Fat-Soluble Antioxidant Vitamins, Iron Overload and Chronic Malnutrition in β-Thalassemia Major

To assess the antioxidant vitamins A (retinol) and E (alpha-tocopherol) levels, iron status and growth retardation in children with beta-thalassemia major in Odisha, an eastern state of India. Forty three children aged 1-15 y diagnosed with beta-thalassemia major (28 males and 15 females) and 42 age-matched healthy controls (22 males and 20 females) were studied. beta-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. 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 mu g/dL, p < 0.001) and alpha-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. This study shows that children with beta-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.