GH1 and anemia: Our study compared two groups divided by developmental stages (Group 1: pre-pubertal, 2–11 years; Group 2: pubertal and adolescent, 12–19 years) and found that children and adolescents with TDT exhibited significant age-related deteriorations, including impaired growth parameters, increased malnutrition, worsening anemia and iron overload, glucose and lipid metabolism disorders, compromised secretion of sex hormones and growth hormone, and reduced vitamin D levels.