title: Iron overload in non-transfusion-dependent thalassemia: association with genotype and clinical risk factors.
abstract: In the present study, we sought to determine the prevalence of iron overload in patients with non-transfusion-dependent thalassemia (NTDT) and its association with genotype and other clinical risk factors, and to evaluate the correlation between serum ferritin (SF) and liver iron concentration (LIC). Myocardial and liver iron concentration was measured by MRI using a T2* gradient multi-echo sequence in NTDT patients, aged 10-50 years. Of 91 patients, 54 (59 %) had hepatic iron overload. None had cardiac iron overload. The clinical risk factors for hepatic iron overload were age >20 years (adjusted OR 30.2, 95 % CI 4.5-203, p < 0.001), hemoglobin level <7 g/dL (adjusted OR 6.3, 95 % CI 1.01-39.5, p = 0.049), and cumulative RBC transfusion >10 units (adjusted OR 53.6, 95 % CI 3.2-884, p = 0.005). Beta-thalassemia genotype was associated with higher risk of iron overload by univariate analysis, but the association was not significant when adjusted for other clinical factors. The correlation coefficient between SF and LIC was 0.60 (p < 0.001). In conclusion, the prevalence of hepatic iron overload is high in NTDT. Older age, lower hemoglobin level, and higher cumulative RBC transfusion are significant risk factors. SF and LIC show a significant positive correlation.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
authors.forename: Adisak
authors.initials: A
authors.lastname: Tantiworawit
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. pimlak.c@cmu.ac.th.
authors.forename: Pimlak
authors.initials: P
authors.lastname: Charoenkwan
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
authors.forename: Sasinee
authors.initials: S
authors.lastname: Hantrakool
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
authors.forename: Worawut
authors.initials: W
authors.lastname: Choeyprasert
authors.affiliation: Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
authors.forename: Chate
authors.initials: C
authors.lastname: Sivasomboon
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
authors.forename: Torpong
authors.initials: T
authors.lastname: Sanguansermsri
mesh_terms: D000328:Adult; D000367:Age Factors; D002648:Child; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005293:Ferritins / Q000097:blood; D005838:Genotype; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019190:Iron Overload / Q000097:blood / Q000209:etiology* / Q000235:genetics; D008099:Liver / Q000737:chemistry / Q000378:metabolism; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry / Q000378:metabolism; D015995:Prevalence; D012307:Risk Factors; D013789:Thalassemia / Q000150:complications*
chemical_list: D006454:Hemoglobins; D005293:Ferritins
keywords: Ferritin; Genotype; Iron overload; Liver iron concentration; Non-transfusion-dependent thalassemia; Prevalence; Risk factor