Lipid profile in children of β-thalassemia major and their correlation with serum ferritin

Abstract

Background: β-thalassemia major is a secondary iron load state. The high serum ferritin accounts for abnormal lipid profile. This study was done to investigate the lipid profile in children with β-thalassemia major and to know their correlation with serum ferritin.Methods: Fifty-five (55) children of beta thalassemia major in the age group of 4-20 years from thalassemia unit of tertiary care hospital who were on regular blood transfusion and oral iron chelators were enrolled. Serum ferritin levels and lipid profile of these children were investigated and their correlation was assessed. Results: Out of total 55 children 31 (56.4%) children were of female sex and 48(87.3%) were Hindu by religion. The mean rate of blood transfusion was 157.02±21.33 ml/kg/year with average dose and duration of iron chelation with Desferroxamine was 34.4±26.86 mg/kg /day and 2.34±1.86 years respectively. Mean cholesterol level, high density lipoprotein (HDL), low density lipoprotein (LDL) levels were on lower side of the range with values of 124.47±19.81 mg/dl, 36.58±12.22 mg/dl, 63.94±4.57 mg/dl respectively. The mean triglyceride level (TG) was on higher side with an average of 142.93±33.7 mg/dl. The average serum ferritin levels were 2130.33±859.85 ng/ml. There was negative correlation of total cholesterol, HDL, LDL with serum ferritin with coefficient of correlation (r= -0.77, -0.55, -0.72) respectively. The serum triglyceride had positive correlation with serum ferritin with coefficient of correlation(r=+0.85).Conclusions: As the serum ferritin increases, there occurs more derangement of lipid profile in form of decreasing serum cholesterol, HDL, LDL and increasing serum TG levels.

Korelasi Kadar Feritin dengan Profil Lipid pada Penyandang Talasemia Beta Mayor Anak

“…Penelitian di India tahun 2016 mengatakan bahwa terdapat korelasi negatif antara tingginya kadar feritin dengan rendahnya kolesterol HDL. Penelitian Suman dkk 16 di India tahun 2016 mengatakan bahwa kadar feritin dengan tingginya kadar trigliserida pada pasien talasemia.…”

“…Namun, didapatkan korelasi negatif lemah antara kadar serum feritin terhadap kadar serum kolesterol HDL. Seperti pada penelitian oleh Suman dkk 16 di India pada tahun 2016. Suman dkk melaporkan korelasi negatif antara kadar feritin yang tinggi dengan kolesterol HDL yang rendah.…”

“…3 Banyak faktor yang memengaruhi metabolisme lipid pada penyandang talasemia, seperti kelebihan besi, gangguan hati, dan gangguan hormonal. 1,7,16,19 Hati merupakan tempat deposisi besi paling awal pada penyadang talasemia yang rutin mendapatkan transfusi. Kelebihan besi terjadi pada sel hepatosit dan retikuloendotelial dengan produksi radikal bebas melalui reaksi fenton.…”

Peningkatan Kadar Feritin Serum Memiliki Korelasi Negatif dengan Kadar High Density Lipoprotein pada Anak Penyandang Thalassemia Beta Mayor

“…3 Beberapa penelitian telah menunjukkan bahwa akumulasi zat besi di tubuh dapat menimbulkan gangguan profil lipid. [5][6][7] Penyandang thalassemia mengalami gangguan profil lipid dalam bentuk kadar kolesterol total, High Density Lipoprotein (HDL), dan Low Density Lipoprotein (LDL) yang lebih rendah serta kadar trigliserida yang lebih tinggi dibandingkan individu normal. 8 Dislipidemia pada thalassemia mayor disebabkan oleh berbagai faktor, antara lain dilusi plasma akibat anemia, meningkatnya aktivitas eritropoeisis yang disertai dengan pengambilan kolesterol oleh makrofag dan histiosit dalam sistem retikuloendotelial, gangguan fungsi hati karena penimbunan zat besi, gangguan hormonal, dan menurunnya aktivitas lipolisis di luar hati.…”

“…Kerusakan hati dihubungan dengan kadar kolesterol total, HDL, dan LDL yang rendah. 5 Pengukuran terhadap kadar zat besi di tubuh manusia dilakukan melalui pemeriksaan kadar feritin serum. Feritin adalah kerangka protein intraselular yang terdiri dari 24 subunit yang mengelilingi inti besi yang mengandung sekitar 4000-4500 atom besi.…”