Correlation of insulin-like growth factor-1 and serum ferritin levels with height-for-age in transfusion-dependent thalassemia children: a cross-sectional study in limited resources setting

Background. Thalassemia is a serious condition that affects children’s growth due to chronic anemia and/or frequent blood transfusions. This study purposed to determine the relationship between ferritin, insulin-like growth factor-1 (IGF-1), and growth disorders in children with transfusion-dependent thalassemia. Materials and methods. This is a cross-sectional study involving children with transfusion-dependent thalassemia aged 2–18 years treated in the Hemato-Oncology Outpatient Clinic, Pediatric Department, Dr. Soetomo General Academic Hospital (Surabaya, East Java, Indonesia) from April to July 2024. For the initial impression of the data, St. Nicholas House Analysis was employed. Additionally, multivariate regression model and Spearman correlation matrix were run using RStudio. Results. This study involved 65 individuals, 53.8 % of them had short stature presented in height standard deviation score (SDS) (mean: –2.13, –5.54 to 0.58). High serum ferritin (mean: 2663 (91.34–10,823.33) ng/mL) and low hemoglobin (mean: 7.8 (5.2–10) g/dL) were found. Low IGF-1 levels were detected in all patients (mean: 9.2 (0.42–32.94) ng/mL). The disease lasted 105.7 (4.4–198.2) months on average. 10.8 % of participants had hepatomegaly. The height SDS showed significant correlations with serum ferritin level, duration of illness, and hepatomegaly (rs = –0.33, p < 0.01; rs = –0.35, p < 0.05; rs = –0.28, p < 0.05, respectively), while no correlation was found with IGF-1 level (r = 0.03; p = 0.8). In the multivariate regression analysis, hepatomegaly (r = –0.012, p < 0.05) and duration of illness (r = –0.108, p = 0.01) exhibited a significant negative correlation with height SDS. Conclusions. Children with thalassemia had lower IGF-1 levels, although short stature had not always happened. Serum ferritin, duration of illness, and hepatomegaly are risk factors associated with short stature.