Factors associated with insulin-like growth factor-1 in children with thalassemia major

Abstract

Background Septic shock remains a major cause of mortality Background Insulin-like growth factor-1 (IGF-1) deficiency is the major cause of growth disorders and delayed puberty in children with thalassemia. Hence, identifying factors contributing to IGF-1 deficiency in thalassemia is of importance. Objectives To evaluate the correlation between IGF-1 level and nutritional status, ferritin, pre-transfusion hemoglobin, thyroid, as well as alanine transaminase levels. Methods We conducted a study in children aged 2 to 18 years with thalassemia major who visited outpatient clinics at two hospitals in Indonesia, Dr. Sardjito Hospital, Yogyakarta and Dr. Moewardi Hospital, Surakarta, Central Java, from July to December 2015. Clinical, laboratory, and demographic data were reviewed from medical records. IGF-1 levels were measured using an immuno-chemiluminiscent method. Results A total of 48 children were recruited into the study. Subjects mean IGF-1 level was 109.28 (SD 90.26) ng/mL. Seventy-five percent of the children had IGF-1 level <8 g/dL (β=-0.090; 95%CI -0.002 to 0.182; P=0.056) and undernutrition (β=0.077; 95%CI 0.045 to 0.109; P<0.001). Conclusion Low pre-transfusion hemoglobin level and undernutrition are significantly correlated to low IGF-1 level in children with thalassemia major.