Noninvasive assessment and risk factors of liver fibrosis in patients with thalassemia major using shear wave elastography

ABSTRACT

Objectives: This study aimed to estimate the prevalence of liver fibrosis and assess the risk factors for developing significant liver fibrosis in patients with Thalassemia Major (TM).

Methods: All patients with TM over the age of 10 years were included in the study.

Results: A total of 94 eligible patients underwent 2-D SWE. The median age was 26.7 years. The median of the average 5-year serum ferritin (5yrSF) and liver iron concentration (LIC) assessed by MRI T2* were 1326 µg/L and 6.7 mg/g dw, respectively. Hepatitis C and hepatitis B core antibodies were positive in 38% and 1% of the patients respectively. The proportion of patients with significant fibrosis was 60%. Male gender increased the risk of significant fibrosis (Odds ratio of 0.4; p = .0373). Additionally, the 5yrSF (p = .00661), the LIC (p = .0225) and the lowest LIC of the previous 5 years (p = .0211) were significant. In the multivariable logistic regression model, only 5yrSF (p = .0035) and gender (p = .00984) remained significant.

Conclusions: The risk of liver fibrosis is associated with iron overload and gender in patients with TM.

KEYWORDS:

• Beta thalassemia major
• iron overload
• ultrasound
• liver fibrosis
• risk factors

Acknowledgments

The authors thank all patients with thalassemia for agreeing to participate in this study and all the nurses of the daycare unit at Sultan Qaboos University Hospital for their support to conduct this study. MK performed the analysis and drafted the manuscript; SD and SB designed the study, collected the data and edited the manuscript; HD analyzed the abdominal ultrasound and edited the manuscript; AA collected the data and edited the manuscript; MH and SR consented the patients, collected the data and edited the manuscript. UA performed the 2D-SWE.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Murtadha Al Khabori http://orcid.org/0000-0002-2937-8838