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重型β地中海贫血患者的载脂蛋白A1、B及其他心血管预后生化危险因素。

Apolipoproteins A1, B, and other prognostic biochemical cardiovascular risk factors in patients with beta-thalassemia major.

作者信息

Ghorban Khodayar, Shanaki Mehrnoosh, Mobarra Naser, Azad Mehdi, Asadi Jahanbakhsh, Pakzad Reza, Ehteram Hassan

机构信息

a Department of Immunology, School of Medicine , AJA University of Medical Sciences , Tehran , Iran.

b Department of Laboratory Medicine, School of Allied Medical Sciences , Shahid Beheshti University of Medical Sciences , Tehran , Iran.

出版信息

Hematology. 2016 Mar;21(2):113-20. doi: 10.1179/1607845415Y.0000000016. Epub 2015 Apr 25.

Abstract

OBJECTIVES

The occurrence of cardiac iron deposition is one of the late effect of iron over load which causes cardiovascular disease (CVD) in patients who are affected by beta-thalassemia major. Evaluation of some cardiovascular risk factors plays a crucial role in prediction and prevention of CVD.

SUBJECTS AND METHODS

This study consisted of 70 young adult subjects with beta-thalassemia major (beta-TM) (aged <30 years) and 71 age- and sex-matched healthy subjects as control group in the range of 20-30 years. Hematological and biochemical laboratory parameters including apolipoprotein (Apo)A1 and ApoB, oxidative stress biomarker pro-oxidant-antioxidant balance (PAB), homocysteine, serum high-sensitivity C-reactive protein (hs-CRP), and lipid profile were evaluated.

RESULTS

ApoA1, ApoB, lipid profiles, and homocysteine were significantly decreased in patients group (P < 0.001); however, very low-density lipoprotein and also mean corpuscular hemoglobin concentration (P > 0.05) were different. Some elements included ferritin (P < 0.001), PAB (P < 0.001), and ApoB/apoA1 ratio (P < 0.05) statistically increased in patients, whereas hs-CRP (P > 0.05) was not significantly different in study groups. Exception of high-density lipoprotein (P > 0.05), other lipid profiles, and apoB had a negative meaningful correlation with PAB (P < 0.05). Likewise, apoA1, apoB, apoB/A1 ratio with apoB and homocysteine showed a strong correlation (P < 0.05). We did not find a slight correlation between apoB/A1 ratio in the company of oxidative stress marker PAB (r = -0.366; P = 0.086). We found a statistical correlation between apoB/A1 and homocysteine (P < 0.05).

DISCUSSION

Higher level of some risk factors like PAB values, apoB/A1 ratio concentration, and lipid profiles is able to involve in the prognostic pathological consequences in patients with beta-thalassemia major. Even so, they contribute toward the gradual development of CVD.

摘要

目的

心脏铁沉积的发生是铁过载的晚期效应之一,铁过载会在重型β地中海贫血患者中引发心血管疾病(CVD)。评估一些心血管危险因素在CVD的预测和预防中起着关键作用。

受试者与方法

本研究包括70名年龄小于30岁的重型β地中海贫血(β-TM)青年成人受试者,以及71名年龄和性别匹配的20至30岁健康受试者作为对照组。评估了血液学和生化实验室参数,包括载脂蛋白(Apo)A1和ApoB、氧化应激生物标志物促氧化剂-抗氧化剂平衡(PAB)、同型半胱氨酸、血清高敏C反应蛋白(hs-CRP)和血脂谱。

结果

患者组的ApoA1、ApoB、血脂谱和同型半胱氨酸显著降低(P < 0.001);然而,极低密度脂蛋白以及平均红细胞血红蛋白浓度(P > 0.05)有所不同。患者体内的一些指标包括铁蛋白(P < 0.001)、PAB(P < 0.001)和ApoB/A1比值(P < 0.05)在统计学上有所升高,而hs-CRP在研究组中无显著差异(P > 0.05)。除高密度脂蛋白外(P > 0.05),其他血脂谱和ApoB与PAB呈负相关(P < 0.05)。同样,ApoA1、ApoB、ApoB/A1比值与ApoB和同型半胱氨酸呈强相关(P < 0.05)。我们未发现ApoB/A1比值与氧化应激标志物PAB之间存在微弱相关性(r = -0.366;P = 0.086)。我们发现ApoB/A1与同型半胱氨酸之间存在统计学相关性(P < 0.05)。

讨论

一些危险因素如PAB值、ApoB/A1比值浓度和血脂谱的较高水平可能参与重型β地中海贫血患者的预后病理后果。即便如此,它们也会促使CVD的逐渐发展。

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