Serum Kisspeptin in Iraqi Men with Beta-Thalassemia Major: A Cross Sectional Study

Abstract

Objective: To evaluate serum concentrations of kisspeptin in Iraqi men diagnosed with beta-thalassemia major and to identify factors that may influence circulating kisspeptin levels.

Study Design: Cross sectional study
Place and Duration of Study: This study was conducted at the National Centre for Thalassemia Patients in Baqubah, Iraq from 1st September 2024 to 30th June 2025.

Methods: Eighty individuals with beta-thalassemia major and 40 healthy controls were included. The parameters measured included kisspeptin, luteinizing hormone, follicle-stimulating hormone, total testosterone, fasting blood glucose as well as hematological assessments and oxidative stress markers (malondialdehyde and ischemia-modified albumin).

Results: Men with hypogonadism due to beta-thalassemia major exhibited significantly higher kisspeptin levels compared to controls (P=0.001). Conversely, levels of testosterone, luteinizing hormone and follicle-stimulating hormone were notably lower in the beta-thalassemia major group than in the control group. Within the patient group, we observed negative correlations between kisspeptin levels and luteinizing hormone and testosterone (P<0.05). Additionally, positive correlations were found for kisspeptin versus inhibin B (r=0.782, P=0.001) and kisspeptin versus ferritin (r=0.286, P=0.010). Lower levels of luteinizing hormone (OR=2.95, P=0.0319), testosterone (OR=0.86, P=0.04) and increasing age (OR=0.927, P=0.014) were associated with elevated kisspeptin levels among Iraqi males with beta-thalassemia major.

Conclusion: Elevated kisspeptin with suppressed luteinizing hormone and testosterone in male thalassemia patients is a hallmark of complex hypothalamic-gonadal-pituitary axis disruption due to iron overload.