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Cystatin C Assessment In Pediatric ?-Thalassemia Major And Intermedia: A Marker Of Subclinical Cardiovascular Dysfunction
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| Author:
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MOHAMED BESHIR, DIANA HANNA, NAGLAA KHALIFA, AHMED ELHEWALA
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| Abstract:
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Background: Cardiovascular complications represent the main determinant of survival in ß-thalassemia patients, with particular pattern of cardiovascular affection inß-thalassemia major (ß-TM) and ß-thalassemia intermedia (ß-TI). Serum cystatin C is a well-known predictor of nephropathy but it has emerged as a strong predictor to cardiovascular dysfunction.
Objective: We assessedcystatin C levels in children and adolescents with ß-TM and ß-TI and its relation to echocardiography parameters and carotid intima media thickness (CIMT) as a marker of subclinical cardiovascular dysfunction.
Methods: Case control study on 60 patients with ß-TM, 30 patients with ß-TI and 60 age- and sex- matched controls focusing on hematological profile, serum ferritin, urinary albumin–creatinine ratio (UACR),serum cystatin C, echocardiography and CIMT.
Results: UACR, serum cystatin C and CIMT were significantly higher in ß-TM and ß-TIgroups compared to control (P < 0.001). Cardiac left ventricle (LV) systolic dysfunction was more prominent in patients with ß-TM (30%) versus (13.33%) in ß-TI, while significantly higher pulmonary pressure in those with ß-TI(73.3%) compared to (43.3%) of ß-TM. Significantly higher cystatin C levels were observed in ß-TM and ß-TI patients with nephropathy, LV systolic dysfunction or pulmonary hypertension than those without. Cystatin C levels were positively correlated with CIMT in both ß-TM and ß-TI groups. Thecystatin C cutoff valuesfor detection of the risk of cardiovascular complications were assessed.
Conclusions: Cystatin C appears to be a promising a marker for subclinical cardiovascular dysfunction in ß-TM and ß-TI patients.
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| Keyword:
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Cystatin C, ß-thalassemia, Cardiovascular, Nephropathy, Carotid intima media thickness.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.04.652
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| Download:
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