Endocrine Disorders in Adult Beta-Thalassemia Patients: Insights from a Long-Term Follow-Up

Objective: There are limited studies regarding endocrine complications in Turkish adult thalassemic patients. Data regarding newly emerging endocrine complications in the long-term monitoring of adult patients with beta-thalassemia are also quite limited.

Methods: The study was a single-center cohort study involving 103 adult patients with betathalassemia.

Results: The most frequent endocrine disorder was vitamin D insufficiency (69%), whereas the most common endocrine complications were hypogonadism (56%) and osteoporosis (37%), in thalassemic patients. Three or more endocrine disorders were present in 42% of the patients. Patients with hypogonadism had higher ferritin levels (P=.014), lower hemoglobin concentrations (P=.028), and increased myocardial iron deposition (P=.002) compared to those without hypogonadism. There was also a link between 5-year calculated mean ferritin levels and fasting plasma glucose (r=0.29, P=.004) and 75 g oral glucose tolerance test second-hour glucose levels (r=0.46r=0.46, P=.001). Osteoporosis was more common in patients with hypogonadism (51% vs. 21%, P=.003) and diabetes (75% vs. 35%, P=.027). The remaining endocrine problems, on the other hand, were not linked to thalassemia-related characteristics or each other. In 3 and 5 years of follow-up, 16% and 12% of patients developed a new endocrine–metabolic complication, respectively, with osteoporosis and prediabetes/diabetes being the most common.

Conclusion: A significant proportion of adult thalassemic patients have multiple endocrine–metabolic complications. All patients with thalassemia major, regardless of their ferritin levels, should be evaluated for the occurrence of endocrine complications. Endocrinologists should be especially vigilant during long-term follow-up for the development of glucose metabolism disorders and osteoporosis in adult thalassemic patients.

Cite this article as: Oğuz SH, Okay M, Fedai AB, et al. Endocrine disorders in adult beta-thalassemia patients: Insights from a long-term follow-up. Endocrinol Res Pract. 2023;27(4):205-212.