| Background: This study aimed to estimate the prevalence of complications and in β‑thalassemia patients, to identify its related risk factors and to
determine the optimal thresholds of serum ferritin and disease duration as a predictor of the endocrine disease. Materials and Methods: A total
of 140 patients with β‑thalassemia major, 65 (46.4%) male with a mean age of 21.4 ± 7.5 (range 8–39) years were enrolled in this study.
Logistic regression and receiver operating characteristic curve were used to estimate the diagnostic power of ferritin level and determine the
optimal cut points. Results: The serum ferritin level was 3395 ± 2611 µg/L with stable trend across the last 5 years. Puberty delay was the
most common complication with the prevalence of 33.6%. There was a significant association between ferritin levels and hypocalcaemia
(odds ratio [OR] = 1.29, P = 0.001), short stature (OR = 1.04, P < 0.001) and puberty delay (OR = 1.02, P = 0.002). A >2100 µg/L and >3400 µg/L
optimal cut‑off values of serum ferritin level for puberty delay was 2100 area under the curve (AUC = 0.78, P = 0.004) and 3400 for short
stature (AUC = 0.74, P < 0.0001). Conclusions: Progressive deterioration of endocrine dysfunction and inadequacy of chelation therapy in
older patients are endocrine complications amongst beta‑thalassemia major patients that need more attention. Prosperous control of the ferritin
levels before puberty with deferoxamine appeared to be an effective treatment to prevent and reduce diabetes and hypothyroidism. The serum
ferritin >1500 µg/L along with early second decade of illness is the best predictor for the development the endocrinopathy. |