Investigating the correlation of ferritin and uric acid levels in hypothyroidism: a case-control study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20262807Keywords:
Subclinical hypothyroidism, Overt hypothyroidism, Serum uric acid, Serum ferritinAbstract
Background: Hypothyroidism is one of the most prevalent endocrinological disorder in our country as well as other parts of the world. Uric acid is a known antioxidant while ferritin, besides its role in iron storage is an acute-phase reactant. The present study is an endeavour to study the metabolic changes in uric acid and ferritin levels in relation to subclinical and overt hypothyroidism.
Methods: The 34 subclinical, 27 overt hypothyroid and 35 age and sex matched control individuals in the age group of 18-60 years were included. Serum thyroid stimulating hormone (TSH), Free thyroxine (fT4) and ferritin were measured using electrochemiluminescence immunoassay techniques; while uric acid was measured using Uricase, Trinder-End Point spectrophotometric method.
Results: The serum uric acid levels were found to be significantly higher in overt hypothyroidism as compared to subclinical hypothyroidism. No significant difference was found in the serum ferritin levels of the individuals with subclinical and overt hypothyroidism.
Conclusions: Hence, the present study suggests that hypothyroidism results in an increased serum uric acid level most probably caused by decreased renal clearance of uric acid due to compromised fT4 function. However, no such effect was found in serum ferritin levels.
Metrics
References
Bagcchi S. Hypothyroidism in India: more to be done. The Lancet: Diabetes and Endocrinol. 2014;2(10):778. DOI: https://doi.org/10.1016/S2213-8587(14)70208-6
Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390(10101):1550-62. DOI: https://doi.org/10.1016/S0140-6736(17)30703-1
Wilson SA, Stem LA, Bruehlman RD. Hypothyroidism: Diagnosis and Treatment. Am Fam Physician. 2021;103(10):605-13.
Garber JR, Cobin RH, Gharib H. American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults. Endocr Pract. 2013;19(1):175.
Khandelwal D, Tandon N. Overt and subclinical hypothyroidism: who to treat and how. Drugs. 2012;72(1):17-33. DOI: https://doi.org/10.2165/11598070-000000000-00000
Li C, Hsieh MC, Chang SJ. Metabolic syndrome, diabetes, and hyperuricemia. Curr Opin Rheumatol. 2013;25(2):210-6. DOI: https://doi.org/10.1097/BOR.0b013e32835d951e
Krishnan E, Kwoh CK, Schumacher HR, Kuller L. Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Hypertension. 2007;49(2):298-303. DOI: https://doi.org/10.1161/01.HYP.0000254480.64564.b6
Chang HY, Lee PH, Lei CC. Hyperuricemia as an independent risk factor of chronic kidney disease in middle-aged and elderly population. Am J Med Sci. 2010;339(6):509-15. DOI: https://doi.org/10.1097/MAJ.0b013e3181db6e16
Gonçalves JP, Oliveira A, Severo M, Santos AC, Lopes C. Cross-sectional and longitudinal associations between serum uric acid and metabolic syndrome. Endocrine. 2012;41(3):450-7. DOI: https://doi.org/10.1007/s12020-012-9629-8
Giordano N, Santacroce C, Mattii G, Geraci S, Amendola A, Gennari C. Hyperuricemia and gout in thyroid endocrine disorders. Clin Exp Rheumatol. 2001;19(6):661-5.
Bhargavi SK, Kumar S, Prasad M. Study of uric acid levels in hypothyroid patients. Int J Clin Biochem Res. 2019;6(1):64-6. DOI: https://doi.org/10.18231/2394-6377.2019.0017
Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV. Serum ferritin: Past, present and future. Biochim Biophys Acta. 2010;1800(8):760-9. DOI: https://doi.org/10.1016/j.bbagen.2010.03.011
Knovich MA, Storey JA, Coffman LG, Torti SV, Torti FM. Ferritin for the clinician. Blood Rev. 2009;23(3):95-104. DOI: https://doi.org/10.1016/j.blre.2008.08.001
Sumitha Prabhu PS, Cheriyan S, Sulaiman L. A comparative study of serum ferritin and thyroid stimulating hormone (TSH) levels in hypothyroid and euthyroid subjects. Int J Clin Biochem Res. 2022;9(3):250-253 DOI: https://doi.org/10.18231/j.ijcbr.2022.048
Torkian P, Mansournia MA, Mansournia N. Evaluation of biochemical markers of kidney function in patients with subclinical hypothyroidism in comparison with euthyroid people. J Family Med Prim Care. 2020;9(8):4234-9. DOI: https://doi.org/10.4103/jfmpc.jfmpc_757_20
Xing Y, Yang L, Liu J, Ma H. The Association with Subclinical Thyroid Dysfunction and Uric Acid. Int J Endocrinol. 2021;2021:9720618. DOI: https://doi.org/10.1155/2021/9720618
Xie H, Li N, Zhou G, He Z, Xu X, Liu Q, et al. The association between the thyroid feedback quantile-based index and serum uric acid in U.S. adults. Eur J Med Res. 2023;28(1):259. DOI: https://doi.org/10.1186/s40001-023-01214-3
See LC, Kuo CF, Yu KH, Luo SF, Chou IJ, Ko YS, et al. Hyperthyroid and hypothyroid status was strongly associated with gout and weakly associated with hyperuricaemia. PLoS One. 2014;9(12):e114579. DOI: https://doi.org/10.1371/journal.pone.0114579
Ittermann T, von Rheinbaben S, Markus MRP, Dörr M, Steveling A, Nauck M, et al. High Thyroid-Stimulating Hormone and Low Free Triiodothyronine Levels Are Associated with Chronic Kidney Disease in Three Population-Based Studies from Germany. J Clin Med. 2023;12(17):5763. DOI: https://doi.org/10.3390/jcm12175763
Eranhikkal H, Asha E, Krishnan NR, Chacko AM, Dhanya AK, Nath MJU, et al. Evaluation of Serum Creatinine and Serum Uric Acid in Hypothyroid Patients: A Cross-sectional Study. J Clin of Diagn Res. 2023;17(10):BC06-10. DOI: https://doi.org/10.7860/JCDR/2023/67161.18537
Saini V, Chopra S, Kaur J. Evaluation of Serum Ferritin Levels in Patients of Hypothyroidism. Indian J Med Biochem. 2024;28(3):60-2.
Swapnika TG, Sabitha Rani SS, Dipankar S, Itagi ABH, Vamshidhar IS. A Comparative Study of Iron Status in Subclinical Hypothyroid and Euthyroid Subjects in a Tertiary Care Hospital. Cureus. 2024;16(1):e52007. DOI: https://doi.org/10.7759/cureus.52007
Tiwari R, Saharia GK, Mangaraj M. Evaluation of Serum Ferritin and Anti-Thyroid Peroxidase Antibody Status in Newly Diagnosed Subclinical Cases of Hypothyroidism. Endocr Metab Immune Disord Drug Targets. 2021;21(8):1453-8. DOI: https://doi.org/10.2174/1871530320666200925125404
Means SH. The thyroid and its diseases, J. B. Lippincott Co., Philadelphia. 1937;217-8.
Xu GM, Hu MX, Li SY, Ran X, Zhang H, Ding XF. Thyroid disorders and gastrointestinal dysmotility: an old association. Front Physiol. 2024;15:1389113. DOI: https://doi.org/10.3389/fphys.2024.1389113
da Conceição RR, Giannocco G, Herai RH, Petroski LP, Pereira BG, Oliveira KC, et al. Thyroid dysfunction alters gene expression of proteins related to iron homeostasis and metabolomics in male rats. Mol Cell Endocrinol. 2024;579:112086. DOI: https://doi.org/10.1016/j.mce.2023.112086
Leedman PJ, Stein AR, Chin WW, Rogers JT. Thyroid hormone modulates the interaction between iron regulatory proteins and the ferritin mRNA iron-responsive element. J Biol Chem. 1996;271(20):12017-23. DOI: https://doi.org/10.1074/jbc.271.20.12017
Hess SY, Zimmermann MB, Arnold M, Langhans W, Hurrell RF. Iron deficiency anemia reduces thyroid peroxidase activity in rats. J Nutr. 2002;132(7):1951-5. DOI: https://doi.org/10.1093/jn/132.7.1951
Moreira AC, Mesquita G, Gomes MS. Ferritin: An Inflammatory Player Keeping Iron at the Core of Pathogen-Host Interactions. Microorganisms. 2020;8(4):589. DOI: https://doi.org/10.3390/microorganisms8040589
Kell DB, Pretorius E. Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics. 2014;6(4):748-73. DOI: https://doi.org/10.1039/C3MT00347G
Downloads
Published
How to Cite
Issue
Section
