title: A Longitudinal Study of Growth and Relation With Anemia and Iron Overload in Pediatric Patients With Transfusion-dependent Thalassemia.
abstract: Short stature is one of the most common endocrinopathies in transfusion-dependent thalassemia (TDT). This study aimed to determine the longitudinal pattern of growth in pediatric patients with TDT and study the relationship between growth and hemoglobin level, serum ferritin level/iron overload parameters, and other clinical factors. The interval height-for-age Z-scores (HAZ) of 50 patients with TDT, of a mean age of 13.3±2.8 years, were analyzed using linear mixed model analysis. Nineteen patients (38%) had short stature with HAZ≤-2.0. The prevalence of short stature increased with age. The estimated mean HAZ decreased by 0.19 SD per year from the age of 5 years until approximately 14 years (95% confidence interval [CI], -0.22 to -0.16, P<0.001). Male sex (estimate, -0.28; 95% CI, -0.43 to -0.14; P<0.001), mean 3-year hemoglobin level ≤8 g/dL (estimate, -0.36; 95% CI, -0.53 to -0.19; P<0.001), mean 3-year ferritin level ≥1800 ng/mL (estimate, -0.44; 95% CI, -0.59 to -0.29; P<0.001), and cardiac T2* ≤20 ms (estimate, -1.05; 95% CI, -1.34 to -0.77; P<0.001) were significantly associated with short stature. In conclusion, short stature in patients with TDT is common and relates significantly with increasing age, male sex, hemoglobin level, and iron overload status.
authors.affiliation: *Department of Pediatrics, Faculty of Medicine†Department of Radiologic Technology, Faculty of Associated Medical Sciences‡Biomedical Engineering Center, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Kwannapas
authors.initials: K
authors.lastname: Nokeaingtong
authors.forename: Pimlak
authors.initials: P
authors.lastname: Charoenkwan
authors.forename: Suchaya
authors.initials: S
authors.lastname: Silvilairat
authors.forename: Suwit
authors.initials: S
authors.lastname: Saekho
authors.forename: Yupada
authors.initials: Y
authors.lastname: Pongprot
authors.forename: Prapai
authors.initials: P
authors.lastname: Dejkhamron
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000740:Anemia / Q000503:physiopathology*; D001803:Blood Transfusion; D001827:Body Height; D002648:Child; D005260:Female; D005293:Ferritins / Q000097:blood; D006130:Growth Disorders / Q000209:etiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019190:Iron Overload / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D013789:Thalassemia / Q000097:blood / Q000150:complications / Q000503:physiopathology*
chemical_list: D006454:Hemoglobins; D005293:Ferritins