Cihan Meriç Kaymak, Belen Burcu, Bolat Fatih, Bülbül Özlem Gümüştekin, Korgalı Elif Ünver, Koçak Ülker
Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey.
Gaziantep Children Hospital, Gaziantep, Turkey.
Indian J Hematol Blood Transfus. 2017 Dec;33(4):552-558. doi: 10.1007/s12288-017-0791-2. Epub 2017 Feb 24.
Iron overload in β-thalassemia major and intermedia patients leads to oxidative stress and causes to formation of lipid hydroperoxides. Thiobarbituric acid reactive substances (TBARS) are a well established method for screening and monitoring of lipid peroxidation. We aimed to investigate serum TBARS and its relationship with biochemical and hematologic parameters of Turkish and immigrant Syrian β-thalassemia children reflecting the effects of this socioeconomic condition on follow up of these patients. Lipid peroxidation products (TBARS) of Turkish (TR) (n = 62, from the cities of Gaziantep and Sivas, Turkey) and Syrian (SYR) (n = 34, from Gaziantep, Turkey) β-thalassemia patients aged 2-17 years and 58 healthy subjects aged 2-16 years were studied. Liver and renal function tests, serum ferritin levels, white blood cell, absolute neutrophil and platelet counts, hemoglobin (Hb) levels of the patients were analyzed. Serum TBARS concentrations were found to be elevated in β-thalassemia patients compared to healthy subjects (mean: 12.47 ± 8.53 vs. 9.78 ± 7.09, = 0.045). In SYR patients mean pretransfusional Hb level (7.26.2.04 vs. 8.49 ± 1.01, = 0.002) was lower and ferritin levels (5983.56 ± 5065.56 vs. 3234.60 ± 2237.82, = 0.001), liver enzymes (ALT: 77.82 ± 76.48 vs. 42.13 ± 51.50, = 0.005) were higher when compared to TR group. Positive correlation between TBARS and ferritin levels ( = 0.029, r = 0.231) and liver enzymes (for ALT < 0.001, r = 0.373) was observed. β-thalassemia patients are under more oxidative stress than healthy subjects. Liver is one of the major organs which are mainly affected by oxidative stress. War and migration might have caused inappropriate transfusion conditions and insufficient chelation therapy in the SYR group.
重型和中间型β地中海贫血患者的铁过载会导致氧化应激，并引发脂质氢过氧化物的形成。硫代巴比妥酸反应性物质（TBARS）是一种用于筛查和监测脂质过氧化的成熟方法。我们旨在研究血清TBARS及其与土耳其和叙利亚移民β地中海贫血儿童生化及血液学参数的关系，以反映这种社会经济状况对这些患者随访的影响。对土耳其（TR）（n = 62，来自土耳其加济安泰普和锡瓦斯市）和叙利亚（SYR）（n = 34，来自土耳其加济安泰普）2至17岁的β地中海贫血患者以及58名2至16岁的健康受试者的脂质过氧化产物（TBARS）进行了研究。分析了患者的肝肾功能测试、血清铁蛋白水平、白细胞、绝对中性粒细胞和血小板计数、血红蛋白（Hb）水平。发现β地中海贫血患者的血清TBARS浓度高于健康受试者（平均值：12.47±8.53对9.78±7.09，P = 0.045）。与TR组相比，SYR组患者输血前平均Hb水平较低（7.26±2.04对8.49±1.01，P = 0.002），铁蛋白水平较高（5983.56±5065.56对3234.60±2237.82，P = 0.001），肝酶（ALT：77.82±76.48对42.13±51.50，P = 0.005）较高。观察到TBARS与铁蛋白水平（P = 0.029，r = 0.231）和肝酶（ALT的P < 0.001，r = 0.373）之间呈正相关。β地中海贫血患者比健康受试者承受更多的氧化应激。肝脏是主要受氧化应激影响的主要器官之一。战争和移民可能导致SYR组输血条件不当和螯合治疗不足。
