The association between
iron overload indices and pathology of the heart and liver in transfusion-dependent patients with β
thalassemia major (TM) has been extensively studied. Nonetheless, data on
endocrine disease remains limited. This was a cross-sectional study of 382 TM patients treated with regular transfusions and
desferrioxamine at the
Thalassemia Center in Dubai, UAE. Retrieved data included demographics,
splenectomy status, steady-state serum
ferritin levels, and the presence of endocrinopathies (
diabetes mellitus,
hypothyroidism,
hypoparathyroidism, and
hypogonadism). Multivariate logistic regression analyses were used to determine which variables were independently associated with the occurrence of each endocrinopathy. The mean age of patients was 15.4 ± 7.6 years, with an equal sex distribution. The mean serum
ferritin level was 2597.2 ± 1976.8 μg/l. The frequencies of specific endocrinopathies were
diabetes mellitus (10.5%),
hypothyroidism (6.3%),
hypoparathyroidism (10.5%), and
hypogonadism (25.9%). On multivariate logistic regression analysis, patients with a serum
ferritin level >2,500 μg/l, but not >1,000-2,500 μg/l, were 3.53 times (95% CI 1.09-11.40) more likely to have
diabetes mellitus, 3.25 times (95% CI 1.07-10.90) more likely to have
hypothyroidism, 3.27 times (95% CI 1.27-8.39) more likely to have
hypoparathyroidism, and 2.75 times (95% CI 1.38-5.49) more likely to have
hypogonadism compared to patients with a serum
ferritin level ≤1,000 μg/l. However, splenectomized patients with serum
ferritin levels ≤2,500 μg/l had comparably high rates of all endocrinopathies as patients with serum
ferritin levels >2,500 μg/l. Endocrinopathy is common in TM patients treated with
desferrioxamine therapy, especially in patients with serum
ferritin levels >2,500 μg/l or those splenectomized.