Abstract
Background and objectives: Hemoglobinopathies are among the most common inherited disorders. Endocrine glands are sensitive to iron toxicity. Hypogonadism is an endocrine complication in patients with thalassaemia major. The study aims are to identify clinical and hormonal factors associated with hypogonadism in male patients with thalassemia major.
Methods: This cross-sectional study was done from June 2022 to December 2022 in Erbil thalassemic center on patients attending for follow-up of their condition. Any patient suspected to have delayed puberty or short stature and sent for endocrine consultation was assessed endocrinologically. History was taken from each patient and physical examination was performed for each participant, including Tanner’s scale for sexual development staging. Patients were fasting for laboratory investigations, and between 8 and 9 am, blood samples were collected for measurement of serum ferritin, FSH, LH, testosterone, TSH and FT4, serum PTH, and vitamin D3.
Results: From 166 patients, 57 were males aged 14 years or more. Out of them, 48 (84.2%) had hypogonadism. The results showed that there was statistically significant correlation between severity of hypogonadism and each of serum testosterone (P < 0.05), serum FSH P = 0.005 and serum LH P = 0.001. Moreover compared to patients with mild hypogonadism, patients with severe hypogonadism had significantly (P < 0.05) higher serum ferritin levels.
Conclusion: In thalassemia major hypogonadism is of the hypogonadotropic type and its severity is associated with presence of spleen and high serum ferritin.