Premature atherosclerosis in children with β-thalassemia major

J Pediatr Hematol Oncol. 2012 Nov;34(8):630-4. doi: 10.1097/MPH.0b013e3182707f4d.


Objectives: In this study, we aimed to investigate the relationship between chronic hemolysis and increased body iron burden with development of premature atherosclerosis by carotid intima-media thickness (IMT), ferritin, serum lipid profile, homocysteine, nitrate/nitrite, and chitotriosidase enzyme activity in children with β-thalassemia major.

Materials and methods: A total of 31 children with a diagnosis of β-thalassemia major between the ages of 4 to 16 years constituted the study group. Control group was consisted of 36 age-matched healthy children. Complete blood count, serum glucose, lipid profile, ferritin, homocysteine, calcium, chitotriosidase, and nitrate/nitrite levels were measured and electrocardiographic and echocardiographic investigation and carotid IMT measurement were performed.

Results: In study group serum total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were found to be significantly reduced, and very-low-density lipoprotein cholesterol levels were found to be significantly elevated. Plasma nitrate/nitrite levels were significantly reduced; chitotroisidase enzyme activity was significantly increased and carotid IMT was significantly increased in study group. Nitrate/nitrite was found to be the only variable that was statistically significantly related to carotid IMT.

Conclusions: Subclinical atherosclerosis in children with β-thalassemia major begins early in life, and these children are at risk for development of premature atherosclerosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Atherosclerosis / epidemiology
  • Atherosclerosis / etiology*
  • Atherosclerosis / pathology
  • Biomarkers
  • Blood Glucose / analysis
  • Carotid Intima-Media Thickness
  • Chelation Therapy
  • Child
  • Child, Preschool
  • Electrocardiography
  • Female
  • Ferritins / blood
  • Hemolysis
  • Hexosaminidases / blood
  • Homocysteine / blood
  • Humans
  • Iron Overload / drug therapy
  • Iron Overload / etiology*
  • Lipids / blood
  • Male
  • Nitrates / blood
  • Nitrites / blood
  • Transfusion Reaction
  • beta-Thalassemia / complications*


  • Biomarkers
  • Blood Glucose
  • Lipids
  • Nitrates
  • Nitrites
  • Homocysteine
  • Ferritins
  • Hexosaminidases
  • chitotriosidase