RELATIONSHIP BETWEEN URIC ACID LEVELS AND CARDIAC FINDINGS IN A LARGE COHORT OF Β-THALASSEMIA MAJOR: GENDER-RELATED DIFFERENCES
(Abstract release date: 05/18/17)
EHA Library. Meloni A. 05/18/17; 182901; PB2188
Dr. Antonella Meloni
Contributions
Contributions
Abstract
Abstract: PB2188
Type: Publication Only
Background
Iron overload, secondary to recurrent transfusions and ineffective erythropoiesis, induces oxidative stress in thalassemia (TM). Uric acid (UA), a major blood antioxidant, may act either as an antioxidant or pro-oxidant.
Aims
Our aim was to evaluate the role of UA in TM and its association with cardiac iron, dysfunction, fibrosis, and complications, and cardiovascular risk factors in a large cohort of TM patients of both sexes.
Methods
397 TM patients (200 men, mean age 32±8 years) enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network were considered.
Myocardial and hepatic iron burdens were quantified by the T2* technique. Atrial dimensions and biventricular function were quantified by cine images. Late gadolinium enhancement (LGE) images were acquired to detect myocardial fibrosis.
Results
As expected, UA resulted significantly higher in male respect to female TM patients (4.74.7±1.3 vs 4.0±1.0 mg/dL; P<0.0001).
UA levels directly correlated with BMI (R=0.25, P=0.0003), and triglycerides (TG) (R=0.20, P=0.005) in female patients. Moreover, female which presented myocardial fibrosis showed higher levels of UA (4.4±1.3 vs 3.9±0.9 mg/dL, P=0.03). The multiple regression model identified BMI (T-value 3.7, P=0.0003), TG (2.1, P=0.04) and cardiac fibrosis (2.5, P=0.01) as independent correlates of UA level in women.
In men, UA levels were positively correlated with BMI (R=0.17, P=0.02), TG (R=0.38, P<0.001), and inversely with HDL (R=-0.20, P=0.006) and glycemia (R=-0.15, P=0.04). Interestingly, UA was also directly correlated with global heart T2* values (R=0.3, P<0.001). After multivariate analysis adjustment, global heart T2* (T-value 2.6, P=0.01), TG (4.7, P<0.001), and BMI (1.9, P=0.05) remained as independent determinants of UA in male TM patients.
Conclusion
UA levels correlates with factors related to metabolic dysfunction in TM patients of both sex, while a more strong correlation between UA and cardiac fibrosis was observed only in females, and a direct relationship between UA and T2* global heart only in males. The differences in male and female TM patients imply some gender-specific mechanisms, providing biochemical basis for the epidemiological differences between sexes.
Session topic: 26. Thalassemias
Keyword(s): iron overload, Gender
Abstract: PB2188
Type: Publication Only
Background
Iron overload, secondary to recurrent transfusions and ineffective erythropoiesis, induces oxidative stress in thalassemia (TM). Uric acid (UA), a major blood antioxidant, may act either as an antioxidant or pro-oxidant.
Aims
Our aim was to evaluate the role of UA in TM and its association with cardiac iron, dysfunction, fibrosis, and complications, and cardiovascular risk factors in a large cohort of TM patients of both sexes.
Methods
397 TM patients (200 men, mean age 32±8 years) enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network were considered.
Myocardial and hepatic iron burdens were quantified by the T2* technique. Atrial dimensions and biventricular function were quantified by cine images. Late gadolinium enhancement (LGE) images were acquired to detect myocardial fibrosis.
Results
As expected, UA resulted significantly higher in male respect to female TM patients (4.74.7±1.3 vs 4.0±1.0 mg/dL; P<0.0001).
UA levels directly correlated with BMI (R=0.25, P=0.0003), and triglycerides (TG) (R=0.20, P=0.005) in female patients. Moreover, female which presented myocardial fibrosis showed higher levels of UA (4.4±1.3 vs 3.9±0.9 mg/dL, P=0.03). The multiple regression model identified BMI (T-value 3.7, P=0.0003), TG (2.1, P=0.04) and cardiac fibrosis (2.5, P=0.01) as independent correlates of UA level in women.
In men, UA levels were positively correlated with BMI (R=0.17, P=0.02), TG (R=0.38, P<0.001), and inversely with HDL (R=-0.20, P=0.006) and glycemia (R=-0.15, P=0.04). Interestingly, UA was also directly correlated with global heart T2* values (R=0.3, P<0.001). After multivariate analysis adjustment, global heart T2* (T-value 2.6, P=0.01), TG (4.7, P<0.001), and BMI (1.9, P=0.05) remained as independent determinants of UA in male TM patients.
Conclusion
UA levels correlates with factors related to metabolic dysfunction in TM patients of both sex, while a more strong correlation between UA and cardiac fibrosis was observed only in females, and a direct relationship between UA and T2* global heart only in males. The differences in male and female TM patients imply some gender-specific mechanisms, providing biochemical basis for the epidemiological differences between sexes.
Session topic: 26. Thalassemias
Keyword(s): iron overload, Gender
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