Premature Atherosclerosis in Children With Transfusion-Dependent Thalassemia: A Twin-Center Cross-Sectional Study

OBJECTIVE: To analyze the risk of premature atherosclerosis in children with transfusion-dependent thalassemia (TDT) compared to controls by measuring carotid intima-media thickness (CIMT) and correlating it with clinical and biochemical parameters. METHODS: Case-control study among children aged 2 to 15 years. RESULTS: Significantly higher CIMT values were observed across all age groups. Mean (SD) CIMT in controls were 0.27(0.07) mm, 0.39 (0.03) mm, and 0.46 (0.05) mm in 2 to 5 years, 6 to 10 years, and 11 to 15 years age groups respectively, as against 0.43 (0.08) mm, 0.55 (0.07) mm and 0.63 (0.08) mm in cases in similar age groups (P<0.001). Mean triglycerides and liver enzymes were significantly elevated in cases. Logistic regression analysis demonstrated that older age group and higher serum ferritin levels, but not dyslipidemia, were significantly associated with high CIMT. CONCLUSION: Children with TDT are at increased risk for premature atherosclerosis.