Relationship between liver iron concentration determined by R2-MRI, serum ferritin, and liver enzymes in patients with thalassemia intermedia

Al-Momen, Hayder; Jasim, Shaymaa Kadhim; Hassan, Qays A.; Ali, Hayder Hussein

doi:10.5045/br.2018.53.4.314

Cited by 7 publications

(9 citation statements)

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“…Patients with TI usually have high iron content loading in their tissues as evidenced by other studies from different areas of the world 13 , 20 , 21 . Our sample of patient had even higher iron content, which is in line with other reports from Middle East 3 , 14 . This might be due to compliance deterioration, background cultural beliefs, possible side effects of iron chelating drugs, and the frequent use of mimic medications in this part of the world 22 .…”

Section: Discussionsupporting

confidence: 93%

“…Physicians have several challenges when using medications that eliminate excessive iron, including type, dose, expected adverse effects, and the best time to start an iron chelator. Therefore, the need for a naturally mediated iron chelator based on plants is increasing along with the increase of thalassemia patients around the world [13][14][15] . Green tea (GT) seems to be one of the best available options due to its natural properties to counteract iron absorption in addition to other promising advantages 16,17 .…”

Section: Discussionmentioning

confidence: 99%

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Green tea influence on iron overload in thalassemia intermedia patients: a randomized controlled trial

et al. 2020

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Background: Although iron chelation therapies have been available for many years for thalassemia intermedia patients, iron accumulation remains the major cause of death. Therefore, the need for additional chelation options is in demand. This randomized controlled study aimed to understand the effects of green tea on iron balance in thalassemia intermedia patients. Methods: Using a random selection method, 141 thalassemia intermedia patients were initially screened for inclusion in this trial; only 68 patients included after applying exclusion criteria. Two equal groups were generated (n=34/group): green tea (three cups/day after meals) + usual treatment (deferasirox iron chelator and on demand blood transfusion); and control (only usual treatment). The study lasted for a period of 12 months. Patients failing to comply to the trial methodology were excluded, leaving a final total of 29 patients in the green tea group and 28 patients in the control group. Liver iron concentration, and serum ferritin were assessed at baseline and 12 months, while hemoglobin levels were assessed monthly. Results: At baseline, both groups were matched regarding general demographics. At 12 months, the net drop of liver iron concentration in the green tea group (7.3 mg Fe/g dry weight) was significantly higher than the control group (4.6 mg Fe/g dry weight) (p<0.05). This was also seen with serum ferritin; net reduction in green tea and control groups were 1289 ng/ml and 871 ng/ml, respectively (p<0.05). Hemoglobin levels were slightly higher in the green tea group compared with the control group, but this was not significant. Conclusions: Regular green tea consumption had a significant capability to improve iron deposition in thalassemia intermedia patients who already undergo deferesirox iron chelation therapy. Trial registration: UMIN-CTR Clinical Trials Registry, UMIN000040841 (retrospectively registered June 21, 2020).

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Green tea influence on iron overload in thalassemia intermedia patients: a randomized controlled trial

et al. 2020

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“…However, other reports did not find a significant relationship between endocrine disorders and serum ferritin level [ 21 , 22 ].. The serum ferritin level could estimate the liver iron concentration in TM [ 23 ]. Moreover, Sobhani et al [ 24 ] found that higher serum ferritin strongly predicted the severity of cardiac and liver iron overload.…”

Section: Discussionmentioning

confidence: 98%

Detection of endocrine disorders in young children with multi-transfused thalassemia major

2021

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Background Beta thalassemia major (TM) is the most common inherited genetic disorder worldwide. Patients are at risk of iron overload, which leads to various forms of tissue damage, including endocrinopathies. The aim of this study was to evaluate the prevalence and risk factors of endocrine disorders in young patients with multi-transfused TM receiving iron chelation therapy. Methods The inclusion criteria included all known cases of TM according to hemoglobin electrophoresis data, aged 12 years or younger, during the study period. The patient’s age, gender, parent’s consanguinity, clinical examination, and types of iron chelating agents used were recorded. Serum ferritin level, complete blood count (CBC), blood glucose homeostasis, thyroid, and parathyroid functions were determined. Results One hundred twenty patients met the inclusion criteria; 70% of them had malnutrition. The presence of endocrine disorders was observed in 28/120 (23.33%) patients. The most common endocrine disorders were thyroid disorders, either subclinical or clinical hypothyroidism in 11/120 (9.17%) patients, followed by abnormalities in glucose homeostasis 9/120 (7.5%). The prevalence of impaired glucose tolerance, impaired fasting glucose, and diabetes mellitus in the present study was 5 (4.17%), 4 (3.33%), and 0 (00%), respectively, while the least frequent endocrine disorder seen in our patients was hypoparathyroidism in 8/120 (6.66%). We noted that high serum ferritin levels and poor patient compliance to therapy were significantly associated with increased endocrine disorders (OR 0.98, 95% CI 0.96–0.99, P = 0.003 and OR 0.38, 95% CI 0.16:0.93, P = 0.03, respectively). Combined chelating iron agents significantly decreased the prevalence of endocrine disorders when compared with monotherapy (OR 0.40, 95% CI 0.16:0.97, P = 0.04). Conclusion Endocrine disorders could occur in TM patients early before or equal to 12 years of life in about one-fourth of the patients. A high serum ferritin level and poor patient compliance to therapy were significantly associated with increased endocrine disorders. Combined iron-chelating agents were associated with a decreased prevalence of endocrine disorders when compared with monotherapy.

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“…It is well known that postmenopausal osteoporosis (PMOP) is mainly caused by the decline of estrogen, and is usually treated with estrogen replacement therapy. Interestingly, increasing studies have revealed that levels of serum ferritin are promoted by more than twofold after menopause and the abnormal iron accumulation (IA) contributes significantly to PMOP development 2–5 . Therefore, it is of great significance to explore the molecular mechanism by which IA regulates osteoporosis pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, increasing studies have revealed that levels of serum ferritin are promoted by more than twofold after menopause and the abnormal iron accumulation (IA) contributes significantly to PMOP development. [2][3][4][5] Therefore, it is of great significance to explore the molecular mechanism by which IA regulates osteoporosis pathogenesis. This will provide benefits for the development of alternative therapeutic targets or strategies for osteoporosis treatment.…”

Section: Introductionmentioning

confidence: 99%

Iron accumulation regulates osteoblast apoptosis through lncRNAXIST/miR‐758‐3p/caspase 3 axis leading to osteoporosis

Wang

Chen

et al. 2021

IUBMB Life

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Postmenopausal osteoporosis (PMOP) is mainly caused by multiple factors. Recent studies have suggested that iron accumulation (IA) was closely related to PMOP. However, the detailed molecular mechanisms have not been well demonstrated. We constructed the IA mouse model by intraperitoneal injections of ferric ammonium citrate (FAC) and cell model by culturing with the medium containing FAC. Osteoporosis was confirmed in mouse bone tissues using H&E staining, and the level of serum ferritin, alkaline phosphatase (ALP), procollagen-1 N-terminal peptide (P1NP), and osteocalcin in mice was examined by ELISA. The expressions of XIST and miR-758-3p were detected by qRT-PCR. Cell proliferation and apoptosis were measured by CCK-8, TUNEL, and flow cytometry. The expression levels of apoptotic-related proteins were evaluated by western blot. Dual luciferase reporter assay was used to examine the molecular interaction. The expressions of ALP, P1NP, and osteocalcin, and the H&E staining of bone tissues in mice were analyzed to confirm the biological function of XIST and miR-758-3p in vivo. XIST was up-regulated while miR-758-3p was down-regulated in IA mouse and cell models. XIST knockdown significantly reduced FAC-induced osteoblast apoptosis, which was mimicked by transfection with miR-758-3p mimics. XIST acted as a sponge of miR-758-3p, which targeted caspase 3. IA led to the high expression of XIST and promoted osteoblast apoptosis through miR-758-3p/caspase 3. Transfection with shXIST or miR-758-3p mimics alleviated IA-induced mouse osteoporosis. IA regulated osteoblast apoptosis through XIST/miR-758-3p/caspase 3 axis, which might provide alternative targets for the treatment of osteoporosis.

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Relationship between liver iron concentration determined by R2-MRI, serum ferritin, and liver enzymes in patients with thalassemia intermedia

Cited by 7 publications

References 25 publications

Green tea influence on iron overload in thalassemia intermedia patients: a randomized controlled trial

Green tea influence on iron overload in thalassemia intermedia patients: a randomized controlled trial

Detection of endocrine disorders in young children with multi-transfused thalassemia major

Iron accumulation regulates osteoblast apoptosis through lncRNAXIST/miR‐758‐3p/caspase 3 axis leading to osteoporosis

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