Total iron binding capacity (TIBC) is a potential biomarker of left ventricular remodelling for patients with iron deficiency anaemia

Yufeng Xu,Yan Chen,Haiyan Lin,Jing Wan,Haidan Xia,Hassah Iftikhar,Ya Li

doi:10.1186/s12872-019-01320-3

Abstract

BackgroundPreclinical studies indicate iron deficiency (ID) plays an important role in cardiac remodelling. However, the relationship between ID and cardiac remodelling remains unknown in clinical setting. This retrospective study aims to identify a potential biomarker for the myocardial remodelling in patients with ID. Due to limited patients with ID are identified without iron deficiency anaemia (IDA), we analyse the relationship of total iron binding capacity (TIBC) and the left ventricular mass index (LVMI) in patients with iron deficiency anaemia.MethodsA total of 82 patients with IDA exhibiting the diagnostic criteria for IDA were enrolled in the study. Among the patients, 65 had reported LVMI values. Subsequently, these patients were divided into two groups according to abnormal LVMI (> 115 g/m2 in men and > 95 g/m2 in women). Linear bivariate analysis was performed to detect the associations of haemoglobin or TIBC with clinical and echocardiographic characteristics. Simple linear regression analysis was used to evaluate the correlation between LVMI and the parameters of IDA, while multivariable linear analysis was used to assess the association of LVMI with age, TIBC and haemoglobin. Logistic regression analysis was utilized to determine the relationship of LV remodelling with anaemia severity and TIBC.ResultsAs compared with control group, the levels of TIBC in abnormal LVMI group are increased. Using log transformed LVMI as the dependent variable, simultaneously introducing age, TIBC, and haemoglobin into the simple linear regression or multivariable linear regression analysis confirmed the positive association among these factors. Bivariate correlation analysis reveals the irrelevance between haemoglobin and TIBC. In logistic regression analysis, TIBC is associated with the risk of LV remodelling.ConclusionsResults of study indicate that TIBC exhibit an explicit association with LVMI in patients with iron deficiency anaemia. Logistic analysis further confirms the contribution of TIBC to abnormal LVMI incidence among this population with IDA.

Highlights

Preclinical studies indicate iron deficiency (ID) plays an important role in cardiac remodelling
It has reported that malnutrition-induced ID in growing rats leads to cardiomyopathy [9], and a recent study showed that mice with transferrin receptor knockout in the heart may suffer from lethal cardiomyopathy involving impaired mitochondrial biogenesis [10]
The 65 patients enrolled in the hospital were divided into two groups according to abnormal left ventricular mass index (LVMI) status (> 115 g/m2 in men and > 95 g/m2 in women) [19]

Summary

Introduction

Preclinical studies indicate iron deficiency (ID) plays an important role in cardiac remodelling. The relationship between ID and cardiac remodelling remains unknown in clinical setting. This retrospective study aims to identify a potential biomarker for the myocardial remodelling in patients with ID. The majority of individuals with iron deficiency (ID) in the early stage of IDA remain undiagnosed in outpatient clinic, and only a few patients reach the point of hospitalization. Cardiovascular manifestations can be observed in patients with IDA and in those with sickle cell disease (SCD), which indicates ventricular systolic and diastolic dysfunction, elevated cardiac output and cardiomegaly [3,4,5]. Related hypotheses include oxidative metabolism, cellular immune mechanisms [14] and mitochondrial injury [8, 15]

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