Evaluation of Anemia Frequency and Types in Patients with Subclinical and Clinical Hypothyroidism in the Endemic Goiter Region
Abstract
ABSTRACT
Objective: Hypothyroidism is a disease that occurs as a result of thyroid hormone deficiency or rarely, due to ineffectiveness at the tissue level. While the prevalence of clinical hypothyroidism is reported to be 2-5% worldwide, of subclinical hypothyroidism it is 4-8.5%, with the prevalence of subclinical hypothyroidism in women over 60 years of age being 14-20%. Hypothyroidism affects many organs and systems in the body, one of which is the hematopoietic system. Thyroid hormone deficiency plays a role in the development of microcytic, normocytic and macrocytic anemia. The frequency of anemia in patients with hypothyroidism varies between 20-60%. In this study, our aim was to determine the regional prevalence of subclinical and clinical hypothyroidism in adult patients in our region and to evaluate the frequency and types of anemia in patients with hypothyroidism.
Method and Material: This study was prospectively conducted between 01.12.2012 and 01.05.2013 at the outpatient clinic of Recep Tayyip Erdogan University Faculty of Medicine Endocrinology. Included in the study were 96 patients who had subclinical hypothyroidism, 30 patients who had clinical hypothyroidism, and 100 healthy controls. Normal fT4 and fT3, high TSH values were used for the diagnosis of subclinical hypothyroidism, and low fT4 and/or fT3, high TSH values were used for the diagnosis of clinical hypothyroidism. The diagnosis of anemia was based on subclinical hypothyroidism, clinical hypothyroidism, and control group Hb value <13g/dl in men and <12g/dl in women.
Results: In our study, we found the prevalence of subclinical hypothyroidism to be 3.6%, and of clinical hypothyroidism to be 1.1%. We found the rate of anemia to be 30.2% in the subclinical hypothyroid patient group, 40% in the clinical hypothyroid patient group, and 25% in the control group. A statistically significant difference was shown between the clinical hypothyroidism group and the control group based on the frequency of anemia (p=0.033). There was no statistical difference in the frequency of anemia between the subclinical hypothyroidism group and the control group (p=0.0586). A statistically significant difference was found between the patient group (subclinical + clinical hypothyroidism) and the control group in terms of the frequency of anemia (p=0.049). In the subgroup analysis of 66 anemic patients in the patient and control groups, in both groups the most common type of anemia was anemia of chronic disease, but there was no statistical difference between the groups in terms of anemia of chronic disease (p=0.223).
Conclusion: We found that there was an increase in the frequency of anemia in patients with hypothyroidism and that the most common anemia subtype in hypothyroidism was anemia of chronic disease (normocytic).
References
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Abstract
References
- REFERENCES 1.Wilson GR, Curry RW Jr (2005) Subclinical thyroid disease. Am Fam Physician 72 (8) : 15,17-1524.
- 2.Cinemre H, Bilir C, Gokosmanoglu F, Bahcebasi T (2009) Hematologic effects of levo- thyroxine in iron-deficient subclinical hypothyroid patients: a randomized, double-blind, controlled study. J Clin Endocrinol Metab 94(1): 151-156.
- 3.Christ-Crain M, Meier C, Huber P, Zulewski H, Staub JJ, Müller B (2003) Effect of resto- ration of euthyroidism on peripheral blood cells and erythropoietin in women with subclinical hypothyroidism. Hormones (Athens) 2:237-242.
- 4.Turkish Journal of Geriatrics ; Diagnosis and Treatment of Chronic Disease Anemia in the Elderly(2000) ,Review Geriatrics 3 (4): 163-168,
- 5.Antonijević N, Nesović M, Trbojević B, Milosević R (1999) Anemia in hypothyroidism. Med Pregl 52(3-5):136-140 (In Croatian).
- 6.Helfand M, Redfern CC. Clinical Guideline Part 2: Screening for thyroid disease: An update. Ann Intern Med. 1998;129:144–58.
- 7.Vanderpump MP, Tunbridge WM. The epidemiology of thyroid disease. In: Braverman LE, Utiger RD, editors. The Thyroid. 9th edn. Philadelphia: Lippencott-Raven;1996. pp. 474-82.
- 8.Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al.The spectrum of thyroid disease in a community:The Whickham survey. Clin Endocrinol (Oxf) 1977;7:481-93.
- 9.Benoist B, McLean E, Egli I, Cogswell M (2008) Worldwide prevalence of anemia 1993-2005; Global database on anemia. WHO Geneva: 1-2.
- 10.Mehmet E, Aybike K, Ganidagli S, Mustafa K. (2011) Characteristics of anemia in subclinical and overt hypothyroid patients; Endocr J. 2012;59(3): 213-20. Epub 2011 Dec 27.
- 11.Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4) and thyroid anti- bodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002; 87:489.
- 12.Mc Lachlan SM, Feldt-Rasmussen U, Young ET, et al. IgG subclass distribution of thyroid autoantibodies: a 'fingerprint' of an individual's response to thyroglobulin and thyroid microsomal antigen. Clin Endocrinol (Oxf) 1987; 26:335.
- 13.Chanchal Das, Pranab K. Sahana, Nilanjan Sengupta, Debasis Giri, Mukut Roy and Prasanta Mukhopadhyay (2012) Etiology of anemia in primary hypothyroid subjects in a tertiary care center in Eastern India. Indian J Endocrinol Metab. 2012 December; 16(Suppl 2): S361–S363.
- 14.Kosenli A, Erdogan M, Ganidagli S, Kulaksizoglu M, Solmaz S, Kosenli O, Unsal C, Canataroglu A. Anemia Frequency and Etiology İn Primary Hypothyroidism. Endocr Abstr 2009;20;140.
- 15.Mitra Kazemi-Jahromi, Ali Shahriari-Ahmadi, Seyed-Hosein Samedanifard, Soraya Doostmohamadian, Esmat Abdolahpoor, Seyed Farshad Allameh. The association between hypothyroidism and anemia: a Clinical study;International Journal of Hematology Oncology and Stem Cell Research (IJHOSCR),July,2010.
- 16.McLean E, de Benoist B, Allen LH (2008) Review of the magnitude of folate and vitamin B12 deficiencies worldwide. Food Nutr Bull 29(2 Suppl): S 38-51.
- 17.Lindenbaum J, Rosenberg IH, Wilson PW, Stabler SP, Allen RH (1994) Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr 60(1): 2-11.
- 18.Jabbar A, Yawar A, Wasim S, et al. (2008) Vitamin B 12 deficiency common in primary hypothyroidism. J Pak Med Assoc 58(5): 258-261.
- 19.Lee G,Dennis A,Unal S. Cecil Medicine(2011),23th edition pp:1179-1191,1231.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | July 29, 2022 |
| Submission Date | April 23, 2022 |
| Published in Issue | Year 2022 Volume: 2 Issue: 3 |
