EFFECT OF AGE, AND SPLEEN AND TREATMENT STATUS ON MALE REPRODUCTIVE HORMONES AND SOME PHYSIOLOGICAL PARAMETER LEVELS IN PATIENTS WITH BETA-THALASSEMIA MAJOR

JAMELA JOUDA; RAJWAN ABDULJABBAR GHAZZAY; WAFAA F AL-MOSAWY

doi:10.22159/ajpcr.2019.v12i5.30728

Authors

JAMELA JOUDA Department of Biology, College of Science, Mustansiriyah University, Baghdad, Iraq.
RAJWAN ABDULJABBAR GHAZZAY Department of Pharmaceutical Chemistry, College of Pharmacy, Kerbala University, Kerbala, Iraq.
WAFAA F AL-MOSAWY Department of Pharmacology, College of Pharmacy, Kerbela University, Kerbala, Iraq.

DOI:

https://doi.org/10.22159/ajpcr.2019.v12i5.30728

Keywords:

TM patients, LH, FSH, testosteron, chelation therapy, and splenectomy

Abstract

Objective: This research was conducted to study the relationship between spleen status and chelation treatment status with the male reproductive hormones and some physiological parameter levels.

Methods: A total of 35 males with thalassemia major (TM) patients are recruited. Patients are grouped according to (1) their age into two groups; ˂18 years and ≥18 years, (2) their spleen status into two groups; splenectomize and non-splenectomize, and (3) their chelation treatment status into two groups; regulation and irregulation. Body mass index (BMI) was calculated and blood was collected from all patients just before blood transfusion session. Hb, ABO blood groups, ferritin, and hormone (luteinizing hormone [LH], follicle-stimulating hormone [FSH], testosterone, prolactin, and cortisone) levels were determined.

Results: The highest frequency of thalassemia was in Group O and the lowest was in AB. BMI was higher in TM patients aged ≥18 years, TM patients with splenectomize, and TM patient who take the treatment irregularly. TM patients aged ≥18 years have high level of LH, FSH, and testosterone. TM patients without splenectomize have higher FSH, prolactin, and testosterone. TM patients take the treatment regularly have significantly higher testosterone levels and non-significantly lower FSH level.

Conclusion: The levels of cortisol and prolactin hormones are not disturbed in TM patients and not associated with the rate of transfusion, but the level of Hb and ferritin leads to underweight in BMI and may lead to endocrine dysfunction, especially sexual hormones (FSH, LH, and testosterone). These BMI and sex hormones are related to age, spleen, and treatment status.

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References

Wangruangsathit S, Hathirat P, Chuansumrit A, Pakakasama S, Hongeng S. The correlation of transferrin saturation and ferritin in non-splenectomized thalassemic children. J Med Assoc Thai 1999;82 Suppl 1:S74-6.

Olivieri NF. The beta-thalassemias. N Engl J Med 1999;341:99-109.

Politis C, Di Palma A, Fisfis M, Giasanti A, Richardson SC, Vullo C, et al. Social integration of the older thalassaemic patient. Arch Dis Child 1990;65:984-6.

Sparrow RL. Time to revisit red blood cell additive solutions and storage conditions: A role for “omics” analyses. Blood Transfus 2012;10 Suppl 2:s7-11.

Toumba M, Sergis A, Kanaris C, Skordis N. Endocrine complications in patients with thalassaemia major. Pediatr Endocrinol Rev 2007;5:642-8.

Collins JF, Prohaska JR, Knutson MD. Metabolic crossroads of iron and copper. Nutr Rev 2010;68:133-47.

Mishra AK, Tiwari A. Iron overload in beta thalassaemia major and intermedia patients. Maedica (Buchar) 2013;8:328-32.

Srisukh S, Ongphiphadhanakul B, Bunnag P. Hypogonadism in thalassemia major patients. J Clin Transl Endocrinol 2016;5:42-5.

Clarke GM, Higgins TN. Laboratory investigation of hemoglobinopathies and thalassemias: Review and update. Clin Chem 2000;46:1284-90.

Cao A, Galanello R. Beta-thalassemia. Genet Med 2010;12:61-76.

Vasilescu C, Stanciulea O, Tudor S, Stanescu D, Colita A, Stoia R, et al. Laparoscopic subtotal splenectomy in hereditary spherocytosis. To preserve the upper or the lower pole of the spleen? Surg Endosc 2006;20:748-52.

Rodgers GP. Pharmacological therapy. Baillieres Clin Haematol 1998;11:239-55.

World Health Organization. Appropriate Body-Mass Index for Asian Populations and its Implications for Policy and Intervention Strategies. Report of a Who Expert Consultation. In: 363. Geneva: World Health Organization; 2004.

Cooley TB, Lee P. A series of cases of splenomegaly in children with anemia and peculiar bone changes. Trans Am Pediatr Soc 1925;37:29-30.

Weatherall DJ. Disorders of globin synthesis: Thalassemia. In: Lichtman MA, Beutler E, Kipps TJ, Seligson U, Kaushansky K, Prchal JT, editors. Williams Hematology. New York: McGraw- Hill; 2006.

Borgna-Pignatti C, Galanello R. Thalassemias and related disorders. Quantitative disorders of hemoglobin synthesis. In: Greer JP, Rodgers GM, Paraskevas F, Foerster J, Lukens JN, Glader B, editors. Wintrob’s Clinical Hematology. Philadelphia, PA: Lippincott Williams and Wilkins; 2004.

Abdulzahra MS, Al-Hakeim HK, Ridha MM. Study of the effect of iron overload on the function of endocrine glands in male thalassemia patients. Asian J Transfus Sci 2011;5:127-31.

Ammar SA, Elsayh KI, Zahran AM, Embaby M. Splenectomy for patients with β-thalassemia major: Long-term outcomes. Egypt J Surg 2014;33:232-6.

Muncie HL Jr., Campbell J. Alpha and beta thalassemia. Am Fam Physician 2009;80:339-44.

Mohssin MY, Mahmood AE, Kamal SB, Batah EH. Frequency distribution of hemoglobin variant and abo blood groups among thalassemia patients from ibn-al-baladi pediatric hospital in Baghdad/ Iraq. World J Pharm Pharm Sci 2015;4:31-9.

Mohammad AF, Pourfathollah A. Association of abo and rh blood groups to blood borne infections among blood donors in Tehran-Iran. Iran J Public Health 2014;43:981-9.

AL-Mosawy WF. Effect of transfusion interval rate on clinical manifestations of patients with beta-thalassemia major and their correlation with some biochemical parameters. Kerbala J Pharm Sci 2017;13:249-57.

Saha AK, Sahadalal BS. Frequency and distribution of blood groups in the donors of a rural hospitals, West Bengal, India. Int J Pharm Bio Sci 2016;7:B414-8.

Iqbal M, Niazi A, Tahir M. Frequency of abo and rh blood groups in healthy donors. J Rawalpindi Med Coll 2009;13:92-4.

Soliman AT, El Banna N, Fattah MA, El Zalabani MM, Ansari BM. Bone mineral density in prepubertal children with beta-thalassemia: Correlation with growth and hormonal data. Metabolism 1998;47:541-8.

Mohseni F, Mohajeri-Tehrani MR, Larijani B, Hamidi Z. Relation between bmd and biochemical, transfusion and endocrinological parameters in pediatric thalassemic patients. Arch Osteoporos 2014;9:174.

Fuchs GJ, Tienboon P, Khaled MA, Nimsakul S, Linpisarn S, Faruque AS, et al. Nutritional support and growth in thalassaemia major. Arch Dis Child 1997;76:509-12.

Rosen CJ, Klibanski A. Bone, fat, and body composition: Evolving concepts in the pathogenesis of osteoporosis. Am J Med 2009; 122:409-14.

Fung EB, Xu Y, Kwiatkowski JL, Vogiatzi MG, Neufeld E, Olivieri N, et al. Relationship between chronic transfusion therapy and body composition in subjects with thalassemia. J Pediatr 2010;157:641-7, 647, e641-2.

Kattamis C, Liakopoulou T, Kattamis A. Growth and development in children with thalassaemia major. Acta Paediatr Scand Suppl 1990; 366:111-7.

Tienboon P, Sanguansermsri T, Fuchs GJ. Malnutrition and growth abnormalities in children with beta thalassemia major. Southeast Asian J Trop Med Public Health 1996;27:356-61.

Filosa A, Di Maio S, Esposito G, De Martinis F, De Terlizzi F. Persistence of delayed adrenarche in boys with thalassemia. J Pediatr Endocrinol Metab 2001;14:407-14.

Asadi-Pooya AA, Karamifar H. Body mass index in children with beta-thalassemia major. Turk J Haematol 2004;21:177-80.

Allegra A, Capra M, Cuccia L, Pulejo ML, Raineri L, Corselli F, et al. Hypogonadism in beta-thalassemic adolescents: A characteristic pituitary-gonadal impairment. The ineffectiveness of long-term iron chelation therapy. Gynecol Endocrinol 1990;4:181-91.

Soliman AT, elZalabany MM, Ragab M, Fattah MA, Hassab H, Rogol AD, et al. Spontaneous and gnrh-provoked gonadotropin secretion and testosterone response to human chorionic gonadotropin in adolescent boys with thalassaemia major and delayed puberty. J Trop Pediatr 2000;46:79-85.

De Sanctis V, Elawwa A, Angastiniotis M, Eleftheriou A, Kattamis C, Karimi M, et al. Highlights from the first thalassaemia forum on growth and endocrine complications in thalassemia doha, (october 2-3, 2011). Pediatr Endocrinol Rev 2012;9:672-9.

Wang C, Tso SC, Todd D. Hypogonadotropic hypogonadism in severe beta-thalassemia: Effect of chelation and pulsatile gonadotropin-releasing hormone therapy. J Clin Endocrinol Metab 1989;68:511-6.

Han X, Ren X, Zeng Y, Zhou Y, Song T, Cao X, et al. Physiological interactions between the hypothalamic-pituitary-gonadal axis and spleen in rams actively immunized against gnrh. Int Immunopharmacol 2016;38:275-83.

Devarshi S, James S, Najafzadeh E, Pawar S, Kalrao V, Bafna V. Assessment of quality of life, complications and post-transfusion adverse reactions in thalassemia pediatric in tertiary care hospital. Int J Pharm Pharm Sci 2016;8:317-23.

Tyagi P, Kumar Y, Gupta D, Singh H, Kumar A. Therapeutic advancements in management of iron overload- a review. Int J Pharm Pharm Sci 2015;7:35-44.