Fat-soluble antioxidant vitamins, iron overload and chronic malnutrition in β-thalassemia major.

Objective: To assess the antioxidant vitamins A (retinol) and E (α-tocopherol) levels, iron status and growth retardation in children with β-thalassemia major in Odisha, an eastern state of India.

Methods: Forty three children aged 1-15 y diagnosed with β-thalassemia major (28 males and 15 females) and 42 age-matched healthy controls (22 males and 20 females) were studied. β-thalassemia was detected by using Bio-rad variant assay. Measurement of blood hemoglobin (Hb), hematocrit, serum vitamins (A and E) and ferritin was carried out by standard methods.

Results: Mean hemoglobin (6.60 ± 1.84 vs. 11.8 ± 2.29 g/dL, p < 0.01), serum retinol (28.0 ± 17.67 vs. 54.4 ± 36.56 μg/dL, p < 0.001) and α-tocopherol (0.2 ± 0.34 vs. 1.1 ± 0.82 mg/dL, p < 0.001) were significantly lower in children with thalassemia compared with control group, however, serum ferritin (storage iron) was elevated in thalassemia patients (553.7 ± 176.80 vs. 57.3 ± 40.73 ng/mL, p < 0.001). Vitamin E had significantly correlated with hemoglobin and hematocrit values in the patients. Growth retardation in terms of stunting (79 % vs. 24 %, p < 0.0001) and thinness (32.6 % vs. 9.5 %, p < 0.05) was significantly higher in thalassemic children compared with normal children.

Conclusions: This study shows that children with β-thalas-semia major are in a state of oxidative stress of hyperfer-ritinemia with deprived antioxidant vitamins (A and E) and poor growth status suggesting a possible need for reduction in iron overload and additional antioxidant supplementation.