Volume 6, Issue 4 (11-2016)                   Iran J Ped Hematol Oncol 2016, 6(4): 249-260 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Shanaki M, Ehteram H, Nasiri H, Azad M, Kouhkan F, Pakzad R et al . Assessment of Liver and Kidney Functional Parameters along with Oxidative Stress and Inflammatory Biomarker in Patients with β- Thalassemia Major. Iran J Ped Hematol Oncol 2016; 6 (4) :249-260
URL: http://ijpho.ssu.ac.ir/article-1-274-en.html
Metabolic Disorders Research Center, Department of biochemistry, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
Abstract:   (7127 Views)


Thalassemias are the most common inherited blood disorders caused by some mutations which can reduce the synthesis of globin chains. Iron overload and its organ deposition are responsible for functional abnormalities and tissue injury in patients who affected by β-thalassemia major. The aim of this case-control study was evaluation of hematological parameters, oxidative stress and some serum liver and kidney risk factors which play crucial role for early prediction and prevention of patients to end-stage tissue failure and mortality.
Materials and Methods:

the present study consisted of Fifty young adult subjects with β-thalassemia major (β- TM) (aged<18 years) and same number age and sex- matched healthy subjects as control group. Hematological and biochemical laboratory parameters included Urea, Creatinine, Uric Acid, Aspartate Aminotransferase (AST), Alanine transaminase (ALT), Alkaline phosphatase (ALP) (pars azmoon kit), oxidative stress biomarker PAB, giving a redox index (chemically), and serum high-sensitivity C-reactive protein (hs-CRP) were evaluated.

Urea, Creatinine and Uric Acid were significantly decreased in patients group (P<0.001); in spite of, serum ferritin, liver biomarkers AST, ALT, ALP and risk factor biomarker PAB were statistically increased in patients versus control group(P<0.001), whereas hs-CRP(P>0.05) was not significantly difference in study groups. Exception hs-CRP and PAB (P>0.05), liver risk factors had a positive correlation with ferritin and serum Urea, Creatinine and Uric Acid tests had negative meaningful with hematological parameters (P<0.001). Likewise, PAB with AST showed a positive correlation (P<0.001) and irreversibly with urea and creatinine (P<0.001). We did not find a slight correlation between hs-CRP in the company to hematological and biochemical laboratory finding (P>0.05).


Higher level of risk factors PAB values and key liver enzyme profiles are able to involve in the prognostic pathological consequences in patients with β-thalassemia major. Even so, they contribute toward the gradual development of tissue injuries.

Full-Text [PDF 401 kb]   (2032 Downloads)    
Type of Study: Research | Subject: Heart
Received: 2016/03/14 | Accepted: 2016/06/28 | Published: 2016/10/29

1. Palit S, Bhuiyan RH, Aklima J, Emran TB, Dash R. A study of the prevalence of thalassemia and its correlation with liver function test in different age and sex group in the Chittagong district of Bangladesh. J Basic Clin Pharm 2012; 3(4):352-7. [Article]
2. Rebulla P. Blood transfusion in beta thalassaemia major. Transfus Med1995 ; 5(4):247-58. [Article]
3. Walter PB, Fung EB, Killilea DW, Jiang Q, Hudes M, Madden J, et al. Oxidative stress and inflammation in iron-overloaded patients with beta-thalassaemia or sickle cell disease. British J haematol 2006 ;135(2):254-63. [Article]
4. Hashemizadeh H, Noori R, Kolagari S. Assessment Hepatomegaly and liver Enzymes in 100 Patients with beta Thalassemia Major in Mashhad, Iran. Iran J Ped Hematol Oncol 2012; 2(4):171-7. [Article]
5. Ehteram H, Bavarsad MS, Mokhtari M, Saki N, Soleimani M, Parizadeh SM, et al. Prooxidant-antioxidant balance and hs-CRP in patients with beta-thalassemia major. Clin Lab 2014; 60(2):207-15. [Article]
6. Bakr A, Al-Tonbary Y, Osman G, El-Ashry R. Renal complications of beta-thalassemia major in children. Am J Blood Res 2014; 4(1):1-6. [Article]
7. Waseem F, Khemomal KA, Sajid R. Antioxidant status in beta thalassemia major: a single-center study. Indian J Pathol Microbiol 2011; 54(4):761-3. [Article]
8. Mobarra N. A Review on iron chelators in the treatment of iron overloads syndromes. Int J Hematol Oncol Stem Cell Res 2016 1; 10(4):239-47. [Article]
9. Nazari A, Sadr SS, Faghihi M, Azizi Y, Hosseini M-J, Mobarra N, et al. Vasopressin attenuates ischemia–reperfusion injury via reduction of oxidative stress and inhibition of mitochondrial permeability transition pore opening in rat hearts. Eur. J. Pharmacol 2015; 760:96-102. [Article]
10. Ozdem S, Kupesiz A, Yesilipek A. Plasma homocysteine levels in patients with beta-thalassaemia major. Scand J Clin Lab Invest. 2008; 68(2):134-9. [Article]
11. Brittenham GM, Griffith PM, Nienhuis AW, McLaren CE, Young NS, Tucker EE, et al. Efficacy of deferoxamine in preventing complications of iron overload in patients with thalassemia major. N Engl J Med 1994; 331(9):567-73. [Article]
12. Kassab-Chekir A, Laradi S, Ferchichi S, Haj Khelil A, Feki M, Amri F, et al. Oxidant, antioxidant status and metabolic data in patients with beta-thalassemia. Clin Chim Acta 2003; 338(1-2):79-86. [Article]
13. Risdon RA, Barry M, Flynn DM. Transfusional iron overload: the relationship between tissue iron concentration and hepatic fibrosis in thalassaemia. J Pathol 1975; 116(2):83-95. [Article]
14. Berdoukas V, Bohane T, Tobias V, De Silva K, Fraser I, Aessopos A, et al. Liver iron concentration and fibrosis in a cohort of transfusion-dependent patients on long-term desferrioxamine therapy. Hematol J 2005; 5(7):572-8. [Article]
15. Jensen PD, Jensen FT, Christensen T, Nielsen JL, Ellegaard J. Relationship between hepatocellular injury and transfusional iron overload prior to and during iron chelation with desferrioxamine: a study in adult patients with acquired anemias. Blood 2003; 101(1):91-6. [Article]
16. Hankins JS, Smeltzer MP, McCarville MB, Aygun B, Hillenbrand CM, Ware RE, et al. Patterns of liver iron accumulation in patients with sickle cell disease and thalassemia with iron overload. Eur J Haematol 2010; 85(1):51-7. [Article]
17. Tantawy AA, El Bablawy N, Adly AA, Ebeid FS. Early Predictors of Renal Dysfunction in Egyptian Patients with beta-Thalassemia Major and Intermedia. Mediterr J Hematol Infect Dis 2014; 6(1):2014057. [Article]
18. Sadeghi-Bojd S, Hashemi M, Naderi M, Shikhani S. Kidney function tests in children with beta-thalassemia minor in Zahedan, southeast of Iran. Iran J Kidney Dis 2011; 5(3):201-3. [Article]
19. Koonrungsesomboon N, Tantiworawit A, Phrommintikul A, Saekho S, Srichairattanakool S, Chattipakorn N. Heart Rate Variability for Early Detection of Iron Overload Cardiomyopathy in beta-Thalassemia Patients. Hemoglobin 2015; 39(4):281-6. [Article]
20. Ghorban K, Shanaki M, Mobarra N, Azad M, Asadi J, Pakzad R, et al. Apolipoproteins A1, B, and other prognostic biochemical cardiovascular risk factors in patients with beta-thalassemia major. Hematology 2016; 21(2):113-20. [Article]
21. Alamdari DH, Paletas K, Pegiou T, Sarigianni M, Befani C, Koliakos G. A novel assay for the evaluation of the prooxidant-antioxidant balance, before and after antioxidant vitamin administration in type II diabetes patients. Clin Biochem 2007; 40(3-4):248-54. [Article]
22. Ghanei M, Adibi P, Movahedi M, Khami MA, Ghasemi RL, Azarm T, et al. Pre-marriage prevention of thalassaemia: eport of a 100,000 case experience in Isfahan. Public Health1997; 111(3):153-6. [Article]
23. Smolkin V, Halevy R, Levin C, Mines M, Sakran W, Ilia K, et al. Renal function in children with beta-thalassemia major and thalassemia intermedia. Pediatr Nephrol 2008; 23(10):1847-51. [Article]
24. Ali D, Mehran K, Moghaddam AG. Comparative evaluation of renal findings in Beta-thalassemia major and intermedia. Saudi J Kidney Dis Transpl 2008; 19(2):206-9. [Article]
25. Ghahremanlu E, Banihashem A, Saber H, Tavallaie S, Mirhosseini N, Ghayour-Mobarhan M, et al. Increased serum heat shock protein 27 antibody titers and prooxidant-antioxidant balance in patients with beta-thalassemia major. Acta Haematol 2013; 129(1):1-9. [Article]
26. Haj Khelil A LS, Nabli N, Ould Salem ML, Abroug S,Amri F, et al. Parade`tres biochimiques chez les h-thalasse´miques. Immunol Anal Biol 2001; 16:315-30. [Article]
27. Fibach E, Rachmilewitz E. The role of oxidative stress in hemolytic anemia. Curr Mol Med 2008; 8(7):609-19. [Article]
28. Loebstein R, Lehotay DC, Luo X, Bartfay W, Tyler B, Sher GD. Diabetic nephropathy in hypertransfused patients with beta-thalassemia. The role of oxidative stress. Diabetes Care 1998; 21(8):1306-9. [Article]
29. Hershko C, Link G, Cabantchik I. Pathophysiology of iron overload. Ann N Y Acad Sci. 1998; 850:191-201. [Article]
30. Livrea MA, Tesoriere L, Pintaudi AM, Calabrese A, Maggio A, Freisleben HJ, et al. Oxidative stress and antioxidant status in beta-thalassemia major: iron overload and depletion of lipid-soluble antioxidants. Blood 1996; 88(9):3608-14. [Article]
31. Soliman A, Yassin M, Al Yafei F, Al-Naimi L, Almarri N, Sabt A, et al. Longitudinal Study on Liver Functions in Patients with Thalassemia Major before and after Deferasirox (DFX) Therapy. Mediterr J Hematol Infect Dis 2014; 6(1):20140-25. [Article]
32. Wanachiwanawin W, Luengrojanakul P, Sirangkapracha P, Leowattana W, Fucharoen S. Prevalence and clinical significance of hepatitis C virus infection in Thai patients with thalassemia. Int J Hematol 2003; 78(4):374-8. [Article]
33. Adil A, Sobani ZA, Jabbar A, Adil SN, Awan S. Endocrine complications in patients of beta thalassemia major in a tertiary care hospital in Pakistan. J Pak Med Assoc 2012; 62(3):307-10. [Article]
34. Hamed EA, ElMelegy NT. Renal functions in pediatric patients with beta-thalassemia major: relation to chelation therapy: original prospective study. Ital J Pediatr 2010; (6):2-10. [Article]
35. Cerasola G, Guarneri M, Cottone S. [Inflammation, oxidative stress and kidney function in arterial hypertension]. G Ital Nefrol 2009; 46:8-13. [Article]
36. Fassett RG, D'Intini V, Healy H, Gowardman J, Gan JS, Sharman JE, et al. Assessment of arterial stiffness, oxidative stress and inflammation in acute kidney injury. BMC nephrol 2009; (10):9-15. [Article]
37. Nicholas SB, Yuan J, Aminzadeh A, Norris KC, Crum A, Vaziri ND. Salutary effects of a novel oxidative stress modulator on adenine-induced chronic progressive tubulointerstitial nephropathy. Am J Transl Res 2012; 4(3):257-68. [Article]
39. Meier-Ewert HK, Ridker PM, Rifai N, Price N, Dinges DF, Mullington JM. Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects. Clin Chem 2001; 47(3):426-30. [Article]
40. Azarpazhooh MR, Mobarra N, Parizadeh SM, Tavallaie S, Bagheri M, Rahsepar AA, et al. Serum high-sensitivity C-reactive protein and heat shock protein 27 antibody titers in patients with stroke and 6-month prognosis. Angiology 2010; 61(6):607-12. [Article]
41. Kanavaki I, Makrythanasis P, Lazaropoulou C, Tsironi M, Kattamis A, Rombos I, et al. Soluble endothelial adhesion molecules and inflammation markers in patients with beta-thalassemia intermedia. Blood cells, molecules & diseases 2009; 43(3):230-4. [Article]
42. Arinzon Z, Peisakh A, Schrire S, Berner Y. C-reactive protein (CRP): an important diagnostic and prognostic tool in nursing-home-associated pneumonia. Arch Gerontol Geriatr 2011; 53(3):364-9. [Article]

Add your comments about this article : Your username or Email:

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Iranian Journal of Pediatric Hematology and Oncology

Designed & Developed by : Yektaweb