Berta Dereje Mengesha, Gelaw Yemataw, Shiferaw Elias, Melkamu Abateneh, Legese Gebrehiwot Lema, Adane Tiruneh, Mandefro Befikad
Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
J Blood Med. 2024 Mar 23;15:157-169. doi: 10.2147/JBM.S453015. eCollection 2024.
Abnormalities in blood cells are frequently associated with thyroid hormone disorders as a result of their involvement in the proliferation and production of blood cells. This study aimed to determine the magnitude and associated factors of hematological abnormalities in patients with hypothyroidism.
A cross-sectional study was conducted from January 1 to June 30, 2023, at the University of Gondar Comprehensive Specialized Hospital. The present study included a total of 300 patients with hypothyroidism prospectively using the systematic random sampling technique. The hematological parameter data were collected using data extraction sheets, whereas the associated factor data were collected using both structured questionnaires and data extraction sheets. For complete blood cell counts, 4 mL of anticoagulated venous blood was collected and analyzed. The data were entered into Epi-data version 3.1 and analyzed with Stata version 14. Both bivariate and multivariate logistic regressions were performed to identify factors associated with hematological abnormalities. A P value < 0.05 was considered to indicate statistical significance.
The median value of red blood cell, hemoglobin, mean cell volume, white blood cell, and platelet were 4.63 x10/µL, 14 g/dL, 84.3fl, 5.3 x10/µL, and 228, respectively. The overall incidences of anemia, leucopoenia, and thrombocytopenia in patients with hypothyroidism were 26.3% (95% confidence interval (CI): 21-32), 15.7% (95% CI: 14.2-17.2), and 9% (95% CI: 7.5-10.5), respectively. Lymphopenia was detected in 9% (95% CI: 8.6-10.1) of the patients, and neutropenia was detected in 6% (95% CI: 4.4-7.6) of the patients. Only three factors, female sex (adjusted odds ratio (AOR) =2.1, 95% CI=1.3-3.1), alcohol consumption (AOR= 3.8, CI=1.7-8.9), and febrile illness (AOR=2.7, 95% CI=1.3-5.4), were found to be significantly associated factors for anemia.
The present study revealed heterogeneous hematological abnormalities in patients with hypothyroidism. Thus, early diagnosis and monitoring strategies are required to minimize complications in patients.
血细胞异常常与甲状腺激素紊乱相关，因为血细胞参与了血细胞的增殖和生成。本研究旨在确定甲状腺功能减退患者血液学异常的程度及相关因素。
2023年1月1日至6月30日在贡德尔大学综合专科医院进行了一项横断面研究。本研究前瞻性地采用系统随机抽样技术纳入了300例甲状腺功能减退患者。血液学参数数据使用数据提取表收集，而相关因素数据使用结构化问卷和数据提取表收集。采集4 mL抗凝静脉血进行全血细胞计数并分析。数据录入Epi - data 3.1版本，并使用Stata 14版本进行分析。进行双变量和多变量逻辑回归以确定与血液学异常相关的因素。P值<0.05被认为具有统计学意义。
红细胞、血红蛋白、平均红细胞体积、白细胞和血小板的中位数分别为4.63×10/µL、14 g/dL、84.3 fl、5.3×10/µL和228。甲状腺功能减退患者贫血、白细胞减少和血小板减少的总体发生率分别为26.3%（95%置信区间（CI）：21 - 32）、15.7%（95% CI：14.2 - 17.2）和9%（95% CI：7.5 - 10.5）。9%（95% CI：8.6 - 10.1）的患者检测到淋巴细胞减少，6%（95% CI：4.4 - 7.6）的患者检测到中性粒细胞减少。仅发现三个因素，即女性（调整优势比（AOR）=2.1，95% CI = 1.3 - 3.1）、饮酒（AOR = 3.8，CI = 1.7 - 8.9）和发热性疾病（AOR = 2.7，95% CI = 1.3 - 5.4）是贫血的显著相关因素。
本研究揭示了甲状腺功能减退患者存在异质性血液学异常。因此，需要早期诊断和监测策略以尽量减少患者的并发症。
