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Premature Atherosclerosis in Children With Transfusion-Dependent Thalassemia: A Twin-Center Cross-Sectional Study
K S Kumaravel1, D Sampathkumar2, P Punitha2
1Department of Pediatrics, Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu.
Insights
Children with transfusion-dependent thalassemia (TDT) show increased carotid intima-media thickness (CIMT), indicating a higher risk of early atherosclerosis. Higher ferritin levels and older age are linked to this increased CIMT.
Area of Science:
- Pediatric Cardiology
- Hematology
- Vascular Biology
Background:
- Transfusion-dependent thalassemia (TDT) is a chronic condition requiring frequent blood transfusions.
- These transfusions can lead to iron overload and other complications.
- Premature atherosclerosis is a growing concern in TDT patients.
Purpose of the Study:
- To assess the risk of premature atherosclerosis in children with TDT.
- To compare carotid intima-media thickness (CIMT) between TDT children and healthy controls.
- To identify clinical and biochemical factors associated with atherosclerosis in TDT.
Main Methods:
- A case-control study was conducted.
- Participants included children aged 2 to 15 years.
- Carotid intima-media thickness (CIMT) was measured and correlated with clinical and biochemical data.
Main Results:
- Children with TDT exhibited significantly higher CIMT values across all age groups compared to controls.
- Elevated triglycerides and liver enzymes were noted in TDT patients.
- Higher CIMT was associated with older age and elevated serum ferritin levels, but not dyslipidemia.
Conclusions:
- Children with TDT face an elevated risk of developing premature atherosclerosis.
- Regular monitoring of CIMT and iron levels is crucial for managing TDT complications.
Objective:
Objective To analyze the risk of premature atherosclerosis in children with transfusion-dependent thalassemia (TDT) compared to controls by measuring carotid intima-media thickness (CIMT) and correlating it with clinical and biochemical parameters.
Methods:
Case-control study among children aged 2 to 15 years.
Results:
Significantly higher CIMT values were observed across all age groups. Mean (SD) CIMT in controls were 0.27(0.07) mm, 0.39 (0.03) mm, and 0.46 (0.05) mm in 2 to 5 years, 6 to 10 years, and 11 to 15 years age groups respectively, as against 0.43 (0.08) mm, 0.55 (0.07) mm and 0.63 (0.08) mm in cases in similar age groups (P<0.001). Mean triglycerides and liver enzymes were significantly elevated in cases. Logistic regression analysis demonstrated that older age group and higher serum ferritin levels, but not dyslipidemia, were significantly associated with high CIMT.
Conclusion:
Children with TDT are at increased risk for premature atherosclerosis.
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