A total of 360 participants of the 240 (110 males, 130 females) patients with thyroid dysfunction and the rest 120 (55 males, 65 females) healthy controls were recruited for this study. Out of 240 patients with thyroid dysfunction, 120 (50%) were with hypothyroidism and the rest 120 (50%) were with hyperthyroidism. Most of the study participants who participated in the current study were in the age range of 25-44 years (41.7) with an average age of 28.7 years(a minimum of 1 year and a maximum of 82 years). The majority of study participants in the current study were females 195 (54.2%). The age of the case group and the control group in the current study was relatively matched (Table 1).
Table 1
Socio-demographic finding of the participants who participated in the current study at MSH, Addis Ababa, Ethiopia from June to August 2021.
Variable | Category | Thyroid functional status |
Normal 120 (33.3%) | Hypothyroidism (120 (33.3%) | Hyperthyroidism 120 (33.3%) |
Sex | Male | 54 (45%) | 56 (46.7%) | 55 (45.8%) |
Female | 66 (55% ) | 64 (53.3%) | 65 (54.2%) |
Age/years | ≤14 | 7 (5..8%) | 5 (4.2%) | 6 (15) |
15-24 | 15 (12.5%) | 15 (12.5%) | 10 (8.3%) |
25 -44 | 45 (37.5%) | 50 (41.7%) | 55 (45.8%) |
45-64 | 34 (28.3%) | 25 (20.8%) | 23 (19.2%) |
≥65 | 19 (15.8%) | 25 (20.8%) | 26 (21.7%) |
Educational status | Illiterate | 3 (2.5%) | 4 (3.4%) | 5 (4.2%) |
Primary school | 5 (4.2%) | 6 (5%) | 20 (16.7%) |
Certificate and diploma | 18 (15%) | 23(19.2%) | 20 (16.7%) |
First degree and above | 97 (80.8%) | 90 (75%) | 75 (62.5%) |
Residence | Rural | 2 (1.7%) | 2 (1.7%) | 12 (10%) |
Urban | 118 (98.3%) | 118 (98.3%) | 108 (90%) |
From a total of 360 study participants, almost all of the respondents 118 (98.33%) healthy controls and 226 (94.2%) patients were from urban residents. The educational status finding also indicated that the majority of study participants 115(95.83%) normal controls and 190(79.2%) participants with thyroid dysfunction were had primary and above education level and was significantly associated with hematological findings (p=0.004) (Table 1 and Table 2).
Table 2
Hematological profile findings of the participants who participated in the current study at MSH, Addis Ababa, Ethiopia from June to August 2021.
Variable | Category | Thyroid functional status |
Normal 120 (33.3%) | Hypothyroidism (120 (33.3%) | Hyperthyroidism 120 (33.3%) |
Hgb (g/dl) | <12 | 21 (17.5%) | 69 (57.5%0 | 64 (53.3%) |
12.1- 17.2 | 86 (71.7%) | 36 (30.0%) | 26 (21.7%) |
>17.2 | 13 (10.8%) | 15 (12.5%) | 30 (25.0%) |
RBC (×1012/L) | <4 | 21 (17.5%) | 69 (57.5%) | 64 (53.3%) |
4-6 | 85 (70.8%) | 41(34.2%) | 30 (25.0%) |
>6 | 14 (11.7%) | 10 (8.3%) | 26 (21.7%) |
MCHC (g/dl) | < 32 | 22 (18.3%) | 70 (58.3%) | 64 (53.3%) |
32 -36 | 86 (71.7%) | 40 (33.3%) | 30 (25.0%) |
>36 | 12 (10.0) | 10 (8.3%) | 26 (21.7%) |
MCH (pg/cell) | >27 | 21 (17.5%) | 69 (57.5%) | 64 (53.3%) |
27-32 | 86 (71.7%) | 36 (30.0%) | 26 (21.7%) |
>32 | 13 (10.8%) | 15 (12.5%) | 30 (25.0%) |
MCV (fl) | <70 fl | 21 (17.5%) | 69 (57.5%) | 64 (53.3%) |
70-100 fl | 86 (71.7%) | 36 (30.0%) | 26 (21.7%) |
>100 fl | 13 (10.8%) | 15 (12.5%) | 30 (25.0%) |
WBCs count((×109/L) | <4 | 12 (10.0%) | 5 (4.2%) | 4 (3.3%) |
4-10 | 101 (84.2%) | 30 (25.0%) | 31 (25.8%) |
≥10.1 | 7 (5.8%) | 85 (70.8%) | 85 (70.8%) |
Neutrophil (%) | <40% | 10 (8.3%) | 5 (4.2%) | 5 (4.2%) |
40- 60% | 105 (87.5%) | 25 (20.8%) | 25 (20.8%) |
> 60% | 5 (4.2%) | 90 (75.0%) | 90 (75.0%) |
Monocyte (%) | < 2% | 12 (10.0%) | 12 (10.0%) | 20 (16.7%) |
2 - 8% | 88 (73.3%) | 86 (71.7%) | 70 (58.3%) |
> 8% | 20 (16.7%) | 22 (18.3%) | 30 (25.0%) |
Lymphocyte | <20% | 4 (3.3%) | 8 (6.7%) | 8 (6.7%) |
20-40% | 110 (91.7%) | 90 (75.0%) | 100 (91.7%) |
> 40% | 6 (5.0%) | 22 (18.3%) | 12 (10.0%) |
Basophiles | < 0.5% | 2 (1.7%) | 3 (2.5%) | 15 (12.5%) |
0.5 -1% | 112 (93.3%) | 112 (93.3%) | 85 (70.8%) |
> 1% | 6 (5.0%) | 5 (4.2%) | 20 (16.7%) |
PLT count (K/mm3) | <150 | 10 (8.3%) | 60 (50.0%) | 45 (37.5%) |
150-450 | 110 (91.7%) | 58 (48.3%) | 45(37.5%) |
>450 | 0 | 2 (1.7%) | 30 (25.0%) |
MPV (femtoliter) | < 7 | 5 (4.2%) | 60 (50.0%) | 50 (41.7%) |
7-12 | 105 (87.5%) | 54 (45.0) | 40 (33.3%) |
>12 | 10 (8.3%) | 6 (5.0%) | 30 (25.0%) |
As indicated in Table 2 hematological profile findings indicated that the majority of the healthy study participants were had normal valve of hemoglobin (71.7%), WBC (84.2%), RBC (70.8%), MCV (71.7%), Neutrophil (87.5%) and PLT (91.7%). On the other hand, most of the study participants who have thyroid problems both hypothyroidism and hyperthyroidism were had relatively low levels of hemoglobin (57.5% and 53.3%), WBC (70.8% and 70.8%), RBC (57.5% and 53.3%), MCV (57.5% and 53.3%), Neutrophil (75.0% and 75.0%) and PLT (50.0% and 50.0%) respectively (Table 1).
Our multivariate logistic regression analysis indicated that study participants with the educational level of the first degree and above had 2.8 more chances to develop thyroid dysfunction when compared with study participants with the educational level of below degree level (AOR 2.8, 95% CI: 1.23, 6.69, p value=0.001) and those whose age is greater than 65 years were have 5.2 times more chance to develop any types of thyroid dysfunction relative with healthy individuals AOR 5.2,95% CI: 1.34-7.90, p value=0.003) (Table 3).
This study finding also indicated that study participants with Hb value of less than 12 g/dl were more likely to be affected by thyroid dysfunction (AOR 2.3, 95% CI (1.03-6.52)), p value=0.001), MCV value less than 70 fl were 3.13 times more likely to develop thyroid dysfunction (AOR 3.13, 95% CI:1.21- 9.46, p value=0.003), RBC value less than 4X1012 cells /L were 3.4 times more likely to develop thyroid dysfunction (AOR 3.4, 95% CI:1.51-3.69, p value=0.002), WBC value greater than 10X109 cells /L were have 5.6 times more chance to develop thyroid dysfunction (AOR 5.6, 95% CI:1.09-10.82, p value=0.001), and those whose PLT value less than 150x109 cells /L were 2.7 times more likely to develop thyroid dysfunction (AOR 2.7, 95% CI:1.26-11.36, p value=0.004) compared with control groups (Table 3).
Table 3
Multivariate analysis outcome of thyroid dysfunction and independent variables for study participants who participated in the current study at MSH, Addis Ababa, Ethiopia from June to August 2021.
Variables | Thyroid dysfunction |
AOR: 95%,CI | p- value |
Age /year | ≤14 | 1.13: 0.20-2.45 | 0.09 |
15-24 | 1: 1.0-12.2 | 0.07 |
25 -44 | 0.9: 1.20-4.5 | 0.07 |
45-64 | 1: 0.12-3.34 | 0.06 |
≥65 | 5.2: 1.34-7.90 | 0.003 |
Educational level | Illiterate | 1 | |
Primary school | 1 | |
Certificate and diploma | 1.2: 1.99-14.65 | 0.06 |
First degree and above | 2.8: 1.23-6.69 | 0.001 |
Hb g/dl | <12 | 2.3: 1.03-6.52 | 0.001 |
12.1- 17.2 | 1 | |
>17.2 | 1 | |
RBC ×1012/ L | <4 | 4.4: 1.51-3.69 | 0.002 |
4-6 | 1 | |
>6 | 1.09: 2.1-22.23 | 1.2 |
MCV (fl) | <70 | 3.13: 1.21-9.46 | 0.003 |
70-100 | 2.1: 0.98-18.71 | 1.0 |
>100 | 1 | |
WBC (x109cells/L) | <4 | 1 | |
4-10 | 5.6: 1.09-10.82 | 0.001 |
≥10.1 | 1 | |
Neutrophil (%) | <40 | 1 | |
41- 60 | 1.8: 1.11-13.36 | 0.005 |
> 60 | 3.7: 1.67-11.23 | 0.003 |
PLT (x109cells/L) | <150 | 2.7: 1.26-11.36 | 0.004 |
150-450 | 1 | |
>450 | 1 | |
* P < 0.05: statistically significant, 1 =Reference group, AOR= Adjusted odd ration, C.I=95% confidence interval
Comparison of hematological parameters between control and participants with thyroid dysfunction
The result of this study showed that there was a statistically significant decrease in RBC count, Hgb, HCT, MCV, MCH, MCHC, MPV, and PLT counts in thyroid dysfunction patients when compared with apparently healthy controls (p-value <0.05). WBC, RDW, and Neutrophils were statistically significantly higher in thyroid dysfunction patients when compared with apparently healthy controls (p-value <0.05). The valve of monocyte, basophils, and eosinophils were not shown a significant difference between the groups (p-value >0.05) (Table 2, and 4).
Table 4
Comparison of RBCs count and RBC indices between patients with hypothyroidism, hyperthyroidism, and healthy controls participated in the current study at MSH, Addis Ababa, Ethiopia from June to August 2021.
Index | Thyroid status | No | Mean±SD | AOR, 95%,CI | P-Value |
Hgb valve less than 12(g/dl | Hypothyroidism | 69 | 13.6 ± 4.7 | 2.4, 1.11-3.56 | <0.001 |
Control | 21 | 14.8 ± 2.2 | 1 | |
Hyperthyroidism | 64 | 13.6 ± 4.2 | 2.6, 1.31-6.56 | <0.001 |
MCV less than 70fl | Hypothyroidism | 69 | 74.3 ± 10.3 | 3.5, 1.64-6.78 | <0.001 |
Control | 21 | 86.4 ± 11.2 | 1 | |
Hyperthyroidism | 64 | 75.2 ± 12.9 | 2.8, 1.82-7.56 | <0.001 |
RBC less than 4×1012/L | Hypothyroidism | 69 | 4.3± 2.3 | 4.4, 1.67-7.56 | 0.001 |
Control | 21 | 4.9± 2.5 | 1 | <0.001 |
Hyperthyroidism | 64 | 5.0 ± 2.6 | 4.8, 1.67-8.76 | 0.001 |
MCH less than 27 pg/cell | Hypothyroidism | 69 | 28 ± 4.8 | 2.2, 1.13-3.56 | <0.001 |
Control | 21 | 31.7 ± 3.9 | 1 | |
Hyperthyroidism | 64 | 27.8 ± 3.8 | 2.6, 1.41-9.99 | <0.002 |
MCHC less than 32 g/dl | Hypothyroidism | 70 | 32 ± 3.3 | 1.8, 1.11-6.66 | <0.001 |
Control | 22 | 35.4 ± 2.8 | 1 | <0.001 |
Hyperthyroidism | 64 | 33.3 ± 2.1 | 3.1, 1.51-4.56 | |
WBC greater than 4×109/L | Hypothyroidism | 85 | 5.3 ± 3.5 | 3.8, 2.11-12.56 | 0.004 |
Control | 7 | 7.3 ± 2.9 | 1 | |
Hyperthyroidism | 85 | 5.6 ± 5.0 | 5.6, 1.31-10.56 | 0.009 |
PLT less than 150×109/L | Hypothyroidism | 60 | 160± 46.3 | 2.9, 1.89-7.56 | <0.001 |
Control | 10 | 320 ± 32.4 | 1 | <0.001 |
Hyperthyroidism | 50 | 165 ± 33.7 | 2.8, 1.33-5.56 | <0.001 |
Neutrophils greater than 60% | Hypothyroidism | 85 | 74 ± 8 | 5.4, 2.32-8.56 | <0.001 |
Control | 7 | 55 ± 6 | 1 | <0.001 |
Hyperthyroidism | 85 | 68 ± 9 | 2.6, 1.41-7.56 | <0.001 |