The Effect of Splenectomy on Lipid Profile and Glucose Metabolism of Beta Thalassemia Major Patients

Background and Objective: Splenectomy is a common treatment for beta thalassemia major. It eliminates many complications by reducing the need for blood transfusion, but it causes new complications which threatens the patients health. Hence, the aim of this study was to determine if splenectomy can alter the lipid profile and glucose metabolism in beta thalassemia major patients .Materials and Methods: 41 splenectomized and 42 non-splenectomized beta thalassemia patients 18-30 years old, with a history of using standard iron-chelating drugs, non-alcoholic, non-smoker, and without any metabolic or infectious disease, from Zafar Thalassemia Clinic, Tehran, Iran, were recruited to this case-control study. This study was approved by the Vice Chancellor for research of Iran University of Medical Sciences (IR.IUMS.REC-95-02-27-26529). Anthropometric and demographic data were collected using standard methods. Blood sampling at least 10 days after the last blood transfusion and 12 hours of fasting overnight was performed to measure Fasting blood glucose (FBG), oral glucose tolerance test (OGTT), TG, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TC/HDL-C, LDL-C/TG, and LDL-C/HDL-C ratio as the main outcomes. Physical activity and food intake were also measured using IPAQ and FFQ questionnaires respectively.All data were assessed using SPSS 21. Findings: 66.1% of subjects used desferrioxamine, 17.7% used deferiprone, and 16.1% used both drugs as iron chelator. 48.9% of the subjects were male and 51.1% were female. Splenectomy significantly reduced the need for blood transfusion and WBC and platelet were also significantly higher in splenectomized participants. Demographic characteristic and dietary intake were not significantly different in the two groups. ANCOVA analysis showed that TG, TC, LDL-C, VLDL-C, TC/HDL-C, LDL-C/TG, and LDL-C/HDL-C ratio were significantly higher and HDL-C was significantly lower in splenectomized patients (P-value < 0.05). Yet, FBG (P-value < 0.39) and OGTT (P-value < 0.53) did not significantly differ between the two groups. Conclusion: According to our results, significantly higher plasma lipid profile and greater risk of cardiovascular disease is a result of splenectomy in thalassemia major patients. Reduced activity of the reticuloendothelial system and reduced removal of cholesterol might be the reason this finding in splenectomized patients. Glucose metabolism on the other hand, seemed not to be affected by splenectomy in adult patients. Prospective studies to clarify this relationship is suggested.

کلیدواژه ها:

Thalassemia ، Splenectomy ، Lipid profile ، Glucose