The differences of lactate dehydrogenase and activin A levels among thalassemia major and non-thalassemia

Abstract

Background: Indonesia is located in the global thalassemia belt region, with major thalassemia prevalence that increase every year. Ineffective erythropoiesis (IE) is a condition that is commonly found in major thalassemia. An increase in lactate dehydrogenase (LDH) level and Activin A level was found in major thalassemia patient, that is caused by ineffective erythropoiesis (IE) and other factors. However until now, there is still no known studies that compare LDH level and Activin A level in major thalassemia and non-thalassemia. The aim of the study is to evaluate difference between LDH level and Activin A level in major thalassemia and non-thalassemia.Methods: An observational analytical study with cross sectional design was conducted in March – September 2020, which consist of 25 major thalassemia patients in Dr. R. Soedjati Grobogan Public Hospital and Dr. R. Soetrasno Rembang Public Hospital, and 25 healthy population with equivalent age. LDH levels were measured using photometry and Activin A levels were measured using ELISA. Differences between LDH levels and Activin A levels in major thalassemia and non-thalassemia were analyzed using Independent Sample T test, which p < 0.05 was considered significant.Results: There is a significant difference (p=0.00) between LDH levels in major thalassemia (524.48 ± 167.44 U/L) and non-thalassemia (294.48 ± 131.24 U/L). There is a significant difference (p = 0.04) between Activin A levels in major thalassemia (118.75 ± 45.47 pg/ml) and non-thalassemia (95.66 ± 26.26 pg/ml).Conclusion: Hypoxia due to IE and the formation of ROS due to repeated transfusions causes an increase in LDH levels and Activin A levels in thalassemia major patients, indicated by a significant difference between LDH levels and Activin A levels in thalassemia major and non-thalassemia.