J Pediatr Hematol Oncol 2012 Nov;34(8):630-4

Premature atherosclerosis in children with β-thalassemia major.

Gursel O, Kurekci AE, Tascilar E, Ileri T, Altun D, Tapan S, Kurt I, Kocaoglu M, Aydin A, Okutan V, Ozcan O.
Department of Pediatric Hematology, Gulhane Military Medical Academy and Medical Faculty, Ankara, Turkey. ogursel@gata.edu.tr

Abstract

OBJECTIVES:

In this study, we aimed to investigate the relationship between chronic hemolysis and increased body iron burden with development of premature atherosclerosis by carotid intima-media thickness (IMT), ferritin, serum lipid profile, homocysteine, nitrate/nitrite, and chitotriosidase enzyme activity in children with β-thalassemia major.

MATERIALS AND METHODS:

A total of 31 children with a diagnosis of β-thalassemia major between the ages of 4 to 16 years constituted the study group. Control group was consisted of 36 age-matched healthy children. Complete blood count, serum glucose, lipid profile, ferritin, homocysteine, calcium, chitotriosidase, and nitrate/nitrite levels were measured and electrocardiographic and echocardiographic investigation and carotid IMT measurement were performed.

RESULTS:

In study group serum total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were found to be significantly reduced, and very-low-density lipoprotein cholesterol levels were found to be significantly elevated. Plasma nitrate/nitrite levels were significantly reduced; chitotroisidase enzyme activity was significantly increased and carotid IMT was significantly increased in study group. Nitrate/nitrite was found to be the only variable that was statistically significantly related to carotid IMT.

CONCLUSIONS:

Subclinical atherosclerosis in children with β-thalassemia major begins early in life, and these children are at risk for development of premature atherosclerosis.