Thyroid Status in Patients with Low Serum Ferritin Level.
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Date
2012
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Abstract
Iron deficiency is the most important but preventable nutritional problem in Bangladesh.
Thyroid peroxidase, an iron containing enzyme, is essential for initial two steps of thyroid
hormone synthesis which is a component of tissue iron. Tissue iron diminishes early in the
course of iron deficiency. So thyroid hormone level may be altered in iron deficient patients.
This case-control study was carried out in the Department of Biochemistry, Bangabandhu
Sheikh Mujib Medical University (BSMMU) from July 2006 to June 2007. This study was
done to find out the changes of thyroid hormonal activity in iron deficiency.
In this study 72 subjects were selected from the out-patient department of the hospital.
Patients with low serum ferritin level <12 mgm/L were selected as cases (n=36) and healthy
persons with normal serum ferritin level were taken as controls. Serum ferritin, thyroid
stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were
measured in all study subjects. Values were expressed as mean ± SD. Unpaired 't' test and
Pearson's correlation test were performed to see the level of significance and p value <0.05
was taken as significant. Serum ferritin level in cases and controls were 6.78±4.05 mgm/L
and 79.04±28.08 mgm/L respectively which showed significant difference (P<0.0001).
Serum TSH concentration in cases and controls were 3.32±1.54 mIU/L and 1.89±0.86
mIU/L respectively. Serum FT4 concentration in cases and controls were 11.66±1.77
pmol/L and 13/10±1.36 pmol/L respectively and that of FT3 were 3.00±0.68 and
3.31±0.61 pmol/L respectively. All showed significant difference between groups.
Serum ferritin and Serum TSH showed significant negative correlation in controls whereas in
cases they showed negative correlation which was not statistically significant.
Both serum FT4 and FT3 revealed positive correlation with serum ferritin but that too was not
significant statistically.
Though the study failed to show any significant positive correlation between serum ferritin
and thyroid hormones, lower level of thyroid status in iron deficient patients suggest that it
could be a reflection of disturbed activities of iron dependent enzymes such as thyroid
peroxidase that impairs thyroid hormone synthesis. However, a large scale study is
recommeded to establish the fact.
This study showed that there was significant difference in thyroid hormonal status between
iron deficient patients and normal healthy persons. Therefore it can be concluded that iron
deficiency may impair normal thyroid hormone status.
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Keywords
Thyroid peroxidase, Ferritin, TSH, FT4, FT3
Citation
Akhter S, Nahar Z U, Parvin S, Alam A, Sharmin S, Arslan M I. Thyroid Status in Patients with Low Serum Ferritin Level. Bangladesh Journal of Medical Biochemistry. 2012; 5(1): 5-11.