Leptin and ghrelin serum concentrations in thalassemia major and intermedia patients and normal subjects

Endocrine dysfunctions related to iron overload, such as delayed puberty, short stature and hypogonadism, lead to major problems in thalassaemic patients. Leptin, a polypeptide with 167 amino acids produced by white adipose tissue, is a hormone which reduces appetite and increases energy consumption by affecting the central nervous system. Ghrelin, a peptide hormone produced by the stomach, stimulates growth hormone release via growth hormone secretagogue receptor. To evaluate leptin and ghrelin serum levels in thalassemia, 50 normal subjects, 50 b-thalassaemia major patients and 50 thalassaemia intermedia patients were randomly selected. Mean leptin concentration was 2.6 ± 1.2 mg/L in patients with b-thalassaemia major, and 2.8 ± 2.4 mg/L in patients with b-thalassaemia intermedia. These values appeared to be significantly lower than controls (9.2 ± 2.9 mg/L) (p < 0.001). Mean ghrelin concentrations were 1042.1 ± 275.9 pg/mL and 989.3 ± 275.5 pg/mL in b-thalassaemia major and intermediate groups, respectively. This value in thalassaemia major appeared to be significantly higher compared to the control group (876.9 ± 384.3 pg/mL) (p < 0.01). There was a positive correlation between serum leptin concentration and body mass index (BMI) in thalassaemia major and intermedia. Leptin levels were significantly lower in thalassaemia major patients with short stature compared to controls, but no correlation was found between ghrelin levels and short stature in any of the three groups. These results suggest that one of the endocrinopathies affecting thalassaemic patients is adipose tissue dysfunction and it may be that low leptin levels play a role in the endocrine dysfunction in these patients. These findings need to be confirmed in further studies.