Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Cardiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Hemoglobin. 2021 Sep;45(5):275-286. doi: 10.1080/03630269.2021.2003382. Epub 2021 Nov 21.
As a cause of chronic blood transfusions, iron overload is an important issue in β-thalassemia (β-thal) patients that leads to multiple organ dysfunctions. This is an updated meta-analysis conducted to summarize the existing evidence of the prevalence of hypothyroidism (HT) among patients with transfusion-dependent (TDT) and non transfusion-dependent β-thal (NTDT) and for the first time we meta-analyzed the relationship between ferritin level and HT. This systematic review and meta-analysis were done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We searched databases including Web of Science (ISI), Scopus, PubMed, Embase, and Scholar. The quality of the included studies was assessed based on the Newcastle-Ottawa scale (NOS) checklist. Meta-analysis was done using Stata statistical software. The pooled prevalence of total HT, subclinical HT, and overt HT among β-thal patients was 13.25 [95% confidence interval (95% CI): 10.29-16.21; 11.84, 95% CI: 8.43-15.25 and 12.46, 95% CI: 1.05-23.87], respectively. The prevalence of total HT was 16.22% (95% CI: 12.36-20.08) in TDT and 7.22% (95% CI: 3.66-10.78) in NTDT patients. Serum ferritin (SF) levels were significantly lower in euthyroid compared to hypothyroid patients [standard mean difference (SMD) -2.15 (95% CI: -3.08, -1.21, value <0.001]. The prevalence of HT was higher in TDT compared to NTDT patients. Moreover, our results showed a significant association of high serum ferritin (SF) levels with hypothyroidism in β-thal patients. Both of these findings highlight the importance of prevention measures and timely diagnosis and management of iron overload in β-thal patients.
作为慢性输血的一个原因，铁过载是导致β-地中海贫血（β-thal）患者多个器官功能障碍的一个重要问题。这是一项更新的荟萃分析，旨在总结铁过载与甲状腺功能减退症（HT）之间的关系。我们首次对依赖输血的（TDT）和非依赖输血的β-地中海贫血（NTDT）患者中 HT 的患病率进行了荟萃分析。这项系统评价和荟萃分析是根据系统评价和荟萃分析的首选报告项目（PRISMA）清单进行的。我们搜索了 Web of Science（ISI）、Scopus、PubMed、Embase 和 Scholar 等数据库。根据纽卡斯尔-渥太华量表（NOS）清单评估纳入研究的质量。使用 Stata 统计软件进行荟萃分析。β-地中海贫血患者总 HT、亚临床 HT 和显性 HT 的汇总患病率分别为 13.25%（95%可信区间[95%CI]：10.29-16.21）；11.84%（95%CI：8.43-15.25）和 12.46%（95%CI：1.05-23.87）。TDT 患者的总 HT 患病率为 16.22%（95%CI：12.36-20.08），NTDT 患者为 7.22%（95%CI：3.66-10.78）。与甲状腺功能正常的患者相比，甲状腺功能减退症患者的血清铁蛋白（SF）水平显著降低[标准化均数差（SMD）-2.15（95%CI：-3.08，-1.21， 值 <0.001）]。TDT 患者的 HT 患病率高于 NTDT 患者。此外，我们的结果表明，β-地中海贫血患者高血清铁蛋白（SF）水平与甲状腺功能减退症显著相关。这两个发现都强调了预防措施和及时诊断和管理β-地中海贫血患者铁过载的重要性。
