Gender-Based Analysis of Anemia Prevalence and Hematological Indices in Individuals with Beta Thalassemia Trait
Anemia Prevalence & Hematological Indices in Individuals with Beta Thalassemia Trait
Keywords:
beta thalssemia, anemia, microcytosis, hypochromiaAbstract
Background: Beta thalassemia trait (BTT) is the heterozygous condition involving a mutation in the HBB gene, characterized by hypochromic, microcytic anemia. Although hematological features of beta thalassemia trait are well-described, gender-specific variations in these features, influenced by many physiological factors, remain less explored.
Objective: This study aims to identify the role of gender in defining anemia and hematological indices in BTT individuals.
Methodology: This cross-sectional study, involving 200 individuals (84 males and 116 females) was conducted at the Department of Hematology, Noor Thalassemia Foundation, Lahore. Blood samples were taken, and a hemogram was performed, and repeated hemoglobin analysis using HPLC was done for confirmation of BTT. WHO guidelines were taken in consideration while defining anemia in both genders and in different age groups. The number of males and females in different age groups and the number of anemic individuals in different age groups were noted and presented as frequency (n) and percentage (%). Chi-square and odds ratios with 95%CI were used to test the association between gender and anemia status. Independent sample t-test was used to compare the hematological indices (Hb, RBC, HCT, MCV, MCH, MCHC) between males and females.
Results: The overall prevalence of anemia in our study population was 62%. Anemia prevalence was relatively higher in females (68.9%) than males (52.3%). Hemoglobin concentration was significantly lower in females (9.75±1.40 g/dL), than in males (11.35±2.12 g/dL), p<0.001. In the same way, females had statistically lower hematocrit (32.95±4.66%) than males (38.13±6.89%), p<0.001.
Conclusion: Anemia is not the defining feature of beta thalassemia trait, as a substantial number of BTT individuals were non-anemic. The diagnosis should not rely on anemia alone; rather, it must involve comprehensive evaluation based on red cell indices and hemoglobin fractions.
References
Tanveer MI, Farzand S, Manzoor A, Anwar A, Farhan S, Moin S. Molecular Characterization of Beta Thalassemia Major in Punjab, Pakistan. Journal of Ayub Medical College Abbottabad. 2026;37(3):334-338. https://jamc.ayubmed.edu.pk/index.php/jamc/article/view/14563
Ali S, Mumtaz S, Shakir HA, Khan M, Tahir HM, Mumtaz S, Mughal TA, Hassan A, Kazmi SA, Sadia, Irfan M. Current status of beta‐thalassemia and its treatment strategies. Molecular genetics & genomic medicine. 2021;9(12):e1788. https://doi.org/10.1002/mgg3.1788
Lin S, Zheng Y, Chen M, Xu L, Huang H. The interactions between ineffective erythropoiesis and ferroptosis in β-thalassemia. Frontiers in Physiology. 2024 ;15:1346173. https://doi.org/10.3389/fphys.2024.1346173
Faizan MU, Rashid NA, Hussain SU, Khan AN, Khan JA, Zeb SA, Ahmed SQ. Prevalence and clinical features of thalassemia minor cases. Pak J Med Health Sci. 2023;17(02):456. DOI: https://doi.org/10.53350/pjmhs2023172456
Putri¹ IM, Gultom FP, Auerkari EI. Genetics and Epigenetics Aspects of Thalassemia. InProceedings of the 4th International Conference on Life Sciences and Biotechnology (ICOLIB 2021) 2023(p. 288). Springer Nature. https://doi.org/10.2991/978-94-6463-062-6_28
Gupta A. Thalassemia trait. InDecision Making Through Problem Based Learning in Hematology: A Step-by-Step Approach in patients with Anemia 2024 (pp. 53-62). Singapore: Springer Nature Singapore. https://doi.org/10.1007/978-981-99-8933-1
Jawad AZ, Chelly M, Al-Zuhairy SH, Bouaziz H. Genetic variations and clinical implications of B-thalassemia in Iraqi population. Plos one. 2026 Mar 4;21(3):e0344034. https://doi.org/10.1371/journal.pone.0344034
Anastasiadi AT, Tzounakas VL, Dzieciatkowska M, Arvaniti VZ, Papageorgiou EG, Papassideri IS, Stamoulis K, D’Alessandro A, Kriebardis AG, Antonelou MH. Innate variability in physiological and omics aspects of the beta thalassemia trait-specific donor variation effects. Frontiers in Physiology. 2022;13:907444. https://doi.org/10.3389/fphys.2022.907444
Shaheen NA, Rehan H, Moghairi A, Gmati G, Damlaj M, Salama H, Rather M, Mendoza MA, Alanazi A, Al Ahmari B, Al Zahrani M. Hematological indices in the adult saudi population: reference intervals by gender, age, and region. Frontiers in Medicine. 2022;9:901937. https://doi.org/10.3389/fmed.2022.901937
Alsagheer S, Khaled F. A comparative study of hematological parameters and serum ferritin levels between males and females in El-Beida City, Libya. AlQalam Journal of Medical and Applied Sciences. 2025:843-855. https://doi.org/10.54361/ajmas.258243
Piplani S, Kaur M, Madan M, Lalit M. Is NESTROF T better than the hematological indices for screening of beta-thalassemia trait: an answer in rural scenario. Indian J Pathol Oncol. 2017;4(1):63-70. DOI: 10.18231/2394-6792.2017.0013
Al Abideen Z, Khurram S, Khan A, Shaikh KH, Omair M, Minhas S, Khurshid S. Appropriateness of β-thalassemia trait screening in patients with hypochromic microcytic anemia and predictors of potentially low-yield testing. Scientific Reports. 2026 Jul 5. https://doi.org/10.1038/s41598-026-60950-8
Singh V, Baranwal AK, Biswas AK, Mishra RC, Singh I. Prevalence and assessment of the impact of iron-deficiency anemia in beta-thalassemia trait subjects: A study from a tertiary care center of Western India. Asian journal of transfusion science. 2023 doi: 10.4103/ajts.ajts_111_22
Petry N, Nizamov F, Woodruff BA, Ishmakova R, Komilov J, Wegmüller R, Wirth JP, Arifdjanova D, Guo S, Rohner F. Risk factors for anemia and micronutrient deficiencies among women of reproductive age—the impact of the wheat flour fortification program in Uzbekistan. Nutrients. 2020;12(3):714. https://doi.org/10.3390/nu12030714
Jamnok J, Sanchaisuriya K, Sanchaisuriya P, Fucharoen G, Fucharoen S, Ahmed F. Factors associated with anaemia and iron deficiency among women of reproductive age in Northeast Thailand: a cross-sectional study. BMC Public Health. 2020;20(1):102. https://doi.org/10.1186/s12889-020-8248-1
Sun A, Chang JY, Jin YT, Chiang CP. Differential diagnosis between iron deficiency anemia and thalassemia trait-induced anemia. Journal of Dental Sciences. 2023 ;18(4):1963-1964.doi: 10.1016/j.jds.2023.07.036
Khan SN, Ullah R, Nawaz K, Saleem MN, Mir A. Coexistence of Beta Thalassemia Trait and Polycythemia: Hematological Insights, Diagnostic Challenges, and Clinical Implications. Link Medical Journal. 2026;4(1):1-0. DOI: https://doi.org/10.61919/61jewz16
