Lipid Profile and Other Measures of Cardiovascular Disease Risk among Anemic Individuals with and without Thalassemia in Metro Manila, Philippines

Objectives: The present study examined biochemical, clinical, and anthropometric factors that influence cardiovascular disease risk among anemic individuals with and without thalassemia. The objectives were to analyze and compare the following conditions in subjects with anemia due to alpha or beta thalassemia and those with anemia due to iron deficiency or other causes: 1) lipid profile, blood pressure, and fasting blood sugar; 2) anthropometric measurements (BMI, waist circumference, waist-hip ratio); and 3) identify significant cardiovascular risk factors that characterize anemic subjects with and without thalassemia.

Methodology: Randomly selected anemic individuals (n=101) were tested for presence of iron deficiency, hemoglobinopathy, or anemia due to other (unidentified) causes. Anemia was determined using cyanmethemoglobin method. Genetic hemoglobin disorders were examined using capillary electrophoresis. Iron deficiency was determined using immunoradiometric assay for serum ferritin. Differences in mean values of biochemical, clinical, and anthropometric measurements by cause of anemia were analyzed using ANOVA. The same test was used to determine the association of age with these cardiovascular risk factors. The likelihood of adverse biochemical, clinical, and anthropometric measurements among thalassemic and non-thalassemic subjects was examined using logistic regression.

Results: Non-thalassemic subjects were more likely to have reduced HDL-C (OR 0.09; 95% CI 0.02, 0.39; P<0.001) and increased VLDL-C (OR 5.6; 95% CI 1.32, 23.8; P<0.020) compared to thalassemic subjects. Majority of anemic individuals had high blood pressure and central obesity. Older age was associated with high blood pressure and increased total cholesterol and LDL-C.

Conclusion: Thalassemic subjects had better lipid profile than those with anemia due to iron deficiency and other causes, but were similar in terms of blood pressure and central adiposity. Further investigation using larger sample sizes is needed to confirm these results and determine their impact on CVD development.