Abstract
BackgroundBody iron status has been implicated in atherosclerotic cardiovascular disease. The main hypothesis is that high iron status is associated with increased risk of atherosclerosis. We investigated the potential role of iron as an additional risk factor promoting atherosclerosis among beta-thalassemic patients.MethodsIn this cross-sectional study, the liver iron load was assessed by quantitative T2* MRI technique and intima-media thickness (IMT) of the common carotid artery by high-resolution ultrasound among 119 patients (62 male, 57 female) with beta-thalassemia (major and intermediate) whose age ranged from 10 to 50 years with a mean of 25.6 years. The patients were divided into three groups according to the severity of iron loading, obtained by T2*MRI technique: group I (normal), group II (mild) and group III (moderate and severe) iron load.For elimination of the effect of age on carotid IMT values, the patients also were divided into four age groups (10-19 y, 20-29 y, 30-39 y and 40-50 y). Mean carotid IMT based on the severity of iron loading were compared at different age groups, using one way ANOVA analysis for assessing the effect of iron loading on carotid IMT. Pearson's coefficient of correlation were used to assess the degree of correlation between studied variables (liver T2*, IMT, age).ResultsThere were significant differences in mean carotid IMT based on the severity of iron loading at different age groups, with P = 0.003 at 20-29 y, P = 0.006 at 30-39 y and p = 0.037 at 40-50 y. Age (p = 0.001) and liver T2*(p = 0.003) had significant correlation with mean carotid IMT independently.At the age group of 10-19 years, there were not significant differences in mean carotid IMT based on the liver iron loading (p = 0.661).No significant differences also are seen in mean carotid IMT between male and female (p = 0.41).ConclusionsThis study identified a relationship between body iron status and carotid IMT. This relationship support to the hypothesis of a link between body iron load and atherosclerosis.
Highlights
IntroductionThe main hypothesis is that high iron status is associated with increased risk of atherosclerosis
Body iron status has been implicated in atherosclerotic cardiovascular disease
The loss of iron with menstruation explains the lower risk of coronary heart disease(CHD) in premenopausal women compared with men and postmenopausal women [11]
Summary
The main hypothesis is that high iron status is associated with increased risk of atherosclerosis. Thalassemia is considered the most common genetic disorder worldwide [1]. It is result from a defect in the synthesis of one or more of the subunits of hemoglobin. Increased common carotid IMT is a marker of early atherosclerosis and has been associated with cardiovascular risk and risk of coronary artery disease events [9,10]. Sullivan in 1981 formulated the iron-heart hypothesis of atherosclerotic cardiovascular disease According to this hypothesis, the loss of iron with menstruation explains the lower risk of coronary heart disease(CHD) in premenopausal women compared with men and postmenopausal women [11]
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