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Association of Iron Overload with Oxidative Stress, Hepatic Damage and Dyslipidemia in Transfusion-Dependent β-Thalassemia/HbE Patients

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Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

Blood transfusion can be a life-saving therapy for β-thalassemia major and β-thalassemia/HbE (β-TM) patients with chronic anemia, major caused severe iron overload particularly in β-TM patients received only blood transfusion therapy. We aim to evaluate the association of iron overload with oxidative stress, liver damage, and elevated very low density lipoprotein cholesterol (VLDL-C) in transfusion-dependent β-TM patients. Serum ferritin, malondialdehyde (MDA), liver profiles, triglycerides levels, and VLDL-C were significantly higher while total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol and total antioxidant capacity were lower in β-TM than controls. Serum ferritin was significantly correlated with MDA, liver enzymes and lipid profiles (p < 0.05). Multiple forward stepwise linear regression analyses of the significant variables showed that in these β-TM patients, independent predictors of iron overload were MDA (β = 0.410, r 2 = 0.671, p < 0.001), ALT (β = 0.493, r 2 = 0.578, p < 0.001), and VLDL-C (β = 0.253, r 2 = 0.711, p < 0.001). In conclusion, iron overload associated with increased oxidative stress, lipid peroxidation, liver damage, decreased TC, LDL-C, HDL-C and over production of VLDL-C, is significantly problem in transfusion-dependent β-TM patients. These appeared the major cause of future morbidity and mortality in β-TM patients.

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Abbreviations

Hb:

Hemoglobin

Hct:

Hematocrit

TB:

Total bilirubin

DB:

Direct bilirubin

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

ALP:

Alkaline phosphatase

TC:

Total cholesterol

HDL-C:

High density lipoprotein cholesterol

LDL-C:

Low density lipoprotein cholesterol

VLDL-C:

Very low density lipoprotein cholesterol

MDA:

Malondialdehyde

RC:

Red blood cell

/g Hb:

Per gram hemoglobin

TAC:

Total antioxidant capacity

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Acknowledgments

We sincerely thank Naresuan University for financial support. We also sincerely thank all co-workers in the Pediatric Unit of Phrae Hospital and Vachira Phuket Hospital, for blood collection and their technical help. We especially thank those who participated and donated blood samples for this study. Finally we sincerely thank Asst. Prof. Dr. Ronald A. Markwardt, Faculty of Public Health, Burapha University, for his critical reading and correcting of the manuscript.

Conflict of interest

No conflict of interest.

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Authors and Affiliations

  1. Chronic Diseases Research Unit, Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000, Thailand

    Chintana Sengsuk, Orathai Tangvarasittichai & Surapon Tangvarasittichai

  2. Pediatric Department, Phrae Hospital, Phrae, Thailand

    Prasert Chantanaskulwong & Somsak Wantaneeyawong

  3. Pediatric Department, Vachira Phuket Hospital, Phuket, Thailand

    Ampai Pimanprom & Anuchit Choowet

  4. Chronic Diseases Research Unit, Department of Optometry, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, 65000, Thailand

    Surapon Tangvarasittichai

Authors
  1. Chintana Sengsuk
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  2. Orathai Tangvarasittichai
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Correspondence to Surapon Tangvarasittichai.

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Sengsuk, C., Tangvarasittichai, O., Chantanaskulwong, P. et al. Association of Iron Overload with Oxidative Stress, Hepatic Damage and Dyslipidemia in Transfusion-Dependent β-Thalassemia/HbE Patients. Ind J Clin Biochem 29, 298–305 (2014). https://doi.org/10.1007/s12291-013-0376-2

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  • DOI: https://doi.org/10.1007/s12291-013-0376-2

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