Nutritional Biomarkers in Children and Adolescents with Beta-Thalassemia-Major: An Egyptian Center Experience

Abstract

Background and Aim. Trace elements and vitamins play a vital role in human body to perform its function properly. Thalassemic patients are at risk of micronutrient deficiency. This study estimated levels of vitamins A, C, E, B12, folic acid, total homocysteine (tHcy), and methylmalonic acid (MMA) along with trace elements, zinc, copper, and selenium in Beta-thalassemia-major patients. Methods. This study included 108 patients with Beta-thalassemia-major and 60 age and sex matched healthy children. Serum levels of vitamin A, E, C, tHcy, and MMA were estimated by high pressure liquid chromatography while serum levels of folic acid and B12 were estimated by thin layer chromatography. Serum zinc, copper, and selenium were determined by atomic absorption spectrometry. Results. There was a significant decrease of vitamins A, C, E, and B12 and trace elements zinc, copper, and selenium in thalassemic patients as compared to controls. tHcy and MMA were significantly elevated in patients. No significant correlations were found between the serum levels of the studied vitamins and trace elements as regards age, frequency of transfusion, duration of transfusion, and serum ferritin. Conclusion. The level of various nutritional biomarkers (vitamins A, C, E, and B12 and trace elements zinc, copper, selenium) was reduced in chronically transfused Egyptian thalassemic patient. These patients should have periodic nutritional evaluation and supplementation. Multicenter studies are highly recommended.

Simultaneous Determination of Plasma Deferasirox and Deferasirox-Iron Complex Using an HPLC-UV System and Pharmacokinetics of Deferasirox in Patients With β-Thalassemia Major: Once-daily Versus Twice-daily Administration

“…Moreover, higher C max values may also reflect the iron excretion efficacy from the chelation therapy. 21 This study revealed that all patients had a higher C max per single dose when BID DEFR administration was compared with once-daily administration. Further study to correlate the C max per single dose or the conversion ratio of Fe-(DEFR) 2 from free DEFR instead of DEFR levels to the outcomes of iron control may be needed.…”

Mineral Levels in Thalassaemia Major Patients Using Different Iron Chelators

“…That study revealed that patients' serum Zn values correlated with their siblings', and they suggested that serum Zn levels are possibly more influenced by familial and environmental factors rather than by thalassaemia. On the other hand, there are many studies showing zinc deficiency in the TM patients using iron chelator [6,[24][25][26]. As a result, zinc level should be measured regularly and replaced if there is any deficiency.…”

“…Selenium (Se) is an essential trace element and a functional component of the antioxidant defence system, an essential constituent of the thioredoxin reductase (TrxR) and glutathione peroxidase (GPx), and also many important proteins are included selenium [6]. Zinc (Zn) is a structural element of many proteins.…”

Delayed adrenache in thalassaemia: a case series

“…Zinc is another important micro-nutrient that is essential for normal hair growth (7) and it is considered as one of the commonest causes of hair loss (8). Zinc deficiency is a common among thalassemic patients (9,10). The chelation of Zinc together with iron due to the use of iron chelators and chronic haemolysis that causes Zinc release are thought to be responsible for zinc deficiency among these patients (9,11).…”

“…Zinc deficiency is a common among thalassemic patients (9,10). The chelation of Zinc together with iron due to the use of iron chelators and chronic haemolysis that causes Zinc release are thought to be responsible for zinc deficiency among these patients (9,11). Although it's deficiency could leads to reduced hair growth and delayed pubarche in these individuals, a direct relationship between zinc deficiency and delayed pubarche has not been properly evaluated.…”