Evaluation of Anemia Frequency and Types in Patients with Subclinical and Clinical Hypothyroidism in the Endemic Goiter Region

Year 2022, , 73 - 79, 29.07.2022

Kadir İlkkılıç , Teslime Ayaz , Ekrem Algün

https://doi.org/10.56016/dahudermj.1108040

Cited By: 1

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).

Keywords

Anemia, Subclinical hypothyroidism, Clinical hypothyroidism

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