Journal of Endocrinological Investigation

, Volume 42, Issue 12, pp 1467–1476 | Cite as

Prevalence of endocrine disorders and their associated factors in transfusion-dependent thalassemia patients: a historical cohort study in Southern Iran

  • M. Bordbar
  • H. Bozorgi
  • F. Saki
  • S. Haghpanah
  • M. Karimi
  • A. Bazrafshan
  • O. R. ZekavatEmail author
Original Article



Transfusion-dependent beta-thalassemia (TDT) patients suffer from various endocrinopathies. The main contributing factor associated with these complications is iron overload, secondary to frequent blood transfusions. To improve patients’ quality of life, we evaluated the prevalence of endocrine disorders while considering the associated factors for further assessment.


Seven hundred thirteen transfusion-dependent thalassemia patients with age range 10–62 years were enrolled in this study. Serum calcium, phosphorous, fast blood sugar, ferritin, 25-OH vitamin D, free thyroxin, thyroid-stimulating hormone and parathyroid hormone were assessed. Bone mineral density was measured by dual-energy X-ray absorptiometry.


In total, 86.8% of the TDT patients suffered from at least one endocrinopathy. The prevalence of endocrinopathies in descending order of frequency was low bone mass (72.6%), hypogonadism (44.5%), diabetes mellitus (15.9%), hypoparathyroidism (13.2%), and hypothyroidism (10.7%). Age, body mass index and splenectomy were significantly associated with most of the endocrine disorders.


Endocrine complications are frequently observed in TDT patients. Splenectomy is a major risk factor and should be generally avoided unless it is highly indicated. Periodic surveillance of endocrine function and proper management of iron overload are advised.


Endocrinopathy Transfusion-dependent beta-thalassemia Risk factors 



The author would like to thank Shiraz University of Medical Science, also the Center for Development of Clinical Research of Namazee Hospital. The authors wish to thank Mr. H. Argasi at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for his invaluable assistance in editing this manuscript.

Compliance with ethical standards

Conflict of interest

None of the authors has financial disclosures or any conflict of interest to be declared.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Endocrinology (SIE) 2019

Authors and Affiliations

  • M. Bordbar
    • 1
  • H. Bozorgi
    • 1
  • F. Saki
    • 1
    • 2
  • S. Haghpanah
    • 1
  • M. Karimi
    • 1
  • A. Bazrafshan
    • 1
  • O. R. Zekavat
    • 1
    Email author
  1. 1.Nemazee Hospital, Hematology Research CenterShiraz University of Medical SciencesShirazIran
  2. 2.Shiraz Endocrinology and Metabolism Research CenterShiraz University of Medical SciencesShirazIran

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