Journal of Clinical and Experimental Investigations

Abstract

Objectives: Growth impairment in children with Beta-thalassemia major (BTM) has several possible etiologies including excess iron overload and endocrinologic abnormalities. We aimed to assess growth in children with BTM and its relation with serum ferritin, thyroid hormones, IGF1 and IGFBP3.
Materials and methods: Thirty-three children with BTM and 30 healthy children (control group) matched in age, sex and height were subjected to full clinical history and examination, including anthropometric measurements. Fasting blood samples from both groups were taken for complete blood counts, fasting blood sugar, liver function tests, serum ferritin, thyroid profiles, IGF1 and IGFBP3. Bone ages for both groups were determined radiologically.
Results: A total of 57.6% of BTM group had retarded linear growth and 45.5% of them were with delayed puberty. There was statistical significant decrease in upper/lower segment (U/L) ratio in the BTM group compared to the control group (p=0.035). No apparent hypothyroidism was found in the thalassemia group, but significant decreases were found in both IGF1 and IGFBP3 levels of the thalassemia group compared with the control group (p=0.022 and p=0.037, respectively). There was a significant correlation between T4 and U/L ratio (p<0.05); IGF1 was significantly correlated with height, duration of transfusions and duration of chelation (p<0.05). No significant correlation was found between serum ferritin and other variables of the patients.
Conclusions: Growth retardation in children with BTM is evident despite regular transfusions and chelation therapy, especially in children with older age and the cause is mainly in growth hormone-IGF1 and IGFBP3 axis.