How Age, Sex and Transfusion Affects the Incidence of Endo-crine and Bone Density Disorders in Major Thalassemic Patients

Mohammad-Reza  Mohajeri-Tehrani; Seyyed Amirsina  Alemzadeh; Fatemeh Abbaszadeh  Marzbali; Sadaf  Nasserisina; Fatemeh  Hosnan; Ameneh  Naghghash; Amir Ali  Hamidieh; Maryam  Behfar; Fariba  Mohseni; Hoda  Rashidian; Sara  Shirazi; Maryam  Aboee-Rad; Mostafa  Qorbani; Bagher  Larijani; Zohreh Hamidi

doi:10.18502/ijph.v53i2.14928

Mohammad-Reza Mohajeri-Tehrani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Seyyed Amirsina Alemzadeh Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Fatemeh Abbaszadeh Marzbali Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Sadaf Nasserisina Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Fatemeh Hosnan Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Ameneh Naghghash Thalassemia Department, Torfeh Hospital, Shahid Beheshti University, Tehran, Iran
Amir Ali Hamidieh Pediatric Stem Cell Transplant Department Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Maryam Behfar Pediatric Stem Cell Transplant Department Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Fariba Mohseni Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Hoda Rashidian Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Sara Shirazi Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Maryam Aboee-Rad Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Mostafa Qorbani Non-Communicable Diseases Research Center, Alborz University of Medical Science, Karaj, Iran
Bagher Larijani Thalassemia Department, Torfeh Hospital, Shahid Beheshti University, Tehran, Iran
Zohreh Hamidi Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v53i2.14928

Keywords: Thalassemia; Endocrine; Bone; Thyroid; Blood sugar

Abstract

Background: Beta-thalassemia major patients frequently have endocrinopathies. We tried to determine relation between demographic and transfusion factor and endocrinopathies.

Methods: Major beta-thalassemia patients (n=114 cases), 3–38 yr of age, entered this study. Female to male ratio was 51/63. Children (less than 20 yr) formed 57% of participants. Information about bone mineral density (BMD) and hormonal and biochemistry blood evaluation including fasting blood sugar (FBS), ferritin, triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH), testosterone (males), and estradiol (females) entered data sheet.

Results: Sex and ferritin level showed no significant correlation with above disorders. Age significantly correlated to short stature, diabetes, low BMD at femur and neck (P, 0.031, 0.008, 0.009 and <0.001, respectively). The risk of short stature had increased in 12 yr and older patients 7.71 times than younger patients (P= 0.008). The risk of diabetes had increased in 35 yr and older patients 26.25 times than younger patients (P= 0.03). The risk of Z-score ≤ -2 in femoral region has increased in 19 yr and older patients 5.84 times than younger patients (P= 0.002). The risk of Z-score ≤ -2 in spinal region has increased in 14 yr and older patients 17 times than younger patients (P= 0.007).

Conclusion: The main factor related with endocrinopathies was age. The correlation between age and short stature, diabetes and low BMD was positive. Therefore, we recommend early monitoring of thalassemia patients (in their late childhood and early teenage) for these complications.