Correlation of serum ferritin with parathyroid hormone level in patients with transfusion-dependent thalassemia

Introduction: Thalassemia is a rare hereditary condition that causes hemoglobin synthesis deficiency. Recurrent blood transfusion in transfusion-dependent thalassemia (TDT) individuals results in iron overload and deposition in body tissues, leading to endocrine malfunctions, including parathyroid. This study aimed to determine the correlation between the level of serum ferritin and parathyroid hormone level in TDT patients. Methods: A cross-sectional study was conducted among adult TDT patients receiving blood transfusions at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from January to June 2023. Serum ferritin was measured using an enzyme-linked fluorescence assay (ELFA), while parathyroid hormone was quantified using an enzyme-linked immunosorbent assay (ELISA). The Spearman correlation analysis was used to identify the correlation between the level of serum ferritin with parathyroid hormone. Results: A total of 46 TDT patients were enrolled in the study, with a median age of 25 years old and represented predominantly by males (56.5%). The median levels of serum ferritin and parathyroid hormone were 5,672.90 ng/mL (min-max: 596.80–24,014.58 ng/mL) and 29.80 pg/mL (min-max: 10.61–97.01 pg/mL), respectively. The Spearman correlation analysis suggested a statistically insignificant negative correlation between serum ferritin and parathyroid hormone in TDT patients (r =-0.166; p=0.270). Conclusion: Serum ferritin was inversely, but not significantly, correlated with parathyroid hormone in TDT patients, suggesting that impaired parathyroid function might be associated with the increment of plasma iron.