Iron overload has a negative correlation with some measures of endocrine function in patients with transfusion-dependent beta thalassemia and growth retardation, according to research in the Journal of Blood Medicine.

People with transfusion-dependent beta thalassemia are at risk of iron overload. Whether iron overload is correlated with endocrine function or growth retardation has not been established. Previous studies have shown that patients with thalassemia tend to have endocrine disorders.

The study authors sought to determine a correlation between transfusion-dependent beta thalassemia and growth retardation in adult patients in Indonesia. The final cross-sectional study included data from 58 adults who had transfusion-dependent beta thalassemia and growth retardation. The subjects had an average height of 149.05 cm, with a Mid Parental Height of 161.25 cm used as the target for patient’s height.

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A total of 79.3% of patients (n=39) had low insulin-like growth factor 1 (IGF-1), and 32.7% (n=19) had subclinical hypothyroidism. Patients with subclinical hypothyroidism had elevated thyroid stimulating hormone (TSH) but normal free T4 (fT4) levels, and most had no symptoms.

The results found a weak, but significant, negative correlation between serum ferritin and fT4 (r=-.361; P =.003) and IGF-1 (r=-.313; P =.008). Serum ferritin and TSH had no significant correlation. There was no correlation between transferrin saturation and fT4, IGF-1, or TSH.

Patients did not have low TSH or fT4 level, which indicates that iron overload did not cause serious damage to the pituitary or thyroid glands.

Overall, the study found a high proportion of patients with low IGF-1. Transferrin saturation did not correlate to thyroid dysfunction. 


Atmakusuma TD, Hasibuan FD, Purnamasari D. The correlation between iron overload and endocrine function in adult transfusion-dependent beta-thalassemia patients with growth retardation. J Blood Med. 2021;12:749-753. doi:10.2147/JBM.S325096