Abstract
Introduction: β thalassemia has emerged as a huge public health problem worldwide. Thyroxine reserve is reduced in multitransfused thalassemia patientsanddiabetes can also be a considerable complication.Vitamin D3 deficiency is noted in thalassemia patients and is related to bone diseases. Aims and Objectives: Study of glycemicstatus, thyroid function, and vitamin D3 level in children with βthalassemia major. Method:Socio-demographic information wascollected by using the pretested and predesigned structured pro forma by interview technique. HbA1c level, vitamin D3 level,and thyroid function had been obtained from the lab. Result:In 89% of subjects TSH levels were normal with a mean value of 5.04.In 10.9%it was increased witha mean value of TSH being 6.67.VitaminD3 level in 2% children was below 20ng/ml, 50.50% had between 21 to 29ng/ml and 47.52% had between 30-60 ng/ml. Vitamin D3 deficiency increased with a higher blood transfusion rate (p-value 0.000). In 88.12%of the study, subjectsHbA1c was normal, 11.18%were inthe pre-diabetic range,and none of the subjects were diabetic as per HbA1C results. The mean value of HbA1C in normal children was 4.79%whereas in prediabetic children mean value of HbA1C was 6.13%. Conclusion: In the present study multiple endocrine abnormalities were common in multi transfused thalassemia major patients. Prevalence of subclinical hypothyroidism and prediabetes increased with a higher blood transfusion rate and higher serum ferritin level. Prevalence of subclinical hypothyroidism and prediabetes increased with age (p-value <0.05).
Highlights
Hemoglobinopathies are genetically determined inherited disorders of human hemoglobin, with significant morbidity worldwide
Frequent blood transfusion in turn can lead to iron overload which may result in hypogonadism, diabetes mellitus, hypothyroidism, hypoparathyroidism, and other endocrine abnormalities [3]
In contrast Eshragi P. et al (2011) reported mean age was 20.95±7.8 years and 14.6%of patients were of hypothyroidism.[6]In a study by Hashemizadeh H et al (2012) Subclinical hypothyroidism was seen in 7% patients andthe mean age of diagnosis was 10.2 ± 2.5 years [7]
Summary
Hemoglobinopathies are genetically determined inherited disorders of human hemoglobin, with significant morbidity worldwide. There is the alpha and betathalassemia major, intermediate, and minor and sickle cell diseases [1]. Beta thalassemia major is an autosomal recessive hereditary anemia, and rapid erythrocyte breakdown, resulting in advanced heart failure and death in early childhood [2]. The combination of transfusion and chelation therapy has dramatically extended the life expectancy of thalassemia patients [3]. Frequent blood transfusion in turn can lead to iron overload which may result in hypogonadism, diabetes mellitus, hypothyroidism, hypoparathyroidism, and other endocrine abnormalities [3]. Chhattisgarh is one of the growing stateswith one-third of its population belongs to scheduled tribes.
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