Carotid Intima-Media Thickness and Oxidative Stress Markers for Assessment of Atherosclerosis in Children with β Thalassemia Major

Abstract

The present study evaluates carotid intimamedia thickness (CIMT) in children with b thalassemia major to assess atherosclerosis and its relation to the underlying proposed causative mechanisms via lipid peroxidation product malondialdehyde (MDA), oxidized lowdensity lipoproteins (LDL), total antioxidant level, and lipid profile. A cross sectional study was conducted on 62 children (31 cases and 31 controls). CIMT by high resolution ultrasound and biochemical parameters i.e., total cholesterol, triglycerides, high-density lipoproteins, LDL, Oxidized LDL, lipoprotein (a), lipid peroxidation product MDA and total antioxidant were measured in enrolled subjects and compared. In our study, CIMT was significantly increased in b thalassemia major patients' as compared to healthy controls. Mean CIMT in cases was 0.69±0.11 mm and in controls 0.51±0.07 mm. Mean oxidized LDL (EU/mL) in cases 39.3±34.4 (range 14.4 to 160) was significantly raised (P=0.02, t test) as compared to controls 23.9±13.4 (range 12 to 70). In our study we found MDA levels (nmol/mL) to be increased in b thalassemia patients as compared to controls. Mean MDA was 10.0±3.27 (4.41 to 17.48) in cases while in controls was 6.87±4.55 (1.5 to 17.9). Our study results show CIMT as an early marker of atherogenesis in b thalassemia major. Oxidative stress markers are also increased in b thalassemia major patients and lipoprotein (a) shows a positive correlation with CIMT. The present study points towards various atherogenetic mechanisms in b thalassemia major.

GDF‐15 is associated with atherosclerosis in adults with transfusion‐dependent beta‐thalassemia

“…Carotid intima‐media thickness (CIMT) is a noninvasive method to detect early subclinical atherosclerosis, and it well correlates with vascular injury and severity of coronary artery disease. So, it is a good tool for detecting early atherosclerosis in such patients [ 7 ]. Thalassemia intermedia patients usually live longer and, thus, are more prone to complications of atherosclerosis.…”