Relationship Between Endocrinopathies and Ferritin Levels in Adult Turkish Patients with Beta Thalassemia Major: A Single-Center Experience

Abstract

Objective: Despite regular transfusions and iron-chelation therapies, endocrine complications still remain an important cause of morbidity in patients with beta thalassemia major (BTM). We aimed to evaluate the relationship between endocrine complications and serum ferritin levels in adult patients with BTM. Materials and Methods: The endocrine test results of adult patients with BTM were retrospectively reviewed. Normality testing was performed using the Shapiro-Wilk test. For the analysis, we used an independent samples t-test when parametric test assumptions were met: otherwise we used Mann-Whitney U test. A p value of <0.05 was considered statistically significant. Results: A total of 66 adult patients with BTM. (female: 56.1%, male: 43.9%, mean age: 25.8 +/- 6.6 years) were evaluated. The mean ferritin level was 1504.9 +/- 861 ng/ml (range 304-5464 ng/ml). Of the patients, 60.6% had endocrinopathy. The rates of hypogonadism was 51.5%, hypothyroidism was 16.7% (subclinical hypothyroidism: 13.6%, central hypothyroidism: 3.03%), hypoparathyroidism was 10.6%, diabetes mellitus was 7.6%, vitamin D insufficiency was 40.9%, vitamin D deficiency was 33.3%, low bone mass was 56.1%, and that of low IGF-1 was 57.6%. We found a significant relationship between ferritin levels and the presence of hypogonadism, low bone mass, and low IGF-1 levels (p<0.001). Patients used higher doses of deferasirox due to iron overload (p<0.001). Patients needed higher deferasirox doses to decrease ferritin levels. Conclusion: Among adult patients with BTM, endocrinopathies were prevalent in patients with elevated ferritin levels. Patients with BTM should undergo regular testing for endocrine disorders, and ferritin levels must be kept under control.