Document Type : original article
1 Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
3 1- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences
Background: Endocrinopathies are common complications in Thalassemia Major (TM) patients. They are important as secular trends of complications in childhood as a critical period for growth and development. The present study, then, aimed to investigate these complications in children and young adults.
Methods: 34 TM patients, with the mean age of 19 ± 6 y/o, entered this study. Female to male ratio was 21/13. Their medical history was obtained by review of medical records. Data about FBS, AST, ALT, TG, cholesterol, and ferritin, TSH, LH and FSH was collected. Due to the lack of normality of some continuous variables, an appropriate transformation method was implemented to convert them to normal distribution. Repeated measure ANOVA was used to assess change of outcomes across time. Correlations between different parameters were also calculated.
Results: After 3 years, only FBS changed significantly in comparison to phase 1 and 2 results (P-value=0.028). Ferritin in the first phase significantly correlated with ALT (P-value = 0.021), in the second phase with AST (P-value=0.029) and ALT (P-value=0.002) and in the third phase with FSH, LH and TG (P-value=0.047, 0.020, 0,027, respectively). In the first phase AST correlated with TG and cholesterol (P-value=0.015, 0.001, respectively) and ALT with cholesterol (P-value <0.001). ALT correlated with TG in the second phase (P-value=0.040). ALT and AST correlated with cholesterol in the third phase (P-value=0.002, 0.007, respectively).
Conclusion: Hormonal parameters do not show significant change during a 3 years period in TM patients.
- Mohajeri-Tehrani MR, Darvishian N, Arab F, Salemkar S, Mohseni F, Larijani B, Hamidi Z. The role of using different reference populations in the prevalence of low BMD in thalassemia patients. 2020; 19(1):431-5.
- Hamidi Z. What We Learn from Bone Complications in Congenital Diseases? Thalassemia, an Example. Osteoporosis: IntechOpen; 2012.
- Belhoul KM, Bakir ML, Saned M-S, Kadhim A, Musallam KM, Taher ATJAoh. Serum ferritin levels and endocrinopathy in medically treated patients with β thalassemia major. 2012; 91(7):1107-14.
- Mahmoud RA, Khodary A, Farhan MSJIJoP. Detection of endocrine disorders in young children with multi-transfused thalassemia major. 2021; 47(1):1-8.
- Jensen C, Tuck S, Agnew J, Koneru S, Morris R, Yardumian A, Prescott E, Hoffbrand AV, Wonke B. High prevalence of low bone mass in thalassaemia major. 1998; 103(4):911-5.
- Poggi M, Sorrentino F, Pugliese P, Smacchia MP, Daniele C, Equitani F, Terlizzi F, Guitarrini MR, Monti S, Maffei L, Losardo A, Pasin M, Toscano V. Longitudinal changes of endocrine and bone disease in adults with β-thalassemia major receiving different iron chelators over 5 years. 2016; 95(5):757-63.
- Cairo H, Holl RW, Debatin K-M, Kohne EJEjop. Insulin sensitivity and β-cell secretion in thalassaemia major with secondary haemochromatosis: assessment by oral glucose tolerance test. 2003; 162(3):139-46.
- Dhouib NG, Khaled MB, Ouederni M, Besbes H, Kouki R, Mellouli F, Bejaoui M. Growth and endocrine function in Tunisian thalassemia major patients. 2018; 10(1).
- Mohajeri-Tehrani M-R, Hamidieh AA, Naghash A, Behfar M, Alimoghaddam K, Mohseni F, et al. How thalassemia affects endocrinological, BMD and bone metabolism parameters-a cross sectional study. 2019; 7(1):0-.
- Hamidieh AA, Mohseni F, Behfar M, Hamidi Z, Alimoghaddam K, Pajouhi M, Larijani B, Mohajeri-Tehrani MR, Ghavamzadeh A. Short-term Assessment of HSCT Effects on the Hypothalamus-Pituitary Axis in Pediatric Thalassemic Patients. 2018; 21(2).
- Hamidi z, mohajeri-tehrani m, alemzadeh a, abbaszadeh-marzbali f, naseri-sina s, hosnan f, et al., editors. How demographic and transfusional parameters effects bmd and endocrinological disorders in thalassemia major patients: an experience with 114 patients. Osteoporosis international; 2017: springer london ltd 236 grays inn rd, 6th floor, london wc1x 8hl, england.
- Shahriari M, Sadjadian NJE-EMHJ, 9, 55-60. Prevalence of endocrine complications in beta-thalassaemia major in the Islamic Republic of Iran. 2003.
- De Sanctis V, Soliman AT, Canatan D, Yassin MA, Daar SJRldMdA-V. How to screen, evaluate and treat hypothyroidism in homozygous ß-thalassemia (3-thal) patients. 2019; 17(1).
- De Sanctis V, Daar S, Soliman AT, Tzoulis P, Karimi M, Di Maio S, Kattamis C. Screening for glucose dysregulation in β-thalassemia major (β-TM): An update of current evidences and personal experience. 2022; 93(1).
- De Sanctis V, Soliman AT, Yassin MA, Di Maio S, Daar S, Elsedfy H, Soliman N, Kattamis C. Hypogonadism in male thalassemia major patients: pathophysiology, diagnosis and treatment. 2018; 89(Suppl 2):6.
- Altincik A, Akin MJJopho. Prevalence of endocrinopathies in Turkish children with β-thalassemia major: a single-center study. 2016; 38(5):389-93.
- Sharma R, Seth A, Chandra J, Gohain S, Kapoor S, Singh P, Pemde H. Endocrinopathies in adolescents with thalassaemia major receiving oral iron chelation therapy. 2016; 36(1):22-7.
- Kell DB, Pretorius EJM. Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. 2014; 6(4):748-73.
- Fan N, Peng L, Xia Z, Zhang L, Song Z, Wang Y, Peng Y. Triglycerides to high-density lipoprotein cholesterol ratio as a surrogate for nonalcoholic fatty liver disease: a cross-sectional study. 2019; 18(1):1-6.
- Arguello G, Balboa E, Arrese M, Zanlungo SJBeBA-MBoD. Recent insights on the role of cholesterol in non-alcoholic fatty liver disease. 2015; 1852(9):1765-78.