Proportion of Hypogonadism in Transfusion-Dependent Thalassemia Patients and Its Contributing Factors

Authors

  • Dian Anindita Lubis 1. Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. 2. Division of Endocrinology Metabolic, Department of Internal Medicine, Faculty of Medicine Universitas Sumatera Utara, Medan, Indonesia. http://orcid.org/0000-0002-9822-6352
  • Imam Subekti Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia — Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Em Yunir Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia — Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Cosphiadi Irawan Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia — Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Andon Hestiantoro Division of Reproductive Immunoendocrinology, Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia — Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Silvia Werdhy Lestari Department of Medical Biology, Faculty of Medicine Universitas Indonesia — Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Aria Kekalih Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  • Merci Monica Br Pasaribu Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia — Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Santi Syafril Division of Endocrinology Metabolic, Department of Internal Medicine, Faculty of Medicine Universitas Sumatera Utara, Medan, Indonesia

Keywords:

Pre-transfusion hemoglobin, hypogonadism, transfusion-dependent thalassemia

Abstract

Background: Beta thalassemia is a lifelong disease involving malformed red blood cells (RBC). One of the disease’s complications is hypogonadism, in which adults tend to exhibit regression in sexual characteristics, experience sexual dysfunction, and therefore have a lower quality of life. Around 3-10% of the Indonesian population carries the beta-thalassemia gene. This study aimed to see the proportions of hypogonadism in transfusion-dependent thalassemia patients and its contributing factors. Methods: This is a cross-sectional study involving 60 male patients admitted to three Indonesian general hospitals from July 2022 to July 2023. All patients were diagnosed with beta-thalassemia via chromatography hemoglobin analysis. We performed a single-time physical examination and laboratory examinations to determine FSH, LH, and free testosterone levels. The correlation between Hb and sexual hormone levels was analyzed using Spearman’s rank correlation coefficient. ROC curve analysis was conducted afterward. All statistical analysis was done in SPSS version 29. Results: 31 out of 60 thalassemia patients had hypogonadism. Pre-transfusion Hb count was found to be linearly correlated with FSH (r = 0.388, p = 0.049), LH (r = 0.338, p = 0.008), and free testosterone (r = 0.255, p = 0.049). ROC analysis indicated that pre-transfusion Hb was viable as a predictor for hypogonadism (AUC = 0.655, 65.5% sensitivity, 67.7% specificity). Conclusion: We confirmed the role of pre-transfusion Hb count as a potential predictor for hypogonadism due to the tissue hypoxia mechanism and transfusion-related iron overload in TDT patients. Decreased Hb is linearly correlated with FSH, LH, and testosterone levels. Decreased Hb also downregulates these factors.

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Published

2024-04-01

How to Cite

Lubis, D. A., Subekti, I., Yunir, E., Irawan, C., Hestiantoro, A., Lestari, S. W., Kekalih, A., Pasaribu, M. M. B., & Syafril, S. (2024). Proportion of Hypogonadism in Transfusion-Dependent Thalassemia Patients and Its Contributing Factors. Acta Medica Indonesiana, 56(1), 13. Retrieved from http://www.actamedindones.org/index.php/ijim/article/view/2607

Issue

Vol. 56 No. 1 (2024): Acta Medica Indonesiana

Section

ORIGINAL ARTICLE

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