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Review
. 2015 Mar-Apr;19(2):245-51.
doi: 10.4103/2230-8210.131750.

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

Ashraf T Soliman  1 , Vincenzo De Sanctis  2 , Rania Elalaily  3 , Mohamed Yassin  4
Affiliations
Review

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

Ashraf T Soliman et al. Indian J Endocrinol Metab. 2015 Mar-Apr.

Abstract

Despite improvement of blood transfusion regimens and iron chelation therapy growth and maturational delay, cardiomyopathy, endocrinopathies and osteoporosis still occur in good number of thalassemic patients. Decreased IGF-1 secretion occurs in the majority of the thalassemic patients particularly those with growth and pubertal delay. Many factors contribute to this decreased synthesis of IGF-I including disturbed growth hormone (GH) - insulin-like growth factor - I (IGF-I) axis. The possible factors contributing to low IGF-I synthesis in thalassemia and the possible interaction between low IGF-I secretion and the occurrence of these complications is discussed in this mini-review. Improvement of IGF-I secretion in thalassemic patients should be intended to improve linear growth and bone mineral accretion in thalassemic patients. This can be attained through adequate correction of anemia and proper chelation, nutritional supplementation (increasing caloric intake), correction of vitamin D and zinc deficiencies, induction of puberty and correction of hypogonadism at the proper time and treating GH deficiency. This review paper provides a summary of the current state of knowledge regarding IGF-I and factors affecting it in patients with thalassaemia major (TM). Search on PubMed and reference lists of articles with the term 'IGF-I, GH, growth, thalassemia, thyroxine, anemia, vitamin D, and zinc' was carried out. A hundred and forty-eight articles were found and used in the write up and the data analyzed was included in this report.

Keywords: Anemia; Insulin-like growth factor-I; ferritin; growth; growth hormone; nutrition; puberty; thalassemia; thyroxine; vitamin D; zinc.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Etiology and pathological effects of low IGF-I secretion in thalassemic patients (From: Ashraf T Soliman, 2013)
See this image and copyright information in PMC

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