ADIPOQ and thalassemia: Also, in a study by Joseph Scott et al on the effects of iron on regulation of adiponectin and leptin, it was stated that there is an inverse significant relationship between BMI- free serum leptin and ferritin levels (25); thus, fat cell in thalassemia patients is unable to produce leptin, partly due to the toxic effects of increased iron and ferritin levels, and the result of this increase in ferritin is reduced level of leptin.