Author/Authors :
Azami, Milad Ilam University of Medical Sciences, Ilam , Parizad, Naser Urmia University of Medical Sciences, Urmia , Sayehmiri, Kourosh Department of Biostatistics - Psychosocial Injuries Research Center - Ilam University of Medical Sciences، Ilam
Abstract :
The present study aimed to determine the prevalence of hypothyroidism, hypoparathyroidism and the frequency
of regular chelation therapy in patients with thalassemia major in Iran. Searching process was performed by two
independent researchers using a valid keywords in the national and international database, including: Magiran,
Iranmedex, SID, Medlib, Scopus, PubMed, Science Direct, Cochrane, Web of Science, Springer, Wiley Online
Library and google scholar search engine. All studies were searched until 2016 with no time limit. All articles
met inclusion criteria were evaluated and the data were analyzed by using SATA Software Ver.11.1. Twenty
seven studies about hypothyroidism (sample size of 4851, the mean age of 16.36±5.5) and 19 studies related to
hypoparathyroidism (sample size of 3219, the mean age of 17.44±6.5) were examined. The prevalence of
hypothyroidism was calculated 5.7% (95% CI: 6.8-4.7) in patients with thalassemia major in Iran (P=0.000; I2
index=93.9%). The prevalence of overt and subclinical hypothyroidism was estimated 3.1% (95% CI: 1-4.7) and
6.7% (95% CI: 3.3-10), respectively. The prevalence of hypoparathyroidism was calculated 10% (95% CI: 7-12)
in patients with thalassemia major in Iran. In reviewing 5 studies, the frequency of regular chelation therapy was
estimated 54.6% (95% CI: 28-81.2) in these patients. The prevalence of hypothyroidism and
hypoparathyroidism is high in patients with thalassemia major in Iran. Thus, new planning and supervising seem
to be essential to minimize endocrine complications in these patients. There is no connection between serum
ferritin level and developing hypoparathyroidism. A high percent of Iranian patients with thalassemia major
perform the chelation therapy irregularly. It's been recommended to adopt the necessary measures such as
educating and enhancing awareness of the patients about its complications.
Keywords :
Chelation Therapy , Hypoparathyroidism , Hypothyroidism , Meta-analysis , Thalassemia Major