Abstract
BackgroundDeficiencies of iodine and iron may have adverse effect on thyroid function. This study was undertaken to investigate the association between iron status and thyroid function in Nepalese children living in hilly regions.MethodsA cross-sectional study was conducted among 227 school children aged 6–12 years living in hilly regions of eastern Nepal. Urine and blood samples were analyzed for urinary iodine concentration, free thyroxine, free triiodothyronine, thyroid stimulating hormone, hemoglobin, serum iron and total iron binding capacity, and percentage transferrin saturation was calculated.ResultsThe cohort comprised euthyroid (80.6 %, n = 183), overt hypothyroid (1.3 %, n = 3), subclinical hypothyroid (16.3 %, n = 37) and subclinical hyperthyroid (1.8 %, n = 4) children respectively. About 35.2 % (n = 80) children were anemic, 43.6 % (n = 99) were iron deficient and 19.8 % (n = 45) had urinary iodine excretion < 100 μg/L. Hypothyroidism (overt and subclinical) was common in anemic and iron deficient children. The relative risk of having hypothyroidism (overt and subclinical) in anemic and iron deficient children was 5.513 (95 % CI: 2.844−10.685, p < 0.001) and 1.939 (95 % CI: 1.091-3.449, p = 0.023) respectively as compared to non-anemic and iron sufficient children. Thyroid stimulating hormone had significant negative correlation with hemoglobin (r = −0.337, p < 0.001) and transferrin saturation (r = −0.204, p = 0.002).ConclusionsThyroid dysfunction, iron deficiency and anemia are common among Nepalese children. In this cohort, anemic and iron deficient children had poor thyroid function.
Highlights
Deficiencies of iodine and iron may have adverse effect on thyroid function
The mean level of Hb, serum iron, Total iron binding capacity (TIBC), transferrin saturation, fT3, fT4 and Thyroid stimulating hormone (TSH) were 12.2 ± 1.9 gm/dl, 70.5 ± 35.4 μg/dl, 382.8 ± 89.5 μg/dl, 20.1 ± 12.6 %, 2.7 ± 0.8 pg/ml, 1.2 ± 0.4 ng/dl and 4.4 ± 2.8 mIU/L respectively in the study population, which are all in normal range
19.8 % (n = 45) children had Urinary iodine excretion (UIE) < 100 μg/L, which is considered as iodine deficiency on the basis of WHO criteria for iodine status [19]
Summary
Deficiencies of iodine and iron may have adverse effect on thyroid function. This study was undertaken to investigate the association between iron status and thyroid function in Nepalese children living in hilly regions. Multiple micronutrient deficiencies are still a major public health problem faced by developing countries. Such deficiencies have adverse effects on growth and development, especially in vulnerable groups like pregnant women and children [1]. Deficiencies of trace elements like iodine, iron, zinc and selenium impairs thyroid function [2]. Iodine deficiency and iron deficiency are considered as the most common cause of preventable brain damage and anemia respectively in developing countries like Nepal [4, 5]. Anemia and iron deficiency have been found to be highly prevalent among Nepalese school
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