Early detection of premature atherosclerosis in β-thalassemia patients by measuring carotid intima-media thickness

Abstract

Background: Beta-thalassemia patients still suffer from many complications. Transfused patients may develop complications related to iron overload including growth retardation and failure or delay of sexual maturation, cardiac involvement (dilated cardiomyopathy or rarely arrhythmia), liver (fibrosis and cirrhosis), endocrine glands (diabetes mellitus, hypogonadism, insufficiency of parathyroid, thyroid, pituitary and less commonly, adrenal glands). Purpose: The present study was undertaken to evaluate the role of Carotid artery intima media thickness (CIMT) measurement as an early detector of premature atherosclerosis in beta-thalassemia children and early adolescents and its relation to biochemical risk factors as iron overload and lipid profile. Patients and Method: Twenty-two β-thalassemia major (TM), 8 β-thalassemia intermedia (TI) with confirmed diagnosis of betathalassemia (major and intermedia) proved by clinical and laboratory investigations, frequent blood transfusion, chelation therapy with their age ranging from 10 to18 years old and 30 age-and sex matched healthy controls were included. Lipid profile (by colorimetric assay), serum ferritin, and CIMT measurements using high-resolution B-mode ultrasonography were estimated. Results: CIMT of thalassemic patients (major and intermedia) was highly significantly increased compared to controls with no significant difference between β-thalassemia major and b thalassemia intermedia groups could be detected. CIMT was positively correlated with serum ferritin, TG, Total cholesterol level in both diseased groups and LDL level in B-TM group only. This provides a good evidence of the presence of premature atherosclerosis in vascular-free TM and TI patients and its relation to increased body iron and dyslipidemia. Conclusion: Carotid artery intima media thickness represented a simple, accurate and non-invasive method for early detection of premature atherosclerosis which started early in b- thalassemia patients This study identified a relationship between body iron status, dyslipidemia and increased carotid IMT.