الفهرس 
The Thalassemia SyndromesOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Beta thalassemia Major is the commonest cause of hemolytic anemia in Egypt (El Beshlawy et al., 1989). Growth disturbance is a major clinical feature of β- thalassemia major children (Spiliotis, 1998). Zinc deficiency is considered to be one of the main factors contributing to growth and puberty disorders in thalassemic patients (Mahyar, 2005).
Oxidative stress plays a role in growth retardation in β- thalassemia major children (Low, 2005).
The objective of the present study was to assess oxidative stress and zinc status and its relation to growth retardation in children with β-thalassemia major.
This work was carried out in the duration from December 2010 to December 2012 and included 50 β- thalassemia major children recruited from the Hematology clinic, Children’s Hospital, Ain Shams University, their ages ranged from 5 to 12 years with a mean of 8.5±2.3, from both sexes and 50 healthy children as a control group.
Patients were subjected to full history taking and thorough clinical examination, height for age, weight for age and BMI for age were taken as parameters for auxological assessment using the Egyptian growth charts and Tanner staging for assessment of pubertal development. In addition detection of hemoglobin concentration, serum ferritin, serum ALT and serum zinc were carried out. Furthermore the evaluation of serum Malondialdehyde as a diagnostic marker of oxidative stress was done. Data about Hb electrophoresis was obtained from patients records.
There was a non significant statistical difference between β- thalassemia major children and control group as regards age, sex.
There was a significant decrease in height for age, weight for age and BMI for age, Tanner staging, hemoglobin concentration and serum zinc in β- thalassemia major patients compared to control group, and a significant increase in serum ferritin, serum ALT and serum Malondialdehyde in β- thalassemia major patients compared to control group.
There was a significant decrease in height for age, weight for age and BMI for age, Tanner staging and serum zinc in β- thalassemia major patients with short stature compared to β- thalassemia major patients with normal stature, and a significant increase in duration of illness, serum ferritin and serum Malondialdehyde in β- thalassemia major patients with short stature compared to β- thalassemia major patients with normal stature.
There was a significant positive correlation between serum MDA level and serum ferritin in β- thalassemia major patients and a significant negative correlation between serum zinc level and serum ferritin in β- thalassemia major patients.
Conclusion:
The current study demonstrated that β- thalassemia major patients showed a significant decrease in height and weight percentiles compared to control subjects. β- thalassemia major patients showed a significant decrease in serum zinc and a significant increase in serum MDA compared to control subjects with a significant negative correlation between both parameters. There was a significant negative correlation between serum zinc and serum ferritin in β- thalassemia major patients and a significant positive correlation between serum MDA and serum ferritin in β- thalassemia major patients.
Saxena A. (2003): Growth Retardation in Thalassemia Major Patients. Int J Hum Genet, 3(4): 237-246.
RECOMMENDATIONS
1. Results of the present study points out to the importance of use of antioxidants to counteract the oxidative stress and its deleterious effect on the prognosis of thalassemia.
2. More nutritional and medical care of beta thalassemia major patients and more studies on the state of antioxidant micronutrients.
3. Nutritional supplementation with antioxidant nutrients especially zinc to reduce the oxidative damage and the related complications in beta thalassemia major patients.
4. Eating a diet rich in zinc is a necessary part of counteracting the oxidative stress state and promoting better growth in beta thalassemia major patients.