Correlation of liver enzymes with serum ferritin levels in beta-thalassemia major

Suman, Rameshwar Lal; Sanadhya, Anuradha; Meena, Pradeep; Goyal, Sanjay

doi:10.18203/2320-6012.ijrms20162278

Cited by 13 publications

(15 citation statements)

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“…[7][8][9][10] In our study, average value of Total cholesterol (mg/dl) of thalassemia patient was (mean±SD) 153.84±5. 13,14,2 This study reveals average value of LDL cholesterol (mg/dl) of thalassemia patient was (mean±SD) 97.16±3.982 mg/dl. Serum 'LDL' cholesterol negatively correlated with Number of previous blood transfusion, 'Hepatomegaly under RCM', 'Splenomegaly under LCM', 'Triglyceride', 'VLDL', 'Ferritin' (Pearson's correlation coefficient -0.284, -0.633, -0.672, -0.572, -0.942, -0.964 respectively) which were statistically significant.…”

Section: Discussionmentioning

confidence: 76%

Study of lipid profile in β thalassemia major pediatric patients with multiple blood transfusion and its correlation with serum ferritin level in tertiary care hospital in Kolkata

Nandi

Samanta

Mondal

et al. 2021

Int J Community Med Public Health

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Background: β-Thalassemia major is associated with iron overload toxicity. This study was done to investigate lipid profile abnormality in β-Thalassemia major patients and to establish their correlation with serum ferritin. Another motto of this study was to signify deleterious effect of multiple blood transfusion and facilitate to understand how it will affect the lipid profile parameters changes so that we can also prevent early dyslipidemia induced complications like atherogenesis by early detection of lipid profile abnormality and also to establish derangement of lipid profile as an indirect evidence of iron overload.Methods: 102 nos. β-Thalassemia major paediatric patients with multiple blood transfusion (≥10) in age group of 6 to12 years admitted in pediatric ward of tertiary care hospital (NRSMCH) were enrolled. Serum ferritin level and lipid profile were investigated and their correlation were assessed.Results: Among 102 β-Thalassemia major pediatric (6 to 12 years) patients 55.88% were male and 66.67% were Hindu by religion and 69.61% children came from lower socio-economic class. The average value of number of previous blood transfusion was 42.79±7.510. The mean value of serum ferritin was 2263.53±833.904 ng/ml. The average value of serum total cholesterol, LDL and HDL were 153.84±5.428 mg/dl and 97.16±3.982 mg/dl and 29.45±4.445 mg/dl respectively and their correlation with serum ferritin were negative (r=-0.941 and r=-0.964 and r=-0.751 respectively). Average value of serum triglyceride and VLDL were 206.22±67.407 mg/dl and 36.16±3.385 mg/dl respectively and their correlation with serum ferritin were positive (r=+0.606 and r=+0.973 respectively).Conclusions: There was significant lipid profile derangement. As the serum ferritin level increases, serum total cholesterol, HDL, LDL decreases and serum triglyceride, VLDL level increases.

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Section: Discussionmentioning

confidence: 76%

Study of lipid profile in β thalassemia major pediatric patients with multiple blood transfusion and its correlation with serum ferritin level in tertiary care hospital in Kolkata

Nandi

Samanta

Mondal

et al. 2021

Int J Community Med Public Health

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“…Serum ferritin remains an inexpensive and easily available tool for assessment of iron overload regardless of its limitation, but T2 * MRI still becomes a recommended strategy to evaluate iron overload [13,18]. Prior works have demonstrated some correlation between liver or cardiac function tests and serum ferritin or T2 * MRI [11,[19][20][21][22][23]. However, most of those studies included pediatric to young adult thalassemic patients.…”

Section: Discussionmentioning

confidence: 99%

Iron Overload in Transfusion-Dependent Indonesian Thalassemic Patients

Fianza

Rahmawati

Widihastha

et al. 2021

Anemia

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Thalassemia is a genetic disease caused by disruption of globin chain synthesis leading to severe anemia and thus regular blood transfusion is necessary. However, there have been known transfusions-related consequences, including iron overload and multi-organ damage. The aims of this study were to evaluate liver and cardiac function in youth and adult transfusion-dependent Indonesian thalassemic patients and to assess its correlation with serum ferritin levels, as well as T2 ∗ magnetic resonance imaging (MRI). Transfusion-dependent thalassemic (TDT) outpatients (n = 66; mean age, 21.5 ± 7.2 years) were carried out for the complete assessment consisting of blood test including liver enzyme and serum ferritin, followed by electrocardiography (ECG) and echocardiography. Subjects were also divided by serum ferritin levels into three groups: < 2500 ng/mL, 2500–5000 ng/mL, and >5000 ng/mL. Additionally, subgroup analysis in patients with T2∗ MRI assessment was conducted. In terms of age of first blood transfusion, subjects with ferritin >5000 ng/mL were the youngest among others. The alanine aminotransferase (ALT) levels in group with serum ferritin >5000 ng/mL were significantly higher than those of the group with serum ferritin <2500 ng/mL. Additionally, youth and adult TDT patients whose serum ferritin >5000 ng/mL had significantly lower tricuspid annular plane systolic excursion (TAPSE) when compared with those who had serum ferritin <2500 ng/mL. Similarly, TAPSE in patients with moderate cardiac siderosis based on cardiac T2∗ MRI was significantly lower than those without cardiac siderosis. There was significant, but only moderate correlation between serum ferritin and cardiac T2∗ MRI. Based on these findings, it is important to routinely monitor iron accumulation-related complications, including liver and cardiac damage in youth and adult TDT patients.

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“…The liver is the earliest organ affected by iron overload in thalassemia children and serum AST and ALT are raised due to peroxidase injury and direct toxic effect of iron on liver cells. 2 As iron deposits in the liver, its functions are affected which are predicted by raised AST and ALT. In our study, AST and ALT levels were raised significantly especially in patients where serum ferritin was >3000 ng/ml and there was a positive correlation between serum ferritin and AST and ALT.…”

Section: Discussionmentioning

confidence: 99%

“…1 Frequent blood transfusion causes progressive iron overload which is a major complication of treatment. 2 Iron toxicity is one of the major complications with consequential end-organ damage and stunted growth. Iron is initially deposited in the liver and then in the endocrine system and then in heart.…”

Section: Introductionmentioning

confidence: 99%

“…Iron overload occurs both in hepatocytes and reticuloendothelial cells. 2 Growth retardation in thalassemia is because of chronic tissue hypoxia, iron toxicity, nutritional deficiency (zinc, folate) and growth hormone failure. 3 With introduction of iron chelators, survival rates have improved 4 but endocrine complications have become more frequent and significantly affect the quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Serum Ferritin Levels with Liver Function Tests and Anthropometric Measurements in Transfusion Dependent Beta-Thalassemia Major Children: A Cross Sectional Study

Harish

Pasha

2019

Pediatric Oncall

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Aim: To determine liver dysfunction and growth in transfusion-dependent beta-thalassemia children of age 2-16 years with iron overload state.Methods: Forty-one children aged 2-16 years with transfusion-dependent beta-thalassemia who were on chelation therapy with oral iron chelator deferasirox for at least 1 year were included in the study. Serum ferritin, growth assessment and liver function tests (LFT) were measured and correlated. Stunting was defined as low height for age (HFA). According to the World Health Organization (WHO), HFA between -2SD to -3SD was defined as moderate stunting and HFA less than -3SD as severe stunting. Spearmen correlation coefficient was used for finding out a correlation among different variables. Multiple linear regression was carried out to estimate the relationship between serum ferritin level, transfusion rate per year, age, sex and HFA status of thalassemia children.Results: Out of 41 children, 25 (60%) patients were in the age group of 5-10 years and the overall median age of the patients was 8 years. The overall median rate of blood transfusion was 12.3 per year and median ferritin levels were 3863 ng/ml (95% CI 2781-4860). There was a significant relationship between ferritin level and transfusion rate per year (p=0.048). The median aspartate aminotransferase (AST) was 51 IU/L (95% CI 43-66), alanine aminotransferase (ALT) 45 IU/L (95% CI 31-58). There was a significant relationship between ferritin level and AST, ALT levels (p<0.005) with correlation coefficient 0.31 and 0.55 respectively. AST and ALT levels were rising as the serum ferritin was increasing and after the level of 3000 ng/ml, there was a steep rise. Moderate stunting was seen in 9 (23%) patients with median ferritin level of 3452 ng/ml (95% CI 370-4992 ), severe stunting was present in 14 (34%) patients with median ferritin level of 4432 ng/ml (95% CI 2781 -4860 ) and normal height was seen in 18 (44%) cases with median ferritin level of 3992 ng/ml (95% CI 1904-4862) (p=0.4). Conclusion:High serum ferritin levels in beta-thalassemia are associated with hepatic dysfunction. Hence liver functions should be monitored frequently in patients with beta-thalassemia major. In our study, we found many children with stunting, but stunting is not affected by iron overload states.

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Correlation of liver enzymes with serum ferritin levels in beta-thalassemia major

Cited by 13 publications

References 1 publication

Study of lipid profile in β thalassemia major pediatric patients with multiple blood transfusion and its correlation with serum ferritin level in tertiary care hospital in Kolkata

Study of lipid profile in β thalassemia major pediatric patients with multiple blood transfusion and its correlation with serum ferritin level in tertiary care hospital in Kolkata

Iron Overload in Transfusion-Dependent Indonesian Thalassemic Patients

Correlation of Serum Ferritin Levels with Liver Function Tests and Anthropometric Measurements in Transfusion Dependent Beta-Thalassemia Major Children: A Cross Sectional Study

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