The study of serum ferritin level as a predictor of growth retardation in Thalassemia-major
Abstract
Objective: This work aims to estimate serum ferritin levels of the B-thalassemia major (BTM) patients in one of the Iraqi thalassemia centers and to evaluate its relationship with their retarded growth.
Methods: this was a cross-sectional study that included 163-patients diagnosed with BTM, undergoing continuous red cells transfusion and chelation therapy. The patients' serum ferritin, height, weight, and body mass index (BMI) was measured. The patients were classified into three groups based on their growth states. All the qualitative parameters were displayed as numerical data and percentages, though the quantitative parameters had displayed as mean ± SD. The variations amongst the 3-groups were analyzed by ANOVA test. The regression fit curves between serum ferritin and growth variables were evaluated. The ROC was examined for ferritin value and growth failure. A p<5% was considered as significant.
Results: The mean age of the studied subjects were 12.6±3.5 years (range 3–19 years). The mean serum ferritin levels were 1812 ±1024.9 ng/mL, which showed a significant correlation with height, weight, and age. The mean height Z-score was -2.1±1.1, and 70% of the patients had growth failure (GF). The mean weight Z-score was -2.0 ±1.3. Both height and weight had a significant correlation with ferritin levels in BTM patients. ROC-curves revealed a sensitivity, specificity, and CI% of [72%,78% & (0.703-0.858)], respectively for predictability of serum ferritin for GF in BTM patients.
Conclusion: In BTM patients, the overall incidence of GF (both mild and severe form) was more than 70%. The mean serum ferritin levels correlated significantly with the growth retardation of BTM patients.
Keywords: growth retardation, β-thalassemia major, ferritin, iron overload.
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