Association of Body Composition and Biochemical Indicators with Serum Ferritin Levels in Patients with β-thalassemia Major: A Cross-Sectional Study

Cirruse  Salehnasab; Farzad  Karimpour; Elaheh  Piraei; Behrooz  EbrahimzadehKour

doi:10.18502/ijpho.v16i1.20427

Cirruse Salehnasab Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
Farzad Karimpour Shahid Beheshti Hospital Clinical Research center, Yasuj University of Medical Sciences, Yasuj, Iran
Elaheh Piraei School of Health and Nutrition Science, Yasuj University of Medical Sciences, Yasuj, Iran
Behrooz EbrahimzadehKour School of Health and Nutrition Science, Yasuj University of Medical Sciences, Yasuj, Iran

DOI: https://doi.org/10.18502/ijpho.v16i1.20427

Keywords: Body composition, Ferritin, Growth, Iron overload, Thalassemia Major

Abstract

Background: This study aimed to assess the body composition and biochemical markers of patients with β-thalassemia major (BTM) in relation to their serum ferritin levels.

Materials and Methods: In this cross-sectional study, 74 BTM patients referred to an educational hospital in the southwest of Iran. They were grouped based on their serum ferritin levels. Given the cutoff point of 1500 ng/mL, 34 patients with acceptable serum ferritin level while 40 with high serum ferritin level. Anthropometric and biochemical indicators were collected following standard protocols. Dietary intake and body composition were evaluated by a 24-hour food recall and bioelectrical impedance analysis (BIA), respectively. The predictors of the serum ferritin level were determined by multivariate binary logistic regression, with the significance set at P < 0.05.

Results: Of the BTM patients, 16 (21.6%), 51 (68.9%) and 7 (9.5) were underweight, normal weight and overweight, respectively and no one them were obese. The daily intakes of vitamin K, vitamin D, vitamin B6 and copper were different significantly between two groups (P < 0.05). The mean blood transfusion interval was longer in acceptable ferritin level group compared to high ferritin group (P = 0.04). Fatness (P = 0.02) and total body water to lean body mass ratio (TBW/LBM) (P = 0.047) differed significantly between two groups. In fully adjusted regression model, the participants in the upper median group of fatness showed 81% lower odds ratio(OR) for high serum ferritin level (OR: 0.19, %95 confidence interval(CI): 0.033-0.84, P = 0.03). The association between TBW/LBM and serum ferritin level was positive, but not statistically significant in the fully adjusted model (OR: 3.66; 95% CI: 0.8–16.7; P = 0.096).

Conclusion: High body fat percent (BFP) is significantly associated with the lower odds of high ferritin levels, suggesting a potential protective role in BTM patients.