Clinical and Biochemical Assessment of Liver Function Test and Its Correlation with Serum Ferritin Levels in Transfusion-dependent Thalassemia Patients

May Al-Moshary, Nayab Imtiaz, Eman Al-Mussaed, Adnan Khan, Samreen Ahmad, Sara Albqami, May Al-Moshary, Nayab Imtiaz, Eman Al-Mussaed, Adnan Khan, Samreen Ahmad, Sara Albqami

Abstract

Aims The aim of our study was to correlate liver function tests with serum ferritin levels in multi-transfused thalassemia patients. Methods This was a descriptive cross-sectional study conducted in the department of hematology, Khyber Medical University, from January 2018 to December 2018. Thalassemia patients of either sex dependent on transfusion ≥ 1 year and having a confirmatory report of the disease were included in our study. The nonprobability convenience sampling technique was used. The Pearson correlation coefficient was applied to observe the correlation between serum ferritin level and liver function tests. A p-value of ≤0.05 was considered statistically significant. SPSS version 23 (SPSS Inc., Chicago, Illinois) was used for data analysis. Results A total of 138 subjects of age range 2-23 years, with a mean age of 12.08 ± 6.02 years, were included in our study. The mean serum ferritin of patients in our study was 3278.64 ng/ml with the lowest of 285.2 ng/mL and the highest of 10940.2 ng/ml. With the increase in serum ferritin levels, a rapid increase in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) levels was seen. When serum ferritin levels were correlated with total bilirubin level, the bilirubin level remains static with a further increase in serum ferritin levels. Conclusion It was deduced that iron deposition is the ultimate reason for increased liver enzymes. There was a positive correlation between serum ferritin and ALT, AST, and ALP while a weak connection was found between serum ferritin and bilirubin levels.

Keywords: alt; ast; bilirubin; ferritin; thalassemia.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2020, Al-Moshary et al.

Figures

Figure 1. Age distribution (n=138)
Figure 1. Age distribution (n=138)
Figure 2. Correlation of serum ferritin with…
Figure 2. Correlation of serum ferritin with ALT (r = + 0.315) and a p-value of
ALT: alanine aminotransferase
Figure 3. Correlation of serum ferritin with…
Figure 3. Correlation of serum ferritin with AST (r = + 0.670) and a p-value of
AST: aspartate aminotransferase
Figure 4. Correlation of serum ferritin with…
Figure 4. Correlation of serum ferritin with ALT (r= + 0.430) and a p-value of
ALT: alanine aminotransferase
Figure 5. Correlation of serum ferritin with…
Figure 5. Correlation of serum ferritin with bilirubin (r= + 0.294) and a p-value of

References

    1. Beta-thalassemia. Galanello R, Origa R. Orphanet J Rare Dis. 2010;5:11–18.
    1. Thalassemia and related hemoglobinopathies. Sharada AS. Ind J Pediatr. 2005;72:319–324.
    1. Relationship between elevated liver enzyme with iron overload and viral hepatitis in thalassemia major patients in Northern Iran. Ameli M, Besharati S, Nemati K, Zamani F. . Saudi Med J. 2008;29:1611–1615.
    1. Hepcidin in iron overload disorders. Papanikolaou G, Tzilianos M, Christakis JI, et al. Blood. 2005;105:4103–4105.
    1. 2017 clinical trials update in new treatments of β‐thalassemia. Makis A, Hatzimichael E, Papassotiriou I, Voskaridou E. Am J Hematol. 2016;91:1135–1145.
    1. Serum ferritin levels and irregular use of iron chelators predict liver iron load in patients with major beta thalassemia: a cross-sectional study. Sobhani S, Rahmani F, Rahmani M, Askari M, Kompani F. Croat Med J. 2019;60:405–413.
    1. Liver iron overload and hepatic function in children with thalassemia major. Wahidiyat PA, Iskandar SD, Rahmartani LD, Sekarsari D. Paediatr Indones. 2018;27:233–237.
    1. Prenatal diagnosis of beta-thalassemia in Southern Punjab, Pakistan. Baig SM, Azhar A, Hassan H, et al. Prenat Diagn. 2006;26:903–905.
    1. Iron metabolism in thalassemia and sickle cell disease. Mariani R, Trombini P, Pozzi M, Piperno A. Mediterr J Hematol Infect Dis. 2009;1:0.
    1. Pathogenesis and management of iron toxicity in thalassemia. Hershko C. Ann N Y Acad Sci. 2010;1202:1–9.
    1. Determination of iron-overload in thalassemia by hepatic MRI and ferritin. Angulo IL, Covas DT, Carneiro AA, Baffa O, Elias Junior J, Vilela G. Rev Bras Hematol Hemoter. 2008;30:449–452.
    1. The challenges of adherence and persistence with iron chelation therapy. Porter JB, Evangeli M, El-Beshlawy A. Int J Hematol. 2011;94:453–460.
    1. Prevalence of endocrine complications and short stature in patients with thalassaemia major: a multicenter study by the Thalassaemia International Federation (TIF) De Sanctis V, Eleftheriou A, Malaventura C, Thalassaemia International Federation Study Group on Growth and Endocrine Complications in Thalassaemia. . Pediatr Endocrinol Rev. 2004;2:249–255.
    1. Cappellini MD, Cohen A, Eleftheriou A, Piga A, Porter J, Taher A. Guidelines for the Clinical Management of Thalassaemia [Internet] Nicosia: Thalassaemia International Federation; 2008. Iron overload.
    1. Non-transferrin bound iron: a key role in iron overload and iron toxicity. Brissot P, Ropert M, Le Lan C, Loréal O. Biochim Biophys Acta. 2012;1820:403–410.
    1. Association of iron overload with oxidative stress, hepatic damage and dyslipidemia in transfusion-dependent β-thalassemia/HbE patients. Sengsuk C, Tangvarasittichai O, Chantanaskulwong P, Pimanprom A, Wantaneeyawong S, Choowet A, Tangvarasittichai S. Ind J Clin Biochem. 2014;29:298–305.
    1. Relationship between hepatocellular injury and transfusional iron overload prior to and during iron chelation with desferrioxamine: a study in adult patients with acquired anemias. Jensen PD, Jensen FT, Christensen T, Nielsen JL, Ellegaard J. Blood. 2003;101:91–96.
    1. Oxidative stress and antioxidant status in beta-thalassemia heterozygotes. de Souza Ondei L, da Fonseca Estevão I, Pereira Rocha MI, Percário S, Silva Souza DR, de Souza Pinhel MA, Bonini-Domingos CR. Rev Bras Hematol Hemoter. 2013;35:409–413.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit