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生长分化因子15与依赖输血的β地中海贫血成年患者的动脉粥样硬化有关。

GDF-15 is associated with atherosclerosis in adults with transfusion-dependent beta-thalassemia.

作者信息

Efat Alaa, Wahb Rana, Shoeib Sabry Abd Allah, Dawod Ashraf Abd ElRaof, Abd ElHafez Mohamad Ahmed, Abd ElMohsen Essam Ali, Elkholy Aly

机构信息

Faculty of Medicine Department of Internal Medicine and Hematology Menoufia University Shebin Al-Kom Menoufia Egypt.

Faculty of Medicine Department of Medical Biochemistry Menoufia University Shebin Al-Kom Menoufia Egypt.

出版信息

EJHaem. 2022 Mar 22;3(2):353-361. doi: 10.1002/jha2.415. eCollection 2022 May.

Abstract

OBJECTIVES

To study serum growth differentiation factor-15 (GDF-15) serum level in β-thalassemia patients and its relation to carotid intima-media thickness.

BACKGROUND

Thalassemia is a common genetic disease resulting in decreased beta-chains, leading to manifested anemia. It may be subsequently complicated by iron overload, which induces numerous morbidities and even death. Growth differentiation factor-15 (GDF-15) is a strong and independent predictor of mortality and disease progression in patients with atherosclerosis alongside with carotid-intimal media thickness (CIMT).

PATIENTS AND METHODS

This monocentric case-control study was done on 90 subjects in the period from January 2020 to March 2021. Sixty transfusion-dependent beta-thalassemia (TDβT) cases (≥18 years) were selected from the thalassemia clinic of Hematology division at Menoufia University hospitals. We included also 30 sex and age matched healthy as the controls. Routine investigations were done beside. Serum GDF-15 was measured by ELISA. CIMT was measured by Doppler Ultrasonography.

RESULTS

CIMT on both sides was statistically significant higher in cases (median of 0.08 cm) than in the controls (median of 0.04). GDF-15 was also significantly higher in cases (median of 1839.89 pg/dl) than in controls (median of 256.14 pg/dl). So, we found that GDF-15 is a predictor of and associated with atherosclerosis in thalassemic adults (OR = 39.198, value 0.008, 95% CI: 2.576-596.5).

CONCLUSION

GDF- 15 is increased in TDβT. CIMT (as a marker of subclinical atherosclerosis) is increased in these patients alongside with GDF-15, is a predictor, and associated with atherosclerosis in thalassemic adults.

摘要

目的

研究β地中海贫血患者血清生长分化因子15(GDF-15)水平及其与颈动脉内膜中层厚度的关系。

背景

地中海贫血是一种常见的遗传性疾病,会导致β链减少,进而引发明显的贫血。随后可能会并发铁过载,从而引发多种疾病甚至死亡。生长分化因子15(GDF-15)是动脉粥样硬化患者死亡率和疾病进展的强有力且独立的预测指标,与颈动脉内膜中层厚度(CIMT)相关。

患者和方法

本单中心病例对照研究于2020年1月至2021年3月期间对90名受试者进行。从曼苏拉大学医院血液科的地中海贫血诊所选取了60例输血依赖型β地中海贫血(TDβT)患者(≥18岁)。我们还纳入了30名年龄和性别匹配的健康人作为对照。同时进行了常规检查。采用酶联免疫吸附测定法(ELISA)检测血清GDF-15。通过多普勒超声测量CIMT。

结果

病例组双侧CIMT(中位数为0.08厘米)在统计学上显著高于对照组(中位数为0.04厘米)。病例组的GDF-15也显著高于对照组(中位数为1839.89皮克/分升)高于对照组(中位数为256.14皮克/分升)。因此,我们发现GDF-15是地中海贫血成年患者动脉粥样硬化的预测指标且与之相关(比值比=39.198,P值0.008,95%置信区间:2.576-596.5)。

结论

TDβT患者的GDF-15升高。这些患者的CIMT(作为亚临床动脉粥样硬化的标志物)与GDF-15一起升高,是地中海贫血成年患者动脉粥样硬化的预测指标且与之相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d843/9175794/881d5b0b8510/JHA2-3-353-g001.jpg

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