participants and to evaluate associationsbetween serum selenium levels and clinical features of Graves orbitopathy (GO). Methods: We conducted a single-center, retrospective case-control study among 33 patients with Graves disease withoutGO (GD), 31 patients with diagnosed GO, and 27 unaffected healthy participants enrolled between 2013 and 2020 at SeveranceHospital. We compared serum selenium concentrations between the GD, GO, and healthy control groups, and analyzedassociations between serum selenium and GO patients’ clinical activity scores, severity (assessed through modified NOSPECSscores), and other clinical features using multivariate linear regression analysis. Results: Mean serum selenium levels were 109.30 ± 16.39, 111.39 ± 14.04, and 126.09 ± 21.09 ng/mL in GO patients, GDpatients, and healthy control participants, respectively. Mean serum selenium levels in Graves patients with and without orbitopathywere significantly lower than those in the healthy control group (p < 0.05), and mean selenium levels were slightlylower in GO than those in GD patients (p = 0.594). Serum selenium levels were significantly lower in GO patients with eyelidretraction than in patients without retraction (p = 0.038). However, serum selenium levels were not associated with clinicalactivity scores and modified NOSPECS scores (p = 0.241 and 0.801, respectively). Conclusions: Serum selenium levels were significantly lower in Graves patients with or without GO, compared to non-Gravescontrol participants. Selenium levels were not associated with clinical activity scores or NOSPECS scores, though we observedan association with eyelid retraction.