{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:59:41Z","timestamp":1791197981111,"version":"4.1.0"},"update-to":[{"DOI":"10.12688\/f1000research.182800.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000}}],"reference-count":27,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Abstract* Background The management of patients with beta thalassemia major (BTH) involves regular blood transfusions which are associated with iron overload. This may result in various endocrine dysfunctions (EDs). This study aimed to assess the obesrved frequency of different EDs in patients with transfusion-dependent BTH. Method A retrospective study that included 496 patients with BTH who were referred from the Basra Center for hereditary blood diseases to Faiha Specialized Diabetes, Endocrine and Metabolsim Center for endocrine-related complaints and underwent detailed endocrine assessments from Jan 2010 to Dec 2023. Results The mean presentation age for endocrine evaluation was 13.6\u00a0\u00b1\u00a06.5\u00a0years with no difference between male and female. The commonest clinical presentations of BTH patients in our center were short stature 65.5%, amenorrhea 16.4, hyperglycemia 13.7%, delayed puberty 13.3, and hypocalcemia 5.2%. The proportion patients with ED was 16.8%. The most frequent EDs were growth hormone deficiency (GHD) 6.0%, diabetes mellitus (DM) 4.9%, hypogonadism 4.5%, hypothyroidism 3.2%. Within those patients, 78.7% had single ED, 16.5% had two EDs and 4.8% had three or more EDs. Conclusion EDs were observed among patients with BTH. The commonest EDs were GHD, DM, and hypogonadism. We recommend regular and timely surveillance using both clinical and hormonal assessment in patients with BTH.<\/ns3:p>","DOI":"10.12688\/f1000research.182800.2","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:08:16Z","timestamp":1789459696000},"page":"978","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endocrine dysfunctions in patients with beta thalassemia major: a single-center retrospective study from Basrah"],"prefix":"10.12688","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3132-1758","authenticated-orcid":false,"given":"Haider","family":"Alidrisi","sequence":"first","affiliation":[{"name":"Faiha Specialized Diabetes, Endocrine, and Metabolism Center Basrah Basra Governorate University of Basrah College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein","family":"Nwayyir","sequence":"additional","affiliation":[{"name":"Faiha Specialized Diabetes, Endocrine, and Metabolism Center Basrah Basra Governorate University of Basrah College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2593-0154","authenticated-orcid":false,"given":"Mahmood","family":"Altemimi","sequence":"additional","affiliation":[{"name":"Thi\u2011Qar Specialized Diabetes, Endocrine and Metabolism Center Nasiriyah Dhi Qar Governorate University of Thi-Qar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3686-0366","authenticated-orcid":false,"given":"Nassar","family":"Alibrahim","sequence":"additional","affiliation":[{"name":"Faiha Specialized Diabetes, Endocrine, and Metabolism Center Basrah Basra Governorate University of Basrah College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Hamid","sequence":"additional","affiliation":[{"name":"Faiha Specialized Diabetes, Endocrine, and Metabolism Center Basrah Basra Governorate University of Basrah College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israa","family":"Abdulbari","sequence":"additional","affiliation":[{"name":"Faiha Specialized Diabetes, Endocrine, and Metabolism Center Basrah Basra Governorate University of Basrah College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nargis","family":"Noman","sequence":"additional","affiliation":[{"name":"Faiha Specialized Diabetes, Endocrine, and Metabolism Center Basrah Basra Governorate University of Basrah College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-6024","authenticated-orcid":false,"given":"Abbas","family":"Mansour","sequence":"additional","affiliation":[{"name":"Faiha Specialized Diabetes, Endocrine, and Metabolism Center Basrah Basra Governorate University of Basrah College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"164-168","DOI":"10.1080\/03630269.2017.1354877","article-title":"Prevalence, incidence, trend, and complications of thalassemia in Iraq.","volume":"41","author":"K Kadhim","year":"2017","journal-title":"Hemoglobin."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1773-1781","DOI":"10.1111\/trf.12571","article-title":"Red blood cell transfusions for thalassemia: results of a survey assessing current practice and proposal of evidence-based guidelines.","volume":"54","author":"C Goss","year":"2014","journal-title":"Transfusion."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2826-2835","DOI":"10.1111\/trf.14875","article-title":"Transfusion practices and complications in thalassemia.","volume":"58","author":"A Lal","year":"2018","journal-title":"Transfusion."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"69-85","DOI":"10.1146\/annurev.physiol.69.031905.164337","article-title":"Iron homeostasis.","volume":"69","author":"N Andrews","year":"2007","journal-title":"Annu. Rev. Physiol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"191-201","DOI":"10.1111\/j.1749-6632.1998.tb10475.x","article-title":"Pathophysiology of Iron Overload.","volume":"850","author":"C Hershko","year":"1998","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.3390\/diagnostics12081921","article-title":"New entity\u2014thalassemic endocrine disease: major beta-thalassemia and endocrine involvement.","volume":"12","author":"M Carsote","year":"2022","journal-title":"Diagnostics."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"25-34","DOI":"10.4236\/ojemd.2014.42003","article-title":"A review of endocrine disorders in thalassaemia.","volume":"04","author":"P De","year":"2014","journal-title":"Open Journal of Endocrine and Metabolic Diseases."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"63-75","DOI":"10.61796\/jmgcb.v1i10.991","article-title":"Hemoglobinopathy in Basrah governorate: center statistics and new registry characteristics.","volume":"1","author":"M Jassim","year":"2024","journal-title":"J Med Genet Clin Biol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"621-625","DOI":"10.12669\/pjms.313.6972","article-title":"Efficacy and adverse effects of oral chelating therapy (deferasirox) in multi-transfused Pakistani children with \u03b2-thalassemia major.","volume":"31","author":"M Ejaz","year":"2015","journal-title":"Pakistan Journal of Medical Sciences."},{"key":"ref12","article-title":"Economic Burden of Thalassemia on Parents of Thalassemic Children: A Multi-Centre Study.","volume":"56","author":"S Safdar","year":"2017","journal-title":"Pak. J. Med. Res."},{"key":"ref13","first-page":"33-37","article-title":"Prevalence of endocrine complications in transfusion dependent thalassemia in Hospital Pulau Pinang: A pilot study.","volume":"75","author":"L Tat","year":"2020","journal-title":"Med. J. Malaya."},{"key":"ref14","article-title":"Prevalence of growth and puberty failure with respect to growth hormone and gonadotropins secretion in beta-thalassemia major.","author":"H Moayeri","year":"2006"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"48","DOI":"10.5334\/aogh.3184","article-title":"A Systematic Review and Meta-Analysis of Stature Growth Complications in \u03b2-thalassemia Major Patients.","volume":"87","author":"M Arab-Zozani","year":"2021","journal-title":"Ann. Glob. Health."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"56-60","DOI":"10.3126\/jnps.v36i1.14479","article-title":"Pattern of Growth Retardation and Sexual Maturation in Children having Beta Thalassaemia.","volume":"36","author":"G Chhabra","year":"2016","journal-title":"Journal of Nepal Paediatric Society."},{"key":"ref17","first-page":"33","article-title":"Statural growth and prevalence of endocrinopathies in relation to liver iron content (LIC) in adult patients with beta thalassemia major (BTM) and sickle cell disease (SCD).","volume":"89","author":"M Yassin","year":"2018","journal-title":"Acta Bio Medica: Atenei Parmensis."},{"key":"ref18","article-title":"Clinical characteristics, biochemical parameters and insulin response to oral glucose tolerance test (OGTT) in 25 transfusion dependent \u03b2-thalassemia (TDT) patients recently diagnosed with diabetes mellitus (DM).","volume":"92","author":"V De Sanctis","year":"2021","journal-title":"Acta Bio Medica: Atenei Parmensis."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1-13","DOI":"10.1155\/2019\/6573497","article-title":"Elevated prevalence of abnormal glucose metabolism and other endocrine disorders in patients with-thalassemia major: a meta-analysis.","volume":"2019","author":"L He","year":"2019","journal-title":"Biomed. Res. Int."},{"key":"ref20","first-page":"268-272","article-title":"Complications of transfusion-dependent \u03b2-thalassemia patients in Sistan and Baluchistan, South-East of Iran.","volume":"11","author":"M Yaghobi","year":"2017","journal-title":"International journal of hematology-oncology and stem cell research."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e27285","DOI":"10.1002\/pbc.27285","article-title":"Clinical utility of endocrine markers predicting myocardial siderosis in transfusion dependent thalassemia major.","volume":"65","author":"L Ehsan","year":"2018","journal-title":"Pediatr. Blood Cancer."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e2019029","DOI":"10.4084\/mjhid.2019.029","article-title":"Thyroid disorders in homozygous \u03b2-thalassemia: current knowledge, emerging issues and open problems.","volume":"11","author":"V De Sanctis","year":"2019","journal-title":"Mediterranean journal of hematology and infectious diseases."},{"key":"ref23","first-page":"799-803","article-title":"High prevalence of central hypothyroidism among patients with transfusion dependent thalassemia in Hospital Pulau Pinang: A cross sectional study.","volume":"76","author":"C Seow","year":"2021","journal-title":"Med J Malaysia."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"515-518","DOI":"10.1097\/MPH.0000000000001489","article-title":"The cutoff of ferritin for evaluation of hypothyroidism in patients with thalassemia.","volume":"41","author":"A Baghersalimi","year":"2019","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1467-1476","DOI":"10.1007\/s40618-019-01072-z","article-title":"Prevalence of endocrine disorders and their associated factors in transfusion-dependent thalassemia patients: a historical cohort study in Southern Iran.","volume":"42","author":"M Bordbar","year":"2019","journal-title":"J. Endocrinol. Investig."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1-8","DOI":"10.1186\/s13052-021-01116-2","article-title":"Detection of endocrine disorders in young children with multi-transfused thalassemia major.","volume":"47","author":"R Mahmoud","year":"2021","journal-title":"Ital. J. Pediatr."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"348-354","DOI":"10.1007\/s12020-018-1562-z","article-title":"Low-dose Synachten test with measurement of salivary cortisol in adult patients with \u03b2-thalassemia major.","volume":"60","author":"A Ambrogio","year":"2018","journal-title":"Endocrine."},{"key":"ref28","article-title":"Growth and endocrine function in Tunisian thalassemia major patients.","volume":"10","author":"N Dhouib","year":"2018","journal-title":"Mediterranean journal of hematology and infectious diseases."},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.6084\/m9.figshare.32301165","article-title":"Endocrine dysfunction in patients with beta thalassemia major in Basrah, Iraq.","author":"H Alidrisi","year":"2026","journal-title":"Figshare."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/15-978\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/15-978\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/15-978\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:09:11Z","timestamp":1791194951000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/15-978\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":27,"URL":"https:\/\/doi.org\/10.12688\/f1000research.182800.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.182800.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.210016.r522623","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.210016.r522623","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/15-978\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.201773.r504418, Ahmed Ghdhban Al-Ziaydi, University of Al-Qadisiyah, Al Diwaniyah, 06 Aug 2026, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/15-978\/v1#referee-response-504418","order":0,"name":"referee-response-504418","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Haider Alidrisi<\/b>; \n<i>Posted: 04 Sep 2026<\/i>; Thanks a lot for your valuable comments. We agree with suggestions to use a more concise wording for results of study based on the study design, and referral strategy. We revise our result data descriptions from &quot;prevalence&quot; to &quot;observed frequency and proportions&quot;. In considering your comment about survielance strategy for patients with BTH for EDs, we agree with your comments that neither the study design nor finding support that as a conclusion. So we changed it to a recommendation.","URL":"https:\/\/f1000research.com\/articles\/15-978\/v2#referee-comment-17097","order":1,"name":"referee-comment-17097","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.201773.r513498, Pradana Zaky Romadhon, Esthiningrum Dewi Agustin, Airlangga University, Surabaya, 31 Aug 2026, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/15-978\/v1#referee-response-513498","order":2,"name":"referee-response-513498","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Haider Alidrisi<\/b>; \n<i>Posted: 04 Sep 2026<\/i>; Thanks for your valuable comments. 1. The study included only transfusion-dependent BTH, we correct that in the revised version. 2. Chief complaints frequencies were presented as presentations in Figure 1. 3. We changed the wording from &quot;prevalence&quot; to &quot;observed frequency and proportion &quot; 4.&nbsp;In our cohort, 181 patients had a single endocrine dysfunction, 38 had two dysfunctions, and only 11 had three or more dysfunctions. We agree that comparing their clinical presentations could be informative. However, the small and uneven sizes of the multiple-dysfunction groups, together with the numerous possible combinations of individual endocrine disorders, would produce sparse cells and unstable estimates. A formal comparison would therefore have limited statistical power and a substantial risk of spurious findings or overinterpretation. For this reason, we did not undertake additional inferential subgroup analyses or add further tables. We have instead expanded the Discussion to clarify that coexisting dysfunctions may reflect the shared, cumulative effects of iron overload, chronic hypoxia, oxidative stress, and duration or adequacy of transfusion and chelation therapy on several endocrine organs. Because the study did not assess iron-overload indices or chelation adequacy in relation to these combinations, the reasons for simultaneous double or triple dysfunctions cannot be established from our data. We have acknowledged this limitation and recommend that larger prospective studies evaluate the clinical phenotype and determinants of multiple endocrine dysfunctions.","URL":"https:\/\/f1000research.com\/articles\/15-978\/v2#referee-comment-17098","order":3,"name":"referee-comment-17098","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.210016.r522623, Anwer Faisal, Mustansiriyah University, Baghdad, 05 Oct 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/15-978\/v2#referee-response-522623","order":4,"name":"referee-response-522623","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}