NEW DATA ON SUBCLINICAL MANIFESTATIONS OF SIDEROPENIC SYNDROME IN ADOLESCENT GIRLS

To determine the functional state of the pituitary-thyroid system in conditions of iron deficiency in 371 girls aged 12-17 years was examined. The data of clinical blood tests, biochemical indices of iron metabolism, urinary iodine excretion, thyroid structure, and function are presented. Analysis of the seven-years observation in adolescent girls revealed a significant prevalence of iron deficiency conditions and euthyroid goiter. The iron deficiency in girls was found to increase the risk for euthyroid goiter formation by 10 times. Significant correlations were determined between thyroid volume indices, levels of thyroid-stimulating hormone (TSH), free thyroxine (cT4), the titer of antibodies to thyroid peroxidase (A-TPO) in blood plasma, changes in hemogram and iron metabolism. Violations of thyroid status and iron metabolism are subclinical manifestations of latent iron deficiency in adolescent girls, which are a risk group for the development of iron deficiency conditions. Iron deficiency has been proven to be a significant risk factor for the formation of euthyroid goiter in girls. In iron deficiency conditions in adolescent girls, structural and functional disorders of the thyroid gland should be excluded and its damage should be prevented.

Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burdenof Disease Study 2015. Lancet. 2016; 8; 388(10053): 1545-602. DOI: 10.1016/S0140-6736(16)31678-6.

Iron Deficiency Anemia: Evaluation and Management. American Family Physician. 2013; 87(2): 98-104.

Polyakova S.I., Anuscenko A.O., Bakanov M.I., Smirnov I.E. Analisys and interpretation of indices of iron metabolism in various forms of pathology in children. Rossiyskiy pediatricheskiy zhurnal. 2014; 3: 17-23. (in Russian)

Maryam Akbari, Mahmood Moosazadeh, Reza Tabrizi, et al. Estimation of iron deficiency anemia in Iranian children and adolescents: a systematic review and metanalysis. Hematology. 2017; 22(4): 231-9. DOI:10.1080/10245332.2016.1240933.

Allen A, Allen S, Rodrigo R, et al. Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey. PLoS One. 2017; 20; 12(11): e0188110. DOI:10.1371/journal.pone.0188110.

Osendarp S., Murray-Kolb L., Black M. Case study on iron in mental development - in memory of John Beard (1947-2009). Nutr. Rev. 2010; 68(Suppl. 1): S48-52.

Zhu Y, Liao Q. Prevalence of iron deficiency in children aged 7 months to 7 years in China. Zhonghua Er ke Za Zhi. 2004; 42(12): 886-91.

Suárez T, Torrealba M, Villegas N, Osorio C, García-Casal MN. Iron, folic acid and vitamin B12 deficiencies related to anemia in adolescents from a region with a high incidence of congenital malformations in Venezuela. Arch Latinoam Nutr. 2005; 55(2): 118-23.

Khatiwada S, Gelal B, Baral N, Lamsal M. Association between iron status and thyroid function in Nepalese children. Thyroid Res. 2016; 27; 9:2. DOI: 10.1186/s13044-016-0031-0.

Allen A, Allen S, Rodrigo R, Perera L, Shao W, Li C, et al. Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey. PLoS One. 2017; 20; 12(11): e0188110. DOI: 10.1371/journal.pone.0188110.

Gaenko E.V., Kovalenko L.F. Risk factors and the frequency of iron deficiency anemia in girls of puberty in the conditions of the Far North. Zhurnal akusherstva i zhenskikh bolezney. 2003; t.LII; 1: 40-2. (in Russian)

Rezanova H.B., Gudikova Zh.V., Borovskij I.V. Regional aspects of the formation of the incidence of anemia of the children’s population of Russia. Sibirskiy meditsinskiy zhurnal. 2008; 4: 67-70. (in Russian)

Tarasova I.S. Iron deficiency anemia at children and teenagers. Voprosy sovremennoy pediatrii. 2011; 10 (2): 40-8. (in Russian)

Pashkina I.V., Suplotov S.N. Age and gender features of indicators of iron metabolism in children of the Tyumen region. Zhurnal nauchnykh statey «Zdorov’e i obrazovanie v XXI veke» (Seriya meditsina). 2012; 14(2): 84. (in Russian)

Li S, Gao X, Wei Y, Zhu G, Yang C. The Relationship between Iron Deficiency and Thyroid Function in Chinese Women during Early Pregnancy. J Nutr Sci Vitaminol (Tokyo). 2016; 62(6): 397-401. doi: 10.3177/jnsv.62.397

Shuxiang LI, Xin GAO, Yancai WEI, et al. The Relationship between Iron Deficiency and Thyroid Function in Chinese Women during Early Pregnancy. Journal of Nutritional Science and Vitaminology. 2016; 62(6): 397-401. DOI: 10.3177/jnsv.62.397.

Hosny MA El-Masry, Amira MM Hamed, Mohammed H Hassan et al. Thyroid Function among Children with Iron Deficiency Anaemia: Pre and Post Iron Replacement Therapy. Journal of Clinical and Diagnostic Research. 2018; 12(1): BC01-BC05. DOI: 10.7860/JCDR/2018/32762.1102330.

Zimmermann MB, Kohrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid. 2002; 12(10): 867-78.

Beard J., Tobin B., Green W. Evidence for thyroid hormone deficiency in iron-deficient anemic rats. J.Nutr. 1989; 119(5): 772-8.

Ermans A.M., Camus M. Modifications of thyroid function induced by hronic administration of iodine in the presence of autonomus thyroid tissue. Acta Endocrinol. 1972; 70(3): 463-75.

Azizi F, Mirmiran P, Sheikholeslam R, Hedayati M, Rastmanesh R. The relation between serum ferritin and goiter, urinary iodine and thyroid hormone concentration. Int J Vitam Nutr Res. 2002; 72(5): 296-9.

Dabbaghmanesh MH, Sadegholvaad A, Ejtehadi F, Ranjbar-Omrani G. The role of iron deficiency in persistent goiter. Arch Iran Med. 2008; 11(2): 157-61. DOI: 08112/AIM.007.

Zimmermann MB. Iron status influences the efficacy of iodine prophylaxis in goitrous children in Côte d’Ivoire. Int J Vitam Nutr Res. 2002; 72(1): 19-25.

Lugovskaya S.A., Morozova V.T., Pochtar’ M.E., Dolgov V.V. Laboratornaya gematologiya. Moscow; Тriada. 2006. (in Russian)

WHO: Assessing the Iron status of populations// Report of a Joint WHO/ Centers for Disease Control and Prevention Technical Consultation on the Assessment of Iron Status at the Population/ Geneva, Switzerland, 6-8 April 2004.

WHO. Serum ferritin concentrations for the assessmentof iron status and iron deficiency in populations. Vitaminand Mineral Nutrition Information System. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.2).

ICCIDD/UNICEF/WHO. Assessment of iodine deficiency disorders and monitoring their elimination. 2nd ed. Geneva: World Health Organization. 2001.

Zimmermann M, Hess S, Molinari L, et al. New reference values from thyroid volume by ultrasound in iodine sufficient schoolchildren: a World Health Organization /Nutrition for Health and Development Iodine Deficiency Study Group Report. Am J Clin Nutr. 2004; 79: 231-37.

Dilman E et al. Hipothermia in iron deficiency due to altered triiodthyronine metabolism. American Journal of Phisiology.1980; 239: 377-R381.

Latypova L.F., Amirova Je.F., Ahljamova A.A. The role of monitoring age-related indicators of endocrine gland function in children with iron deficiency anemia. Health and education in the XXI century. 2017; 19 (11): 59-64. (in Russian)

Maldonado-Araque C, Valdés S, Lago-Sampedro A, et al. Iron deficiency is associated with Hypothyroxinemia and Hypotriiodothyroninemia in the Spanish general adult population: Di@bet.es study. Scientific Reports. 2018; 8: 65-71. DOI: 10.1038/s41598-018-24352-9.

Dedov I.I., Troshina E.A., Jushkov P.V., Aleksandrova G.F. Diagnosis and treatment of nodular goiter [Diagnostika i lechenie uzlovogo zoba]. Moscow; Meditsina; 2003. (in Russian)

Akhter S, Nahar ZU, Parvin S, Alam A, Sharmin S, Arslan MI. Thyroid status in patients with low serum ferritin level. J Med Biochem. 2012; 5: 05-11.