Serum Adipocytokine and Vascular Inflammation Marker Levels in Beta-Thalassaemia Major Patients

Abstract

Background/Aim: The adipocytokines leptin and adiponectin represent a critical link between metabolism, immunity and chronic inflammation. A chronic vascular inflammatory state plays an important role in the pathophysiology of thalassaemia. We aimed to analyze the levels of these adipocytokines and determine any possible correlations with disease severity or vascular inflammation markers in beta-thalassaemia. Methods: Serum leptin, adiponectin, high-sensitivity C-reactive protein, endothelins, vascular adhesion molecule-1, intracellular adhesion molecule-1 and L- and E-selectin were measured in 28 beta-thalassaemia patients and compared with levels in healthy controls. Results: Leptin was significantly lower in patients compared to controls (2.23 ± 1.8 vs. 10.24 ± 5.78 µg/l; p = 0.0018), whereas adiponectin was elevated (11.75 ± 5.67 vs. 6.83 ± 2.75 µg/l; p = 0.009). For both adipocytokines, no correlations were found with characteristics such as age, gender, type of chelation, body mass index z score or haemoglobin. Leptin, but not adiponectin, was negatively correlated with ferritin (p = 0.032, r = –0.61). No correlations were found between leptin and the inflammation markers. However, adiponectin was positively correlated with endothelin-1 (p = 0.022, r = 0.63). Conclusions: Serum leptin is low in beta-thalassaemia, perhaps due to the toxic effect of iron overload on adipose tissue. Paradoxically, adiponectin levels are high and positively correlated with endothelin-1, raising questions about the pro- or anti-inflammatory role of this adipocytokine in beta-thalassaemia.

Elevated serum adiponectin is related to elevated serum ferritin and interleukin-6 in β-thalassaemia major children

“…This was matched with previous studies [14,16,18]. Increasing evidence supports the role of inflammation in the pathogenesis of complications in β-thalassaemia, a genetic haematological disease.…”

“…Elsayh et al's [16], study on 35 patients with β-thalassaemia major patients, reported positive correlation between adiponectin and highly senstive CRP (hsCRP). In contrast, Chaliasos et al's [14], study on 28 patients with β-thalassaemia major patients did not found significant correlation between serum adiponectin and CRP. Linear regression analysis revealed that IL-6 was an independent predictor of adiponectin level.…”

Calprotectin

“…P < 0.01 the relation is statistically highly significant. This is in agreement with that reported in other studies, which found that adiponectin, resistin, and visfatin concentrations were significantly higher in both b-thalassemia intermedia and BTM patients compared with controls and speculated that these adipocytokines may play a role in the development of complications in b-thalassemia [20,21].…”

“…A growing number of studies have examined the potential role of different inflammatory, endothelial adhesion molecules (sVCAM-1 and sICAM-1) and adipocytokines (adiponectin, resistin, and visfatin) in thalassemia, suggesting the potential role of these markers in the development of inflammation and complications in b-thalassemia [15,20,21].…”

Heme-bound iron activates placenta growth factor in erythroid cells via erythroid Krüppel-like factor

“…60,61 This proposed model of pulmonary vasculopathy promoted by iron burden is of general interest in light of other studies suggesting that iron promotes systemic endothelial dysfunction and atherosclerosis in patients without SCD 62,63 and suggests that these pathways each comprise elements of systemic vasculopathy. These pathways are likely to pertain also to b-thalassemia major, 64,65 another hemoglobinopathy with transfusion-associated iron overload and prevalent pulmonary hypertension. 66 Figure 5.…”