linear growth deficiency in b-thalassemia patients: is it growth hormone dependent?

background: b-thalassemia major is a serious medical problem. growth retardation is commonly seen in poly-transfused b- thalassemia patients. the exact mechanism of short stature in children with thalassemia major is not well understood, however, it is believed to be multi-factorial. objective: to study the growth state and its relationship to growth hormone (gh) deficiency in b-thalassemia patients. methods: the extent of growth and growth hormone deficiency were evaluated in 150 patients aged 10-22 years (84 males, 66 females) residing in shiraz. the age, sex, height, weight and serum ferritin levels were recorded using a questionnaire. growth hormone secretion was determined with l-dopa provocative test in 138 b- thalassemia patients. results: short stature was present in 64% of patients (63.6% of girls, 69% of boys). growth hormone deficiency was present in 57.5% of 138 patients, (53.5% of boys, 46.5% of girls). short stature was found in 83.5% of gh deficient and 74.6% of gh sufficient (p=0.22) subjects. there was no difference between the height of gh deficient and gh sufficient patients (p=0.297). age at the start of chelating therapy, height deficiency and serum ferritin levels did not differ in gh deficient compared to gh sufficient patients. conclusion: this study suggests that growth retardation and gh deficiency are common in thalassemic patients and that height deficiency may not be related to gh reserve with the current testing methods for measurement of gh reserve.