Insulin-like growth factor- I and factors affecting it in thalassemia major

Area of Science:

• Endocrinology
• Hematology
• Pediatrics

Background:

• Thalassemia major (TM) patients face significant growth and maturational delays, cardiomyopathy, endocrinopathies, and osteoporosis despite advanced treatments.
• Decreased insulin-like growth factor-I (IGF-I) secretion is prevalent in TM patients, especially those with growth and pubertal delay, linked to a disturbed growth hormone (GH)-IGF-I axis.

Purpose of the Study:

• To review the factors affecting IGF-I synthesis in thalassemia.
• To explore the relationship between low IGF-I secretion and common TM complications.
• To highlight strategies for improving IGF-I secretion to enhance linear growth and bone mineral accretion.

Main Methods:

• Literature review of 148 articles from PubMed and reference lists.
• Keywords used: 'IGF-I, GH, growth, thalassemia, thyroxine, anemia, vitamin D, and zinc'.
• Analysis of current knowledge on IGF-I and its influencing factors in TM.

Main Results:

• Low IGF-I secretion is a significant issue in TM, contributing to growth and pubertal delay.
• Multiple factors, including anemia, nutritional deficiencies (zinc, vitamin D), and hormonal imbalances, impact IGF-I synthesis.
• Improving IGF-I secretion is crucial for addressing complications like poor linear growth and reduced bone mineral density.

Conclusions:

• Optimizing IGF-I secretion in TM patients requires a multifaceted approach.
• Interventions include correcting anemia, ensuring proper iron chelation, nutritional support, correcting vitamin D and zinc deficiencies, and managing hormonal issues (hypogonadism, GH deficiency).
• Targeting IGF-I offers a promising strategy to improve the overall health and development of individuals with thalassemia major.