Evaluation of serum levels in T3, T4 and TSH in beta-thalassemic patients referred to the Abuzar hospital in Ahwaz
Keywords:
Thyroid, Beta-thalassemia, AhwazAbstract
Introduction: Regarding the functioning of the endocrine system, and especially in the thyroid of patients with thalassemia, multiple studies in different parts of the world have reported conflicting results. The aim of this study was to assess the levels of thyroid hormones and TSH in beta-thalassemic patients in the city of Ahwaz.
Methods: In this matched case-control study, 105 patients in the case group and 105 subjects as controls were randomly selected from clients referred to the Abuzar hospital in 2015-2016. Serum levels of T3, T4, and TSH hormones were measured using ELISA. Data was processed with the SPSS15 software and tested by using independent t-tests and logistic regression.
Results: The study results showed that the serum level of T3 hormone did not significantly differ between the two groups (p> 0.05). Whereas the serum level of T4 was lower in the case group, compared to the controls, which was statistically significant (p <0.05). The serum level of thyroid stimulating hormone (TSH) in the case group was higher than the control group, and this difference was statistically significant (p <0.05). Logistic regression analysis showed significant differences in serum levels of T4 (OR: 0.58) and TSH (OR: 1.57) between the case and control groups (p<0.05).
Conclusion: Hypothyroidism is clear in patients with beta thalassemia. With regard to the possible effect of iron on the disorder, a blood transfusion schedule should be performed at intervals, and the desferal injection program should be done regularly to prevent hemochromatosis in patients with thalassemia major due to the effect of accumulation of iron on thyroid function and detection of hypothyroidism. This course of action will prevent incidence of this complication in patients with thalassemia major.
References
Zandian Kh, Eshagh Hossani K, Riahi K. A study of prevalence of hypothyroidism in β- thalassemia major
in Ahvaz Shafa hospital. Scientific Medical Journal of Ahwaz University of Medical Sciences. 2009; 8(62):
-4.
Company F, Rezaei N, Mozafari R. Cardiovascular complications of thalassemia major and thalassemia
intermedia. SJKU. 2008; 13(2): 1-9.
Chekandi T. Evaluation of thyroid and parathyroid function in patients with thalassemia major. Journal of
Birjand University of Medical Sciences. 2004; 11(2): 46-50
Company F, Rezaei N, Pourmohmmad B, Gharibi F. Assessment of thyroid dysfunction in patients with ßthalassemia major. SJKU. 2009; 13(4): 37-44.
Heydarian S, Jafari R, Karami H. Refractive errors and ocular biometry components in thalassemia major
patients. Int Ophthalmol. 2016: 36(2): 267-71. doi: 10.1007/s10792-015-0161-8. PMID: 26646775.
Hashemi AS, Ordooei M, Golestan M, Akhavan Ghalibaf M, Mahmoudabadi F, Arefinia M, et al.
Hypothyroidism and serum ferritin level in patients with major ß thalassemia. Iranian Journal of Pediatric
Hematology Oncology. 2011; 1(2): 53-6.
Eshragi P, Tamaddoni A, Zarifi K, Mohammadhasani A, Aminzadeh M. Thyroid function in major
thalassemia patients: Is it related to height and chelation therapy? Caspian J Intern Med. 2011; 2(1): 189- 93. PMID: 24024013, PMCID: PMC3766932.
Zandian Kh , Kykhai B , Pedram M , Kykhai B , Pedram M , Zandian Kh. Prenatal Diagnosis and
Frequency Determination of α, β-Thelassemia, S, D and C Hemoglobinopathies Globin Mutations among
Ahwazian Volunteers. Scientific Medical Journal of Ahwaz University of Medical Sciences. 2006; 5(50):
-3.
Tabatabaie SM. Principles of prevention and treatment of diseases. Nashre Seda Publisher First edition.
Shamshirsaz AA, Bekheirnia MR, Kamgar M, Pourzahedgilani N, Bouzari N, Habibzadeh M, et al.
Endocrinologic complications in major beta thalassemia: a multicenter study in Tehran. BMC Endocrine
disord. 2003; 3: 1472-88.
Karamifar H, Shahriari M, Sadjadian N. Prevalence of endocrine complications in beta-thalassaemia major
in the Islamic Republic of Iran. East Mediterr Health J. 2003; 9(1-2): 55-60. PMID: 15562733.
Najafipour F, Aliasgarzadeh A, Aghamohamadzadeh N, Bahrami A, Mobasri M, Niafar M, et al. A cross- sectional study of metabolic and endocrine complications in beta-thalassemia major. Ann Saudi Med. 2008;
(5): 361-6. doi: 10.4103/0256-4947.51683. PMID: 18779644.
De Sanctis V, De Sanctis E, Ricchieri P, Gubellini E, Gilli G, Gamberini MR. Mild subclinical
hypothyroidism in thalassaemia major: prevalence, multigated radionuclide test, clinical and laboratory
long-term follow-up study. Pediatr Endocrinol Rev. 2008; 6(1): 174-80. PMID: 19337174.
Soliman AT, Al Yafei F, Al-Naimi L, Almarri N, Sabt A, Yassin M, et al. Longitudinal study on thyroid
function in patients with thalassemia major: high incidence of central hypothyroidism by 18 years. Indian J
Endocrinol Metab. 2013; 17(6): 1090-5. doi: 10.4103/2230-8210.122635. PMID: 24381890, PMCID:
PMC3872691.
Mariotti S, Loviselli A, Murenu S, Sau F, Valentino L, Mandas A, et al. High prevalence of thyroid
dysfunction in adult patients with β-thalassemia major submitted to amiodarone treatment. J Endocrinol
Invest. 1999; 22(1): 55-63. doi: 10.1007/BF03345479. PMID: 10090138.
Rovet J, Alvarez M. Thyroid hormone and attention in congenital hypothyroidism. J Pediatr Endocrinol
Metab. 1996; 9(1): 63-6. PMID: 8887135.
Jain M, Sinha RS, Chellani H, Anand NK. Assessment of thyroid functions and its role in body growth in
thalassemia major. Indian pediatr. 1995; 32(2): 213-9. PMID: 8635784.
Marshall WA, Tanner JM. Variation in The Pattern of Pubertal Changes in boys. Arch Dis Child. 1970;
(239): 13-23. doi: 10.1136/adc.45.239.13. PMID: 5440182, PMCID: PMC2020414.
World Health Organization. Indicators for assessing Iodine deficiency disorders and their control
programmes. Report of a joint WHO/ UNICEF/ICCIDD Consulation (unpublished document WHO/NUT
: 1; available on request from the nutrion unit, WHO, Geneva, 1993)
Senanayake MP, Suraweera SA, Hubert HD. Thyroid function in thalassaemia major. The Ceylon medical
journal. 1999; 44(4): 166-8. PMID: 10895267.
Gulati R, Bhatia V, Agarwal SS. Early onset of endocrine abnormalities in beta-thalassemia major in a
developing country. J Pediatr Endocrinol Metab. 2000; 13(6): 651-6. doi: 10.1515/JPEM.2000.13.6.651.
PMID: 10905390.
Jensen CE, Tuck SM, Old J, Morris RW, Yardumian A, De Sanctis V, et al. Incidence of endocrine
complications and clinical disease severity related to genotype analysis and iron overload in patients with
β‐thalassaemia. Eur J Haematol. 1997; 59(2): 76-81. doi: 10.1111/j.1600-0609.1997.tb00729.x. PMID:
Magro S, Puzzonia P, Consarino C, Galati MC, Morgione S, Porcelli D, et al. Hypothyroidism in patients
with thalassemia syndromes. Acta haematologica. 1990; 84(2): 72-6. doi: 10.1159/000205032. PMID:
Agarwal MB, Shah S, Vishwanathan C, Rajadhyaksha G, Bhave AA, Dube SR, et al. Thyroid dysfunction
in multi-transfused iron loaded thalassemia patients. Indian pediatrics. 1992; 29(8): 997-102. PMID:
Multicenter study on prevalence of endocrine complications in thalassemia major. Italian working Group
on Endocrine Complications in Non-endocrine Diseases. Clin Endocrinol. 1995; 42(6): 581-6. doi:
1111/j.1365-2265.1995.tb02683.x. PMID: 7634497.
Berkovitch M, Bistritzer T, Milone SD, Perlman K, Kucharczyk W, Olivieri NF. Iron deposition in the
anterior pituitary in homozygous beta-thalassemia: MRI evaluation and correlation with gonadal function. J
Pediatr Endocrinol Metab. 2000; 13(2): 179-84. doi: 10.1515/JPEM.2000.13.2.179. PMID: 10711663.
Pignatti C, Rugollotto S, De Stefano P, Zhao H, Forni G, Piga A, et al. Survival and complication in
patients with beta thalassemia major. Heamatologica. 2004; 89: 1187-93.
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.