Effect of Serum Ferritin on Serum Zinc Levels in Patients with Thalassemia Major: A Prospective Cross-sectional Study

Abstract: Background: One of the most common cause of hereditary anemia is thalassemia, with carrier rate of 5.2% globally. Repeated blood transfusions lead to accumulation of iron in multiple organs which causes multiple complications. Among many complications, micronutrient deficiency of zinc does contribute to further hampering of overall general wellbeing of thalassemic patients. Keeping this in mind, a study is conducted to see the association of increased ferritin levels on serum zinc levels. Objective: The objective of the study is to observe for a likely association between serum ferritin and zinc in patients with Thalassemia Major. Secondary objective is to assess growth and development of Thalassemic children as per growth centile charts. Materials and Methods: A cross -sectional study was conducted at National Institute of Blood Disease & Bone Marrow Transplantation (NIBD), Karachi with the duration of 3 months from January 04, 2025 to April 14, 2025, after the approval of Ethical Review Committee bearing number NIBD/IRB/267/02-2024, dated: 31-05-2024. Data collected in this study included: age, sex, anthropometric assessment was done by CDC Growth centile charts. Serum ferritin and Zinc level were also estimated. Data was recorded and analyzed by SPSS 25.0 and the statistically significant level, considered as 0.05. Result: Out of all patients, 40% exhibited zinc insufficiency, 35.7% had serum ferritin levels >3000 ng/ml, 28.6%had levels over 4000, and 21.4% had levels over 5000ng/ml. There was a substantial inverse relationship between high ferritin and low zinc levels. The growth of 62.9% of thalassemic patients were at fifth centile indicating deceleration in growth. Girls being dominant figure (57.1%) showing poor growth velocity. Conclusion: Patients with Thalassemia major have showed substantial development retardation. Forty percent of the Thalassemic children had low serum zinc levels. Additionally, low zinc levels were significantly correlated with high ferritin levels. Keywords: Thalassemia, Zinc deficiency, Serum ferritin levels, Beta globin, Transfusion.