Archives of Medicine and Health Sciences

LETTERS TO THE EDITOR
Year
: 2020  |  Volume : 8  |  Issue : 1  |  Page : 165-

Does thyroid dysfunction correlates with iron overload in Eβ thalassemia patients? A study from a tertiary care thalassemia center in India


Mahmood Dhahir Al-Mendalawi 
 Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
P. O. Box 55302, Baghdad Post Office, Baghdad
Iraq




How to cite this article:
Al-Mendalawi MD. Does thyroid dysfunction correlates with iron overload in Eβ thalassemia patients? A study from a tertiary care thalassemia center in India.Arch Med Health Sci 2020;8:165-165


How to cite this URL:
Al-Mendalawi MD. Does thyroid dysfunction correlates with iron overload in Eβ thalassemia patients? A study from a tertiary care thalassemia center in India. Arch Med Health Sci [serial online] 2020 [cited 2021 May 9 ];8:165-165
Available from: https://www.amhsjournal.org/text.asp?2020/8/1/165/287339


Full Text



Sir,

I spent a good time reading an interesting study by Baul et al.[1] published in the July–December 2019 issue of the Archives of Medicine and Health Sciences. The authors nicely studied the relationship between disordered thyroid function and iron overload among an Indian cohort with hemoglobin E/β-thalassemia. Based on thyroid function tests (TFT), they found that 44% of patients had thyroid dysfunction; overt hypothyroidism noticed in 12% of patients with a mean ferritin level of 1077 ng/ml and subclinical hypothyroidism reported in 32% of patients with a mean ferritin level of 1200 ng/ml. However, normal thyroid function was noted in 56% of patients with a mean ferritin level of 1155 ng/ml.[1] I assume that the study results ought to be cautiously interpreted. Apart from a few study limitations addressed by the authors, I presume that the following methodological limitation might be relevant. It is worthy to mention that the proper assessment of thyroid health status necessitates the use of thyroid reference values (TRV). Actually, there are many determinants controlling the construction of TRV, notably age, gender, and ethnicity.[2] Hence, many population-specific TRV have been formulated to be employed in researches institutions and clinical fields.[3],[4] India is among pioneer countries that have already generated their own TRV for different age groups for both genders separately.[5] In the study methodology, Baul et al.[1] addressed the normal ranges of various parameters of TFT and the cutoff values used to assess the function of the thyroid gland among the studied cohort. However, they did not mention exactly which TRV they employed. This might consequently render their study results questionable.

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References

1Baul S, Dolai TK, Sahana PK, De R, Mandal PK, Chakrabarti P. Does thyroid dysfunction correlates with iron overload in Eβ thalassemia patients? A study from a tertiary care thalassemia center in India. Arch Med Health Sci 2019;7:206-11.
2Chaker L, Korevaar TI, Medici M, Uitterlinden AG, Hofman A, Dehghan A, et al. Thyroid function characteristics and determinants: The Rotterdam study. Thyroid 2016;26:1195-204.
3Jammah AA, Alshehri AS, Alrakhis AA, Alhedaithy AS, Almadhi AM, Alkwai HM, et al. Characterization of thyroid function and antithyroid antibody tests among Saudis. Saudi Med J 2015;36:692-7.
4Park SY, Kim HI, Oh HK, Kim TH, Jang HW, Chung JH, et al. Age- and gender-specific reference intervals of TSH and free T4 in an iodine-replete area: Data from Korean national health and nutrition examination survey IV (2013-2015). PLoS One 2018;13:e0190738.
5Marwaha RK, Tandon N, Ganie MA, Mehan N, Sastry A, Garg MK, et al. Reference range of thyroid function (FT3, FT4 and TSH) among Indian adults. Clin Biochem 2013;46:341-5.