Evaluation of Osteopontin and Malondialdehyde Level and its Correlation with Iron Status in Hypothyroidism Patients: A Case-control Study

Introduction: Hypothyroidism is a clinical condition characterised by abnormally low thyroid hormone production. Hypothyroidism is associated with increased Malondialdehyde (MDA), Total Iron Binding Capacity (TIBC) and decreased Osteopontin (OPN), iron and ferritin level.

Aim: To evaluate OPN and MDA level and its correlation with iron status in hypothyroidism subjects also to compare the OPN, MDA, iron, ferritin and TIBC levels in cases with the controls.

Materials and Methods: This case-control study was done at Santosh Medical College, Ghaziabad, in collaboration with Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India from September 2018 to September 2020. The current study involved a total of 240 female participants. There were 120 female hypothyroidism (cases) and 120 female normal healthy (control) participants of the same age group in the current study (30-60 years). Blood samples were collected from all participants and analysed for OPN, MDA, iron, ferritin and TIBC. OPN was estimated using sandwich- Enzyme Linked Immunosorbent Assay (ELISA) method. MDA was estimated by Kei satoh method. Serum ferritin was estimated by Immuno-turbidimetric on Access 2 Immunoassay Beckman Coulter and serum iron and TIBC were estimated by Beckman Coulter AU480 Clinical Chemistry Analyser. Pearson’s correlation was used to evaluate the association between these parameters, which were represented as mean with Standard Deviation (SD).

Results: Female hypothyroidism subjects had significantly (p-value <0.001 for all) increased body mass index, waist circumference, hip circumference, and waist hip ratio than controls. Study showed increased levels of MDA and TIBC and decreased levels of serum OPN, ferritin and iron in hypothyroid subjects as compared to controls. A significant positive correlation was found between OPN vs ferritin (r=0.465, p-value <0.001), OPN vs iron (r=0.521, p-value <0.001) , MDA vs TIBC (r-value=0.591, p-value <0.001), whereas significant negative correlation was found between OPN vs TIBC (r=-0.454, p-value <0.001), OPN vs MDA (r=-0.501, p-value <0.001), MDA vs ferritin (r=-0.543, p-value <0.001) and MDA vs iron (r=-0.573, p-value <0.001).

Conclusion: The decreased levels of OPN and increased level of MDA in hypothyroidism subject, which increases risk of iron deficiency anaemia in hypothyroidism patients. Furthermore, OPN and MDA were well correlated with ferritin, iron and TIBC in hypothyroidism subjects. As a result, these aspects should be considered while assessing risks of iron deficiency anaemia in hypothyroidism.