Subclinical atherosclerotic predictive value of inflammatory markers in thalassemia intermedia patients

Expert Rev Hematol. 2021 Jul;14(7):669-677. doi: 10.1080/17474086.2021.1959316. Epub 2021 Aug 6.


Background: A high incidence of thromboembolic events is observed in thalassemia patients. This study investigated the relationship between carotid intima-media thickness (CIMT) and lipid profile, iron metabolic indices (IMI), and inflammatory markers in β-thalassemia intermedia (β- TI) patients.

Patients and methods: Forty-five β-TI patients at Assiut University Hospital and 34 healthy individuals were enrolled in the study. We measured Lipid profile, IMI, high sensitive CRP (Hs-CRP), and interleukin-6 (IL-6) and compared the results between both groups. We used CIMT measurement as a marker for subclinical atherosclerosis. We used both univariate and multivariate analyses to test relations and independent predictors of CIMT.

Results: β-TI patients had higher CIMT (P = 0.000). CIMT was positively correlated with absolute neutrophil count (ANC) (r = 0.320, p = 0.032), ferritin (r = 0.544, p = 0.000), Hs-CRP (r = 0.603, p = 0.000), and IL-6 (r = 0.520, p = 0.000). Hs-CRP was an independent predictor of CIMT (p = 0.000). Hs-CRP cut off value of 60.4 ug/dl has sensitivity of 63.3% and specificity of 93.3% in predicting premature atherosclerosis.

Conclusion: β-TI patients had higher CIMT despite the protective lipid profile. Hs-CRP was an independent predictor of CIMT.

Trial registration: NCT03170245.

Keywords: Carotid intima-media thickness; subclinical atherosclerosis; thalassemia; thalassemia intermedia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / etiology
  • Biomarkers
  • C-Reactive Protein / metabolism
  • Carotid Intima-Media Thickness
  • Humans
  • beta-Thalassemia* / complications
  • beta-Thalassemia* / diagnosis


  • Biomarkers
  • C-Reactive Protein

Associated data