Clin Lab. 2023 Jun 1;69(6). doi: 10.7754/Clin.Lab.2022.220916.
Cardiac complications in patients with transfusion-dependent thalassemia (TDT) are one of the major causes of mortality in these patients which annually impose economic burden on the endemic countries. Heart T2 MRI is a good modality for evaluating iron overload. Our aim was to investigate the pooled correlation between the serum ferritin level and heart iron overload in TDT patients and compare the effect size in different geographical areas.
PRISMA checklist was used to summarize the literature search. Three major databases were used for the papers and exported into endnote for screening. Data were extracted into an Excel spreadsheet. The data were analyzed using STATA software. CC was considered as the effect size, and the amount of heterogeneity was indicated by I-squared. Meta-regression was used for age. Also, sensitivity analysis was performed.
The present study showed a statistically significant negative correlation of the serum ferritin level with heart T2 MRI: -0.30 (95% CI -0.34, -25). This correlation was not significantly affected by the patients' age (p-value: 0.874). Given different geographic area, most of the studies from different countries indicated that the correlation between the serum ferritin and heart T2 MRI was statistically significant.
The pooled analysis showed a significant negative moderate correlation between the serum ferritin level and heart T2 MRI in patients with TDT, regardless of their age. This issue underscores the importance of periodical evaluation of serum ferritin level in patients with TDT in developing countries with low financial supports and limited resources. Further studies are suggested to evaluate the pooled correlation of the serum ferritin level with iron concentration of other vital organs.
依赖输血的地中海贫血症（TDT）患者的心脏并发症是导致这些患者死亡的主要原因之一，每年给流行地区的国家带来经济负担。心脏 T2 MRI 是评估铁过载的一种很好的方式。我们的目的是研究 TDT 患者血清铁蛋白水平与心脏铁过载之间的总体相关性，并比较不同地理区域的效应大小。
采用 PRISMA 清单总结文献检索。使用三个主要数据库对论文进行筛选，并将其导出到 endnote 中。将数据提取到 Excel 电子表格中。使用 STATA 软件分析数据。CC 被视为效应大小，I 平方表示异质性的程度。采用元回归进行年龄校正。同时，还进行了敏感性分析。
本研究表明，血清铁蛋白水平与心脏 T2 MRI 之间存在统计学上显著的负相关：-0.30（95%CI -0.34，-25）。这种相关性不受患者年龄的影响（p 值：0.874）。考虑到不同的地理区域，来自不同国家的大多数研究表明，血清铁蛋白与心脏 T2 MRI 之间的相关性具有统计学意义。
汇总分析表明，TDT 患者的血清铁蛋白水平与心脏 T2 MRI 之间存在显著的负相关，与年龄无关。这个问题强调了在资源有限、经济支持低的发展中国家，定期评估 TDT 患者血清铁蛋白水平的重要性。建议进一步研究评估血清铁蛋白水平与其他重要器官铁浓度之间的总体相关性。
