Evaluation of endocrine complications in beta-thalassemia intermedia (β-TI): a cross-sectional multicenter study

Mehran Karimi, Tahereh Zarei, Sezaneh Haghpanah, Azita Azarkeivan, Christos Kattamis, Vassilis Ladis, Antonios Kattamis, Yurdanur Kilinc, Shahina Daar, Saif Alyaarubi, Doaa Khater, Yasser Wali, Mohamed Elshinawy, Ali Almadhani, Mohamed Yassin, Ashraf T. Soliman, Duran Canatan, Maha Obiedat, Hala Al-Rimawi, Demetris MariannisConstantinos Christodoulides, Soteroula Christou, Ploutarchos Tzoulis, Saveria Campisi, Salvatore Di Maio, Vincenzo De Sanctis*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Background: Data on the prevalence and type of endocrine disorders in β-thalassemia intermedia (β-TI) patients are scarce. This multicenter study was designed to determine the prevalence of endocrine complications and the associated risk factors in a large group of β-TI patients. Methods: In this cross-sectional multicenter study, 726 β-TI patients, aged 2.5–80 years, registered at 12 thalassemic centers, from nine countries, were enrolled during 2017. In a subgroup of 522 patients (mean age 30.8 ± 12.1; range: 2.5–80 years) from Qatar, Iran, Oman, Cyprus, and Jordan detailed data were available. Results: Overall, the most prevalent complications were osteopenia/osteoporosis (22.3%), hypogonadism (10.1%), and primary hypothyroidism (5.3%). In the subgroup multivariate analysis, older age was a risk factor for osteoporosis (Odds ratio: 7.870, 95% CI: 4.729–13.099, P < 0.001), hypogonadism (Odds ratio: 6.310, 95% CI: 2.944–13.521, P < 0.001), and non-insulin-dependent diabetes mellitus (NIDDM; Odds ratio: 17.67, 95% CI: 2.217–140.968, P = 0.007). Splenectomy was a risk factor for osteoporosis (Odds ratio: 1.736, 95% CI: 1.012–2.977, P = 0.045). Hydroxyurea was identified as a “protective factor” for NIDDM (Odds ratio: 0.259, 95% CI: 0.074–0.902, P = 0.034). Conclusions: To the best of our knowledge, this is the largest cohort of β-TI patients with endocrine disorders evaluated in extremely heterogenic thalassemic populations for age, clinical, hematological, and molecular composition. The study demonstrates that endocrine complications are less common in patients with β-TI compared with β-TM patients. However, regular monitoring with timely diagnosis and proper management is crucial to prevent endocrine complications in β-TI patients.

Original languageEnglish
Pages (from-to)220-227
Number of pages8
Issue number1
Publication statusPublished - Jul 1 2020


  • Endocrine complications
  • Prevalence
  • β-thalassemia intermedia

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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