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Journal of Endocrinological Investigation

25-03-2024 | Hypogonadism | Original Article

Very low serum IGF-1 levels are associated with vertebral fractures in adult males with beta-thalassemia major

Authors: G. Costanzo, A. Naselli, M. L. Arpi, T. Piticchio, R. Le Moli, A. Belfiore, F. Frasca

Published in: Journal of Endocrinological Investigation

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Abstract

Purpose

Patients with beta-thalassemia major (BTM) often develop several endocrine disorders due to chronic iron overload. They are also prone to osteoporosis and vertebral fractures. Plasmatic insulin-like growth factor-1 (IGF-1) levels are often low in subjects with BTM, which origin is multifactorial. The aim of this study was to evaluate a possible relationship between serum IGF-1 levels and the presence of osteoporosis and/or vertebral fractures.

Methods

We retrospectively evaluated the occurrence of vertebral fractures in 30 adult male patients affected by BTM (mean age 43.3 ± 7.9 years) with low serum IGF-1 (median value 52.4 ng/ml, 38.5–83.4). Only 6 of them (20.0%) were diagnosed with GH deficiency (GHD) after GHRH/arginine stimulation test, while 23 (76.7%) had osteoporosis and 12 (40.0%) had known vertebral fractures. All patients except one also showed at least one endocrine disorder.

Results

Serum IGF-1 was significantly lower in BTM patients with vertebral fractures compared to patients without vertebral fractures (U = 41.0, p = 0.005) while it was not significantly different between patients with low bone mass compared to patients without low bone mass. The diagnosis of GHD was significantly associated with lower serum IGF-1 (p = 0.001) and vertebral fractures (p = 0.002) but not with low bone mass. After ROC analysis, we found that very low IGF-1 (≤ 50.0 ng/dl) was associated with vertebral fractures (sensitivity 83.3%, specificity 75.0%) and was also predictive of GHD (sensitivity 75.0%, specificity 100.0%).

Conclusion

Our study shows that, in male patients with BTM, serum IGF-1 ≤ 50.0 ng/dl is a marker of vertebral fractures and it is predictive of a diagnosis of GHD.
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Metadata
Title
Very low serum IGF-1 levels are associated with vertebral fractures in adult males with beta-thalassemia major
Authors
G. Costanzo
A. Naselli
M. L. Arpi
T. Piticchio
R. Le Moli
A. Belfiore
F. Frasca
Publication date
25-03-2024
Publisher
Springer International Publishing
Published in
Journal of Endocrinological Investigation
Electronic ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-023-02270-6
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