Endocrine Abstracts

GHD in adults (AGHD) is a clinical syndrome associated with lack of positive well-being, depressed mood, feelings of social isolation, decreased energy, alterations in body composition with reduced bone and muscle mass, diminished exercise performance, and cardiac capacity. These manifestations are also common in adults with beta-thalassemia major (BTM). Performing provocative testing in all patients is cumbersome and expensive. Many studies suggested that IGF1 may be used for primary screening, to avoid performing GH stimulation tests in the majority of healthy or diseased subjects, when appropriate normative sex and age-correlated ranges are available.

Objectives: The International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescence Medicine (ICET-A) promoted a study to collect more information on IGF1 values in young adult Italian BTM patients.

Methods: Plasma total IGF1 was measured by CLIA method for 120 patients with BTM (58M, 62F) with an age range of 26.0–53.2 years for females and 20.8–51.2 years for males. 64.4% of the patients were above 35 years of age. The mean BMI was 22.48±3.34 kg/m².

Results: IGF1 data, expressed in percentiles. No significant differences were observed between IGF1 values in men and women with TM.

Analysis and discussion: On the basis of the present results and data from the literature, ICET-A concluded their survey with the following recommendations: a GH stimulation test should be indicated in presence of the following clinical and laboratory parameters: short stature (HtSDS <−2.5), severe and/or prolonged iron overload, presence of severe osteoporosis and/or serum IGF1 level <−2 SDS. In adult TM patients, with normal liver function, an IGF1 level <50th percentile should be taken in consideration as a cut-off level for the GH assessment.