Subclinical atherosclerotic predictive value of inflammatory markers in thalassemia intermedia patients

ABSTRACT

Background

A high incidence of thromboembolic events is observed in thalassemia patients. This study investigated the relationship between carotid intima-media thickness (CIMT) and lipid profile, iron metabolic indices (IMI), and inflammatory markers in β-thalassemia intermedia (β- TI) patients.

Patients and methods

Forty-five β-TI patients at Assiut University Hospital and 34 healthy individuals were enrolled in the study. We measured Lipid profile, IMI, high sensitive CRP (Hs-CRP), and interleukin-6 (IL-6) and compared the results between both groups. We used CIMT measurement as a marker for subclinical atherosclerosis. We used both univariate and multivariate analyses to test relations and independent predictors of CIMT.

Results

β-TI patients had higher CIMT (P = 0.000). CIMT was positively correlated with absolute neutrophil count (ANC) (r = 0.320, p = 0.032), ferritin (r = 0.544, p = 0.000), Hs-CRP (r = 0.603, p = 0.000), and IL-6 (r = 0.520, p = 0.000). Hs-CRP was an independent predictor of CIMT (p = 0.000). Hs-CRP cut off value of 60.4 ug/dl has sensitivity of 63.3% and specificity of 93.3% in predicting premature atherosclerosis.

Conclusion

β-TI patients had higher CIMT despite the protective lipid profile. Hs-CRP was an independent predictor of CIMT.

KEYWORDS:

• Carotid intima-media thickness
• subclinical atherosclerosis
• thalassemia
• thalassemia intermedia

Acknowledgments

We would acknowledge the role of Dr Mohammed Gamal Azizeldine, house officer at Assiut University Hospital, in data collection in our work.

Author contributions

Osama Ahmad Ibrahim: Conception and design of the work, obtaining funding, supervision, careful revision of the protocol, revision of the methodology of the study and interpretation of the results then finally, revision of the paper before submission.

Ahmad B. Ahmad: Study and revision of the study aims and methodology, responsible for doing echocardiography and doppler required in the study, interpretation of the echocardiography and doppler results in relation to the studied markers then lastly, sharing in the paper writing.

Dalia Ahmad Nigm: Substantial contribution to the conception of the work, concerned about the laboratory results, revision of the methodology, and interpretation of the results.

Asmaa Nady Hussien: The principal investigator responsible for the design of the work, collection of data, obtaining fund, analysis of study results and paper drafting then finally, approval of the version to be published.

Walaa H. Mohammad Ibrahim: Significant revision of the protocol and work design, analysis of the data and interpretation of results then final revision of the paper.

Disclosure statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The present work was sponsored by the Faculty of Medicine’s research grant office - Assiut University. The grant number was 001-22∕02⁄2017.