Insulin-like Growth Factor-1 and Calcium Ion Levels are Negatively Associated with Serum β-Cross Laps in Multi-transfused β-thalassemia Major Patients

Sabar Widodo (Clinical Pathology Residency Program, Faculty of Medicine, Universitas Diponegoro, Jl. Prof. Soedarto, Semarang 50275)
Nyoman Suci Widyastiti (Department of Clinical Pathology, Faculty of Medicine, Universitas Diponegoro, Jl. Prof. Soedarto, Semarang 50275)
Edward Kurnia Setiawan Limijadi (Department of Clinical Pathology, Faculty of Medicine, Universitas Diponegoro, Jl. Prof. Soedarto, Semarang 50275)
Meita Hendrianingtyas (Department of Clinical Pathology, Faculty of Medicine, Universitas Diponegoro, Jl. Prof. Soedarto, Semarang 50275)
Dwi Retnoningrum (Department of Clinical Pathology, Faculty of Medicine, Universitas Diponegoro, Jl. Prof. Soedarto, Semarang 50275)
Ariosta Ariosta (Department of Clinical Pathology, Faculty of Medicine, Universitas Diponegoro, Jl. Prof. Soedarto, Semarang 50275)
Yetty Movieta Nency (Department of Child Health, Faculty of Medicine, Universitas Diponegoro, Jl. Prof. Soedarto, Semarang 50275)

The Indonesian Biomedical Journal
Vol 17, No 4 (2025)

BACKGROUND: Thalassemia patients with repeated transfusions (multi-transfusion) are often at risk of experiencing early osteoporosis. Several studies have demonstrated that osteoporosis in these individuals was associated with altered bone remodeling, characterized by decreased insulin-like growth factor-1 (IGF-1) and serum calcium ions, as well as increased serum β-Cross Laps (β-CTx) levels. Despite the prevalence of this condition, there is limited literature on the relationship between IGF-1 levels and calcium ions with β-CTx. Therefore, this study was conducted to examine the relationship between IGF-1 and calcium ions levels with serum β-CTx in multi-transfused β-thalassemia major patients.METHODS: A cross sectional study involved 29 thalassemia patients with multiple transfusions, aged 2-18 years, that were selected from the electronic medical records. Calcium ion levels were examined using ion selective electrode method. Subsequently, IGF-1 and serum β-CTx levels were examined by enzyme-linked immunosorbent assay (ELISA), and the data were analyzed using the Pearson correlation test.RESULTS: The results showed that the mean serum IGF-1 levels, calcium ion, and β-CTx were 20.11±20.763 ng/mL, 1.26±0.07 mmol/L, and 9330.40±1696.76 ng/mL, respectively. Statistical analysis showed a significant relationship between the levels of IGF-1 (r=-0.573; p=0.001) and calcium ion (r=-0.373; p=0.046) with serum β-CTx. A moderate negative relationship was found between IGF-1 levels and β-CTx, while calcium ion levels and β-CTx showed a weak negative relationship.CONCLUSION: A moderate negative correlation between IGF-1 and serum β-CTx, and a weak negative correlation between calcium ion and serum β-CTx suggest that IGF-1 and calcium ions may serve as potential indicators of bone turnover and osteoporosis risk in multi-transfused β-thalassemia major patients, underscoring their potential role in routine clinical evaluations.KEYWORDS: miR-200a expression, NO level, early-onset preeclampsia, late-onset preeclampsia