Endocrinopathy complications and the role of serum ferritin as a marker of endocrinopathy prediction in patients with beta-thalassemia major

• Main Authors: Seyed Kamal Eshaqh-hosseini, Tohid Jafari-Koshki, Shahram Arsang-Jang, Javad Shapouri
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Advances in Human Biology
• Subjects: Diabetes; hypocalcemia; Iran; Iron overload; pubertal delay
• Online Access: http://www.aihbonline.com/article.asp?issn=2321-8568;year=2018;volume=8;issue=3;spage=169;epage=174;aulast=Eshaqh-hosseini
• ISSN: 2321-8568; 2348-4691

Background: This study aimed to estimate the prevalence of complications and in β-thalassemia patients, to identify its related risk factors and to determine the optimal thresholds of serum ferritin and disease duration as a predictor of the endocrine disease. Materials and Methods: A total of 140 patients with β-thalassemia major, 65 (46.4%) male with a mean age of 21.4 ± 7.5 (range 8–39) years were enrolled in this study. Logistic regression and receiver operating characteristic curve were used to estimate the diagnostic power of ferritin level and determine the optimal cut points. Results: The serum ferritin level was 3395 ± 2611 μg/L with stable trend across the last 5 years. Puberty delay was the most common complication with the prevalence of 33.6%. There was a significant association between ferritin levels and hypocalcaemia (odds ratio [OR] = 1.29, P = 0.001), short stature (OR = 1.04, P < 0.001) and puberty delay (OR = 1.02, P = 0.002). A >2100 μg/L and >3400 μg/L optimal cut-off values of serum ferritin level for puberty delay was 2100 area under the curve (AUC = 0.78, P = 0.004) and 3400 for short stature (AUC = 0.74, P < 0.0001). Conclusions: Progressive deterioration of endocrine dysfunction and inadequacy of chelation therapy in older patients are endocrine complications amongst beta-thalassemia major patients that need more attention. Prosperous control of the ferritin levels before puberty with deferoxamine appeared to be an effective treatment to prevent and reduce diabetes and hypothyroidism. The serum ferritin >1500 μg/L along with early second decade of illness is the best predictor for the development the endocrinopathy.