Elevated serum parathormone levels are associated with myocardial iron overload in patients with beta-thalassaemia major.
OBJECTIVE
Despite advances in conventional treatment, iron-induced cardiomyopathy is still the most frequent cause of death among patients with beta-thalassaemia major. Recent studies have correlated increased myocardial iron content to decreased levels of vitamin D in thalassaemic patients. The aim of this study was to measure parathormone (PTH) and metabolites of vitamin D and consequently to investigate whether these parameters predispose to myocardial iron overload in patients with beta-thalassaemia major.


METHODS
In 62 patients (29 M and 33 F, mean age: 22.79 +/- 6.18 yr) with beta-thalassaemia major levels of intact parathormone (iPTH) and vitamin D metabolites [25(OmicronH)D(3) and 1,25(OmicronH)(2)D(3)] were measured in serum. Additionally, estimation of myocardial iron content was performed by magnetic resonance imaging, whereas mean serum ferritin concentrations were calculated for 1 yr prior to the study.


RESULTS
Results showed markedly decreased levels of serum 25(OH)D(3) in 37 patients (60%), whereas 7 patients (11%) had borderline 25(OH)D(3) levels (between 50 and 75 nmol/L). Serum iPTH levels were significantly higher in patients having increased myocardial iron compared to those having normal myocardial iron (44.04 +/- 22.09 pg/mL vs. 31.39 +/- 14.30 pg/mL, P = 0.017). Multivariant regression analysis identified PTH levels as the major predictor of increased myocardial iron.
Dimitriadou
Meropi
M
1st Paediatric Department, Aristotle University of Thessaloniki, Greece.
Christoforidis
Athanasios
A
Economou
Marina
M
Tsatra
Ioanna
I
Vlachaki
Efthimia
E
Fidani
Liana
L
Katzos
George
G
Athanassiou-Metaxa
Miranda
M
D000293:Adolescent; D000328:Adult; D002112:Calcifediol / Q000097:blood; D002117:Calcitriol / Q000097:blood; D002648:Child; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007501:Iron / Q000032:analysis* / Q000097:blood; D019190:Iron Overload / Q000209:etiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009206:Myocardium / Q000737:chemistry* / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood*; D065227:Transfusion Reaction; D014808:Vitamin D Deficiency / Q000097:blood / Q000209:etiology*; D055815:Young Adult; D017086:beta-Thalassemia / Q000097:blood / Q000473:pathology / Q000628:therapy*
D010281:Parathyroid Hormone; D005293:Ferritins; D007501:Iron; D002117:Calcitriol; D002112:Calcifediol