The Correlation Between Thyroid Disease And Anemia

Objective:This study focused on the relationship between thyroid disease and anemia,correlation analysis of thyroid hormone and erythrocyte-related indexes,and the impact of thyroid hormone on anemia.All of the investigations provide experimental evidences for clinical diagnosis and treatment of anemia and thyroid disease.Methods:By retrospective analysis,the data collected from Jan.1 2012 to Dec.31 2016 on the same day of patients who were tested for thyroid function(FT3,FT4,TSH)and blood routine at the first visiting to Zhujiang Hospital of Southern Medical University.The data from the same patient repeated detection were excluded,only to retain the data of thyroid-related diseases.The data of other diseases were also excluded.According to age,the data was divided into 2 groups,14 years old and above included in the total data group,14 years of age and below into the children group.Due to insufficient data in children group,it is not included in the statistical analysis.Finally,14,580 cases were collected in the first group.The 14,580 cases were classified into thyrotoxicosis group,subclinical hyperthyroid group,hypothyroid group,subclinical hypothyroidism group and normal group according to laboratory data.After the logarithmic transformation of TSH,the detection index of each group was described by mean and standard deviation(x±S),one-way analysis of variance was used when compared between groups,chi-square test was conducted when compared whether there are differences on the prevalence of anemia between different groups,and Pearson correlation analysis was used to examine the correlation between thyroid-related and erythrocyte-related indexes.Results:①The levels of Hb,MCV and MCH in thyrotoxicosis group and subclinical hyperthyroid group were lower than those in control group,RDW was higher than control group,and there was no significant difference between thyrotoxicosis group,subclinical hyperthyroid group and control group when compared on RBC and MCHC.The levels of RBC,Hb and MCH in the hypothyroid group were lower than those in the control group,while the MCW and MCHC had no significant difference compared with the control group.The RBC and Hb in the subclinical hypothyroidism group were lower than those in the control group,while the MCV,MCH,MCHC and RDW had no significant difference compared with the control group.②The prevalence of female with anemia in the thyrotoxicosis group,subclinical hypothyroidism group and control group was higher than that in male group,but the prevalence of anemia was no significant difference in different sex between subclinical hyperthyroid group and hypothyroidism group.③ The prevalence of anemia in the thyrotoxicosis group increased with age,and the prevalence of anemia in the control group was age-related,but there was no significant linear trend.There was no significant correlation between age and the prevalence of anemia in subclinical hyperthyroidism group,hypothyroidism group and subclinical hypothyroidism.④The prevalence of anemia in thyrotoxicosis group and subclinical hyperthyroid group was higher than that in control group,and the prevalence of anemia in thyrotoxicosis group and subclinical hyperthyroid group was not significantly different.The prevalence of anemia in hypothyroidism group was higher than that in subclinical hypothyroid group,and the prevalence of anemia was lower in hypothyroidism group and subclinical hypothyroidism group than in control group.⑤There was no significant difference in the types of anemia in subclinical hyperthyroid group and subclinical hypothyroidism group compared with the control group.The prevalence of microcytic hypochromic anemia and normocytic anemia was higher in thyroid poison and hypothyroidism group than control group,and the prevalence of normocytic anemia increased more obvious than the prevalence of microcytic hypochromic anemia.There was no significant difference in the degree of anemia between the thyroid dysfunction group and the control group.⑥When 0 ≤TSH<0.35 mIU/L or TSH>10.0 mIU/L,the prevalence of anemia was higher than that when 0.35 mIU/L≤TSH ≤ 5.5 mU/L(reference interval)and 5.5 mIU/L<TSH ≤10 mIU/L,the prevalence of anemia was not significantly different from that when 0.35 mIU/L≤TSH ≤5.5 mU/L.⑦FT3 and FT4 were always positively correlated with RBC while TSH and RBC were always negatively correlated.FT3 and FT4 were negatively correlated with Hb in thyrotoxicosis group and subclinical hyperthyroidism group while positively correlated with Hb in normal group,hypothyroidism group and subclinical hypothyroidism group;TSH and Hb was negatively correlated in hypothyroidism group and subclinical hypothyroidism group while not significantly correlated in thyrotoxicosis group,subclinical hyperthyroidism group and control group.Conclusion:FT3 and FT4 promote the production of RBC while TSH inhibit that;the synthesis of Hb is inhibited when suffers from thyrotoxicosis,subclinical hypothyroidism,hypothyroidism,subclinical hypothyroidism.The prevalence of anemia increases in patients with thyroid disease,which are often coexist.We should consider the possibility of thyroid disease when there is no specific reason and effective treatment responce for clinical anemia.For patients with thyroid disease,we should also pay attention to whether there exists anemia and whether it needs to treat anemia at the same time.