Risk of Premature Atherosclerosis in Patients with Transfusion Dependent Beta- Thalassemia Major

Abstract

Objective: To assess the risk of premature atherosclerosis in transfusion-dependent beta thalassemia major patients using Atherogenic Index of plasma.
Study Design: Comparative Cross-sectional study.
Place and Duration of the Study: Pathology Department, Fauji Foundation Hospital Rawalpindi, from 1st March 2024 to 31st August 2024.
Materials and Methods: Total 120 participants were included in our study comprising of 64 β-Thalassemia major patients and 56 healthy subjects. Patients with poor compliance for blood transfusions or iron-chelating therapy; individuals with age <3 years, having history of familial hyperlipidaemia, diabetes mellitus, hypothyroidism, liver or renal disease were excluded. Consent was obtained and anthropometric along with clinical details were recorded. Fasting blood samples were analyzed for serum lipid profile, serum Ferritin and
plasma hemoglobin. Atherogenic index of plasma was calculated by the formula: log TG/HDL-C. Data was analyzed on SPSS 23.
Results: Sixty-four β-Thalassemia major patients with mean age 13.2±4 years and 56 healthy subjects with mean age 12.6±5 years participated in our study. Elevated serum triglyceride level while reduced serum total cholesterol, low density lipoprotein and high-density lipoprotein cholesterol levels were found among β- Thalassemia major patients than healthy individuals (p <0.001). Atherogenic Index of Plasma was markedly elevated among β-Thalassemia patients than their healthy counterparts; 0.27(0.08-0.38) vs. 0.06(0.03-0.08) (p
<0.001), indicating high propensity of premature atherosclerosis in them. Plasma Atherogenic Index exhibited positive correlation with serum Ferritin (r= 0.41, p = 0.001) and negative correlation with plasma Hemoglobin (r= -0.65, p < 0.001).
Conclusion: β-Thalassemia major patients have elevated Plasma Atherogenic Index value than age-matched healthy subjects, implying high risk of premature atherosclerosis and future cardiovascular events in this vulnerable group.