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 beta-thalassemia. Results: The most frequent endocrine disorder was vitamin D insufficiency (69%), whereas the most common endocrine complications were hypogonadism (56%) and osteoporosis (37%) in thalasse-mic 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 = 0.46, P = .001). Osteoporosis was more common in patients with hypogonadism (51% vs. 21%, P = .003) and diabe-tes (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-meta-bolic complications. All patients with thalassemia major, regardless of their ferritin levels, should be evaluated for the occurrence of endocrine complications. Endocrinologists should be especially vigi-lant during long-term follow-up for the development of glucose metabolism disorders and osteopo-rosis in adult thalassemic patients.