Prevalence of Endocrinopathies in Turkish Children With β-Thalassemia Major: A Single-Center Study

Abstract

Present chelation protocols have increased the life quality and survival of the patients with β-thalassemia major (BTM). However, endocrine complications are still mostly experienced. The aim of this study was to determine the prevalence of endocrine complications in children with BTM, and to study the relationship between serum ferritin levels and complications. Forty-five children (female: 23/male: 22, mean age: 12.39±3.72 y) with BTM were enrolled into the study. Blood samples were taken after an overnight fasting, early in the morning from entire study group. Median (range) serum ferritin of the patients was 1365 ng/mL (362 to 5996 ng/mL). The most prevalent endocrine complications were vitamin D insufficiency (54.5%), short stature (42%), pubertal impairment (25% for each sex), and osteopenia (13%), respectively. Ferritin levels were not correlated with anthropometric or laboratory data. Monitoring of growth, vitamin D status, and endocrine functions are essential to achieve a good quality of life in BTM patients.

A Systematic Review and Meta-Analysis of Stature Growth Complications in β-thalassemia Major Patients

“…After that, 433 records were excluded, and 213 records entered full-text assessment for eligibility criteria. Finally, 74 studies included in the meta-analysis ( Figure 1 ) [ 6 7 11 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 ].…”

Elevated Prevalence of Abnormal Glucose Metabolism and Other Endocrine Disorders in Patients withβ-Thalassemia Major: A Meta-Analysis

“…The selection flow chart is shown in Figure 1. Of the included studies, seven studies [30, 33, 34, 36, 39, 40, 43] were from Italy; seven studies [14, 16, 18, 20, 21, 31, 42] were from Iran; five studies [17, 19, 27, 44, 45] were from Egypt; five studies [4, 8, 22, 23, 35] were from the China region, including the mainland [22], Hong Kong [23], and Taiwan [4, 8, 35]; three studies [11, 12, 32] were from India; two studies [41, 47] were from Arabia; one study [37] was from Germany. The other studies were from Australia [26], Brazil [3], France [9], Lebanon [41], Oman [15], Turkey [25, 38], the United Kingdom [46], and the United States of America [2].…”

“…Seven studies [12, 14, 18, 22, 32, 34, 44] examined impaired fasting glucose. The results of the analysis showed that the prevalence of IFG in β -thalassemia major was 17.21% (95% CI: 8.43%-26.00%).…”

“…Impaired glucose tolerance was inconsistently mentioned, and twelve studies were reported [13, 14, 19, 25, 27–29, 32, 35, 37, 44, 47]. The results of the analysis showed that the prevalence of IGT in β -thalassemia major was 12.46% (95% CI: 5.98%-18.94%).…”

Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations

“…Left ventricular ejection fraction and shortening fraction were positively correlated with 25(OH)D, while indices of cardiac stress (NT-proBNP) were negatively correlated with serum vitamin D. 66 In addition, cardiac T2*, a marker of cardiac iron unloading, was positively associated with 25(OH)D. 24 Wood et al 57 Intervention with high-dose supplemental vitamin D ( > 50,000 IU/wk) consistently increases serum 25(OH)D in subjects with Thal (Table 1). 23,62 In a single-arm study conducted in †Levels of evidence generated from the 2016 publication by the American Society of Plastic Surgeons (ASPS) available at: www.plasticsurgery.org/ documents/medical-professionals/quality-resources/ASPS-Evidence%E2%80%90Based-Clinical-Practice-Guideline-Methodology.pdf. Strong: represents a recommendation based on 2 or more "high" quality studies with consistent findings, where benefit to the patient is evident.…”