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Published on: January 31, 2022
Correlation between plasma biochemical parameters and cardio-hepatic iron deposition in thalassemia major patients
Hakimeh Saadatifar1, Maysam Mard-Soltani2, Arezoo Niayeshfar3
1Department of Echocardiography, Dezful University of Medical Sciences, Dezful, Iran.
Insights
In major thalassemia, elevated blood sugar, liver enzymes, and low magnesium correlate with cardiac iron overload. Serum ferritin indicates liver iron overload, offering potential indirect monitoring for patients.
Area of Science:
- Hematology
- Medical Imaging
- Biochemistry
Background:
- Major thalassemia patients face significant risks from iron overload, leading to severe organ damage, particularly in the heart and liver.
- Effective management of iron overload through chelation therapy is crucial for reducing complications and mortality.
- Non-invasive monitoring methods are needed to assess iron deposition in organs.
Purpose of the Study:
- To identify biochemical and hematological predictors of cardiac and hepatic iron deposition in major thalassemia patients.
- To compare these predictors against cardiac and liver MRI T2* measurements, the gold standard for assessing iron overload.
Main Methods:
- Sixty-two major beta-thalassemia patients on regular transfusion and chelation therapy were assessed.
- Cardiac and liver tissue iron levels were measured using MRI T2*.
- Serum ferritin, electrolytes, liver enzymes, hemoglobin, blood glucose, and serum magnesium were analyzed for correlations.
Main Results:
- Serum ferritin showed a significant positive correlation with liver siderosis (p=0.015) but not cardiac siderosis (p=0.79).
- Cardiac iron deposition correlated positively with fasting blood sugar (p=-0.049) and liver enzymes (ALT p=0.001, AST p=0.01).
- Cardiac iron overload showed a significant negative correlation with serum magnesium (p=0.014).
Conclusions:
- Increased blood sugar, liver enzymes, and decreased serum magnesium are associated with cardiac iron overload in major thalassemia patients.
- Serum ferritin serves as a significant indicator for liver iron overload.
- These biochemical markers may offer an alternative, indirect method for monitoring organ-specific iron deposition.
Introduction:
Major Thalassemia patients suffer from iron overload and organ damage, especially heart and liver damage. Early diagnosis and treatment with a chelator can reduce the complications and mortality of iron overload. Therefore, we aimed to investigate the biochemical and hematological predictors as an alternative and indirect indicator of iron deposition in heart and liver cells in comparison with the MRI T2* method as the gold standard.
Material And Method:
MRI T2* was evaluated in the heart and liver tissues of 62 major beta-thalassemia patients undergoing regular transfusion and chelator therapy. Biochemical and hematological factors were also measured, including serum ferritin, serum electrolytes, liver enzymes, hemoglobin, blood glucose, and serum magnesium. The correlation between these factors was assessed using statistical evaluations.
Result:
Serum ferritin had a positive and significant correlation with liver siderosis based on MRI T2* (p-value = .015), and no significant association was observed with cardiac siderosis (p-value = .79). However, there was a significant positive correlation between cardiac iron deposition and fasting blood sugar level (p-value = -.049), and plasma level of liver enzymes (alanine aminotransferase (ALT) (p-value = .001), aspartate aminotransferase (AST ((p-value = .01)). Moreover, there was a significant negative correlation between cardiac iron overload and plasma magnesium level (p-value = .014). According to MRI T2*, there was no significant correlation between cardiac and hepatic iron overload (p value = .36).
Conclusion:
An increase in blood sugar or liver enzymes and a decrease in serum magnesium was associated with an increase in cardiac iron overload based on MRI T2*. Liver iron overload based on MRI T2* had a significant correlation with serum ferritin.
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