Association of age and serum ferritin with audiometric hearing loss in transfusion-dependent β thalassemia

This study aimed to examine the association of age and serum ferritin with audiometric hearing loss in patients with transfusion-dependent β-thalassemia major (TDT).

In this cross-sectional study, conducted from February to August 2025, 96 patients with TDT underwent pure-tone audiometry at frequencies from 250 to 8000 Hz. Hearing loss was defined as an auditory threshold greater than 25 dB. Serum ferritin was categorized as <1000 ng/mL or ≥1000 ng/mL. Age was classified as <20 years or ≥20 years. Statistical analyses were performed with SPSS-16, and significance was set at p < 0.05.

Hearing loss was detected in 10.42% of the patients (n = 10). Among these 10 patients, 9 had sensorineural hearing loss and 1 had mixed hearing loss. Regarding severity, 5/10 experienced mild impairment, 1 had moderate, and 4 suffered from severe impairment. A relatively strong correlation was observed between hearing loss and advancing age, although it was only borderline statistically significant (r = 0.65, P = 0.04). Conversely, serum ferritin levels showed no statistically significant correlation with hearing loss (r = 0.28, P = 0.44).

Advancing age showed a borderline significant correlation with hearing loss, while ferritin did not. This suggests iron overload alone is not the main cause of auditory dysfunction in these patients. Thus, routine hearing screening and further investigation of other risk factors are warranted.