Assessment of serum asymmetric dimethylarginine level in children with beta-thalassemia

Objective The aim was to evaluate serum asymmetric dimethylarginine (ADMA) level in pediatric patients who received a diagnosis of beta-thalassemia as a predictor of endothelial dysfunction. Background Beta-thalassemia is one of most common global autosomal recessive disorders. It causes poor growth and skeletal abnormalities along with hemolytic anemia that regularly involves long-term blood transfusions. Methods This cross-sectional study included 60 children divided equally in two groups. The patient group was previously diagnosed with beta-thalassemia major (β-TM), and the control group was healthy subjects who were age, sex, and socioeconomically matched with the patient group. Both groups were evaluated regarding complete blood count, liver and kidney function tests, ADMA, and carotid intima–media thickness. Results The most prevalent clinical presentation of β-TM was pallor and jaundice. The authors reported a statistically significant difference regarding hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width, platelet, white blood cells, serum ferritin, alanine transferase, and aspartate transferase between cases and controls. In addition, we observed a statistically significantly higher mean carotid intima–media thickness among the patient group for right and left sides (P=0.012). Serum ADMA also showed a statistically significantly increased levels for the patient group (P=0.001), and the best-detected cutoff point was 10 458.5 ng/l with a sensitivity of 96.7% and a specificity of 76.7%. Conclusion Major endothelial dysfunction is responsible for β-TM cardiovascular complications, and serum level of ADMA may be used as an early marker for endothelial dysfunction.