DIAGNOSTIC SIGNIFICANCE OF SERUM FIBROBLAST GROWTH FACTOR-23 IN CHILDREN WITH β-THALASSEMIA MAJOR

Abstract

The present study investigates the serum levels of fibroblast growth factor-23 (FGF-23) in children with β-thalassemia major and evaluates its relationship with iron metabolism-related proteins. The study included laboratory data from 60 children who received regular blood transfusions between 2019 and 2023. The control group consisted of 15 age-matched practically healthy children. The main cohort was 123 subdivided into two age groups: 6-11 years and 12-17 years. Serum levels of iron, ferritin, vitamin D, ferroportin, hepcidin, and FGF-23 were comparatively analyzed between the groups. The findings demonstrated that in children with β-thalassemia major, progressive iron accumulation and elevated ferritin levels with increasing age were associated with a statistically significant decrease in hepcidin levels. In patients undergoing long-term transfusion therapy, vitamin D deficiency was accompanied by a statistically significant elevation of FGF-23 levels. This pattern was more pronounced in the 12-17-year age group. Correlation analysis of the studied parameters demonstrated that the elevation of serum FGF-23 levels is associated with alterations in iron metabolism, suggesting that dysregulation of iron homeostasis may contribute to increased FGF-23 expression. The obtained results suggest that FGF-23 may serve as a clinically relevant biomarker in the diagnostic assessment and optimization of therapeutic strategies in children with β-thalassemia major.