Comparison of erythrocyte glucose-6-phosphate dehydrogenase (G6PD) enzyme activity and thyroid hormone levels in beta-thalassemia carriers and healthy individuals

Rouzbehan, Sahereh; Rezaei gorjaei , Soroosh; Ghasemi, Mohammad Jafar; Shafiee, Sayed Mohammad

Volume 13, Issue 2 (6-2025) jmsthums 2025, 13(2): 56-67 | Back to browse issues page

Mendeley

Zotero

RefWorks

Rouzbehan S, Rezaei gorjaei S, Ghasemi M J, Shafiee S M. Comparison of erythrocyte glucose-6-phosphate dehydrogenase (G6PD) enzyme activity and thyroid hormone levels in beta-thalassemia carriers and healthy individuals. jmsthums 2025; 13 (2) :56-67
URL: http://jms.thums.ac.ir/article-1-1405-en.html

Comparison of erythrocyte glucose-6-phosphate dehydrogenase (G6PD) enzyme activity and thyroid hormone levels in beta-thalassemia carriers and healthy individuals

Sahereh Rouzbehan¹

, Soroosh Rezaei gorjaei¹

, Mohammad Jafar Ghasemi¹

, Sayed Mohammad Shafiee²

1- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
2- Department of Clinical Biochemistry, School of Medicine Shiraz University of Medical Sciences, Shiraz, Iran & Autophagy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract: (13 Views)

Background & Aim: Thyroid hormones are affected by oxidative conditions and the functional status of follicular cells. It has been suggested that decreased G6PD activity in individuals with beta-thalassemia may increase oxidative stress and cause thyroid dysfunction. Therefore, this study aimed to compare erythrocyte glucose-6-phosphate dehydrogenase (G6PD) enzyme activity and thyroid hormone levels (TSH and free T4) in beta-thalassemia carriers (beta-thalassemia minor) and healthy individuals.
Methods: This study was conducted on blood samples from 120 participants (some with beta-thalassemia minor and some healthy controls) who were referred to Dastgheib Hospital in Shiraz City. Thyroid hormones (TSH and FT4) and G6PD enzyme activity were measured. Data were analyzed using SPSS version 26, employing the Mann–Whitney and Chi-square statistical tests.
Results: The frequency of G6PD enzyme deficiency was the same in both groups (five individuals each), and Fisher’s exact test showed no statistically significant difference between the groups (p = 1). The mean ± SD of FT4 levels in the control group was 1.00 ± 0.26 ng/dL, and in the beta-thalassemia minor group, it was 1.19 ± 0.83 ng/dL. The Mann–Whitney test showed no statistically significant difference (p = 0.781). The mean ± SD of TSH levels in the control group was 3.19 ± 2.30 mIU/L, and in the beta-thalassemia minor group, 3.23 ± 2.34 mIU/L, with no significant difference between the two groups (p = 0.823).
Conclusion: This study showed that there is no meaningful association between thyroid hormone levels and the quality (levels) of G6PD enzyme between normal individuals and those with beta-thalassemia minor. It is recommended that this issue be investigated in other populations with different races and age groups.

Keywords: Beta-thalassemia minor, Thyroid hormones, G6PD enzyme

Full-Text [PDF 364 kb] (26 Downloads)

Type of Study: Research | Subject: Special
Received: 2024/11/15 | Accepted: 2025/05/16 | Published: 2025/11/16

References

1. Shah SS, Stone EF, Francis RO, Karafin MS. The global role of G6PD in infection and immunity. Frontiers in Immunology. 2024;15:1393213. [DOI:10.3389/fimmu.2024.1393213]

2. Kwok MK, Leung GM, Yeung SLA, Schooling CM. Glucose-6-phosphate dehydrogenase deficiency and metabolic profiling in adolescence from the Chinese birth cohort:"Children of 1997". International Journal of Cardiology. 2019;281:146-9. [DOI:10.1016/j.ijcard.2019.01.100]

3. Richardson SR, O'Malley GF. Glucose-6-phosphate dehydrogenase deficiency. 2017.

4. Luzzatto L, Bancone G, Dugué P-A, Jiang W, Minucci A, Nannelli C, et al. New WHO classification of genetic variants causing G6PD deficiency. Bulletin of the World Health Organization. 2024;102(8):615. [DOI:10.2471/BLT.23.291224]

5. Galanello R, Origa R. Beta-thalassemia. Orphanet journal of rare diseases. 2010;5:1-15. [DOI:10.1186/1750-1172-5-11]

6. Evangelidis P, Venou T-M, Fani B, Vlachaki E, Gavriilaki E. Endocrinopathies in hemoglobinopathies: what is the role of iron? International Journal of Molecular Sciences. 2023;24(22):16263. [DOI:10.3390/ijms242216263]

7. Cao A, Galanello R. Beta-thalassemia. Genetics in medicine. 2010;12(2):61-76. [DOI:10.1097/GIM.0b013e3181cd68ed]

8. Pornprasert S, Phanthong S. Anemia in patients with coinherited thalassemia and glucose-6-phosphate dehydrogenase deficiency. Hemoglobin. 2013;37(6):536-43. [DOI:10.3109/03630269.2013.819558]

9. Viprakasit V, Ekwattanakit S. Clinical classification, screening and diagnosis for thalassemia. Hematology/Oncology Clinics. 2018;32(2):193-211. [DOI:10.1016/j.hoc.2017.11.006]

10. Venou T-M, Barmpageorgopoulou F, Peppa M, Vlachaki E. Endocrinopathies in beta thalassemia: a narrative review. Hormones. 2024;23(2):205-16. [DOI:10.1007/s42000-023-00515-w]

11. Viguerie N, Langin D. Effect of thyroid hormone on gene expression. Current Opinion in Clinical Nutrition & Metabolic Care. 2003;6(4):377-81. [DOI:10.1097/01.mco.0000078998.96795.e7]

12. Shulhai A-M, Rotondo R, Petraroli M, Patianna V, Predieri B, Iughetti L, et al. The role of Nutrition on thyroid function. Nutrients. 2024;16(15):2496. [DOI:10.3390/nu16152496]

13. Núñez A, Bedregal P, Becerra C, Grob L. Neurodevelopmental assessment of patients with congenital hypothyroidism. Revista Medica De Chile. 2017;145(12):1579-87. [DOI:10.4067/s0034-98872017001201579]

14. Lassman M, O'brien R, Pearson H, Wise J, Donabedian R, Felig P, et al. Endocrine evaluation in thalassemia major. Annals of the New York Academy of Sciences. 1974;232(1):226-37. [DOI:10.1111/j.1749-6632.1974.tb20589.x]

15. Flyn D, Fairmen A, Jackson D, Clayton B. Hormonal changes in thalassemia major. Arch Dis Child. 1976;57:828. [DOI:10.1136/adc.51.11.828]

16. Magro S, Puzzonia P, Consarino C, Galati M, Morgione S, Porcelli D, et al. Hypothyroidism in patients with thalassemia syndromes. Acta haematologica. 1990;84(2):72-6. [DOI:10.1159/000205032]

17. Grundy R, Woods K, Savage M, Evans J. Relationship of endocrinopathy to iron chelation status in young patients with thalassaemia major. Archives of disease in childhood. 1994;71(2):128-32. [DOI:10.1136/adc.71.2.128]

18. Greengard O. Hormonal regulation of enzyme synthesis in differentiating mammalian tissues. Harvard Medical School, Boston, Mass.(USA); New England Deaconess Hospital …, 1974. [DOI:10.2172/4220794]

19. Orosz F, Wágner G, Ortega F, Cascante M, Ovádi J. Glucose conversion by multiple pathways in brain extract: theoretical and experimental analysis. Biochemical and biophysical research communications. 2003;309(4):792-7. [DOI:10.1016/j.bbrc.2003.08.072]

20. Haghighi B, Mesripour A, Mesripour M. The Effects of Hypo-and Hyperthyroidism on Glucose 6-Phosphate Dehydrogenase Activities in Regions of Rat Brain. 2005.

21. Björkman U, Ekholm R. Generation of H2O2 in isolated porcine thyroid follicles. Endocrinology. 1984;115(1):392-8. [DOI:10.1210/endo-115-1-392]

22. Dore MP, Fanciulli G, Pes GM. Is glucose-6-phosphate dehydrogenase deficiency a risk factor for autoimmune thyroid disease? A retrospective case-Control study. International Journal of Environmental Research and Public Health. 2023;20(3):2709. [DOI:10.3390/ijerph20032709]

23. Moustafa SA. Effect of glutathione (GSH) depletion on the serum levels of triiodothyronine (T3), thyroxine (T4), and T3/T4 ratio in allyl alcohol-treated male rats and possible protection with zinc. International journal of toxicology. 2001;20(1):15-20. [DOI:10.1080/109158101750103332]

24. Luzzatto L, Ally M, Notaro R. Glucose-6-phosphate dehydrogenase deficiency. Blood, The Journal of the American Society of Hematology. 2020;136(11):1225-40. [DOI:10.1182/blood.2019000944]

25. Farasat T, Liaqat A, Mughal T. Assessment of thyroid hormones level in premenopausal and postmenopausal females. J App Pharm. 2010;1(3):165-78. [DOI:10.21065/19204159.3.33]

26. Moosazadeh M, Amiresmaili M, Aliramezany M. Prevalence of G6PD deficiency in Iran, a mata-analysis. Acta medica Iranica. 2014:256-64.

27. Beutler E, Blume K, Kaplan J, Löhr G, Ramot B, Valentine W. International Committee for Standardization in Haematology: recommended screening test for glucose‐6‐phosphate dehydrogenase (G‐6‐PD) deficiency. British journal of haematology. 1979;43(3):465-7. [DOI:10.1111/j.1365-2141.1979.tb03774.x]

28. Kaplan M, Leiter C, Hammerman C, Rudensky B. Comparison of commercial screening tests for glucose-6-phosphate dehydrogenase deficiency in the neonatal period. Clinical chemistry. 1997;43(7):1236-7. [DOI:10.1093/clinchem/43.7.1236]

29. Albuquerque KV, Miller AA, Roeske JC. Implementation of electronic checklists in an oncology medical record: initial clinical experience. Journal of Oncology Practice. 2011;7(4):222-6. [DOI:10.1200/JOP.2011.000237]

30. Viherkoski M, Lamberg B-A. The glucose-6-phosphate dehydrogenase activity (G-6-PD) of the red blood cells in hyperthyroidism and hypothyroidism. Scandinavian Journal of Clinical and Laboratory Investigation. 1970;25(2):137-43. [DOI:10.3109/00365517009049195]

31. Nehal M, Baquer N. Changes in hexokinase and glucose-6-phosphate dehydrogenase in red cells during hypo and hyperthyroidism. Biochemistry International. 1989;19(1):193-9.

32. Yilmaz S, Ozan S, Benzer F, Canatan H. Oxidative damage and antioxidant enzyme activities in experimental hypothyroidism. Cell Biochemistry and Function: Cellular biochemistry and its modulation by active agents or disease. 2003;21(4):325-30. [DOI:10.1002/cbf.1031]

33. Kaur P, Brar RK, Suri AK, Kaur N. G6PD deficiency and Thalassemia: Is there any correlation? An institutional study from Northern India.

34. SHAHRIARI M, KHALGH EM. EFFECT OF G6PD DEFICIENCY ON HEMATOLOGICAL INDICES IN BETA THALASSEMIA MINOR. 2004.

35. Eshragi P, Tamaddoni A, Zarifi K, Mohammadhasani A, Aminzadeh M. Thyroid function in major thalassemia patients: Is it related to height and chelation therapy? Caspian journal of internal medicine. 2011;2(1):189.

36. Benli AR, Yildiz SS, Cikrikcioglu MA. An evaluation of thyroid autoimmunity in patients with beta thalassemia minor: A case-control study. Pakistan Journal of Medical Sciences. 2017;33(5):1106. [DOI:10.12669/pjms.335.13210]