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All Journal The Indonesian Biomedical Journal Paediatrica Indonesiana
Ludi Dhyani Rahmartani
Department Of Child Health - Dr. Cipto Mangunkusumo National General Hospital, Indonesia - Faculty Of Medicine University Of Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Glucose and Lipid Profiles in Adolescents with Thalassemia Major and Its Association with Iron Overload in Specific Organs Aryono Hendarto; Teny Tjitra Sari; Ludi Dhyani Rahmartani; Anggia Widyasari; Stephen Diah Iskandar
The Indonesian Biomedical Journal Vol 11, No 2 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i2.693

Abstract

BACKGROUND: Organ damage due to iron toxicity is one factor that increases the risk of getting cardiovascular and metabolic diseases in thalassemia patient. This study aims to determine glucose and lipid profiles in adolescents with thalassemia major and its association with iron overload in pancreas and liver.METHODS: This was a cross sectional study. Subjects were thalassemia major adolescents without any confounding factors that may affect glucose and lipid levels. Blood samples were collected to measure the glucose level, lipid profiles, ferritin level and transferrin saturation. T2-Magnetic Resonance Imaging was used to evaluate the iron overload in organs.RESULTS: From a total of 60 subjects, diabetes mellitus was diagnosed in 1 subject and impaired fasting glucose was diagnosed in 3 subjects. All subjects had high triglycerides/ high density lipoprotein-cholesterol (HDL-C) ratio, 59 subjects (98%) had low HDL-C, 18 subjects (30%) had hypertriglyceridemia, and none had abnormal high level of low density lipoprotein-cholesterol (LDL-C). The majority of subjects had ferritin ≥2,500 ng/mL (70%), mild pancreatic iron overload (56.6%), and moderate hepatic iron overload (43.8%). Degree of hyperferritinemia was not associated with glucose and lipid profiles. Blood glucose profiles were not associated with various degree of pancreatic iron overload. Similar result was also observed between lipid profiles and hepatic iron overload.CONCLUSION: Abnormal glucose and lipid profiles in thalassemia major can be found in adolescence. Normal blood glucose level isn’t necessarily associated with normal pancreatic iron deposition. Hepatic iron overload may worsen dyslipidemia in thalassemia major patients.KEYWORDS: glucose profile, lipid profile, pancreatic iron overload, hepatic iron overload, thalassemia major
Liver iron overload and hepatic function in children with thalassemia major Pustika Amalia Wahidiyat; Stephen Diah Iskandar; Ludi Dhyani Rahmartani; Damayanti Sekarsari
Paediatrica Indonesiana Vol 58 No 5 (2018): September 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (273.956 KB) | DOI: 10.14238/pi58.5.2018.233-7

Abstract

Background Routine blood transfusions and increased intestinal iron absorption lead to iron accumulation in various organs, especially the liver. To date, T2-star magnetic resonance imaging (T2*MRI) is a valuable tool to evaluate iron level in organs. Objective To assess the degree of liver iron overload among children with thalassemia major (TM) and its possible correlations with hepatic function laboratory values. Methods This cross-sectional study was conducted in Cipto Mangunkusumo Hospital. The degree of liver iron overload was evaluated by T2*MRI. Assessments of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, and bilirubin levels were done to evaluate liver function. Results A total of 291 TM children were included in this study. The mean age of subjects was 12 years. Most of the subjects were diagnosed as β-thalassemia homozygote (54.6%) and β-thalassemia/HbE (41.2%). Deferiprone (DFP) was the most commonly used iron chelator. Less than 10% of the subjects had normal liver iron deposition. The AST and ALT values increased proportionally with the severity of liver iron overload, with significant, moderately negative correlation coefficients (r=-0.388 and -0.434, respectively). However, albumin level decreased proportionally with the severity of liver iron overload, with a significant, moderately positive correlation coefficient (r=0.323). Liver T2* MRI had no significant correlations with direct, indirect, and ratio of direct/total bilirubin levels. Conclusion Most of the children with TM have mild to severe liver iron overload. Liver T2* MRI had significant, moderate correlations with AST, ALT, and albumin values. Bilirubin level has no correlation with T2* MRI. Our findings suggest that monitoring of AST, ALT, and albumin levels is important because they may reflect the severity of liver iron overload. However, they should not be used as the only predictors of iron overload.
Survival of thalassemia patients at Dr. Cipto Mangunkusumo Hospital: a single center retrospective study Teny Tjitra Sari; Damayanti Angelina; Ludi Dhyani Rahmartani; Anna Mira Lubis; Pustika Amalia Wahidiyat
Paediatrica Indonesiana Vol. 66 No. 3 (2026): May 2026
Publisher : Indonesian Pediatric Society

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Abstract

Background Thalassemia is a serious health challenge around the world, especially in countries within the “Thalassemia belt,” including Indonesia. The effectiveness of treatment for thalassemia is often measured by how well patients survive and thrive. However, the information is still limited on the survival of thalassemia patients in Indonesia. Objective To evaluate factors related to mortality risk,  characteristics and age distribution of thalassemia patients at Dr. Cipto Mangunkusumo National Central General Hospital (CMNH), Indonesia. Methods Using patient medical records from the Thalassemia Center of CMNH, covering the years 2017 to 2023, we examined patient characteristics, age distribution, and survival rates. To understand survival over time, the Kaplan–Meier and Cox regression tests were used. Results The 562 thalassemia patients studied had an average age of 18.3 years and 286 (51%) were male. The majority of patients (55.8%) had β-thalassemia. Most patients were between 11 and 20 years old (38.6%), and nearly half of them (49%) received deferiprone as their iron chelation therapy. Patients with mean serum ferritin ≥ 2,500 ng/mL (87.7%) had lower survival than patients with mean serum ferritin < 2,500 ng/mL (12.3%), but the difference was not statistically significant [hazard ratio (HR) 1.23; 95%CI 0.29 to 5.16; P=0.779]. Conclusion At CMNH, most thalassemia patients were adolescents or young adults, and β-thalassemia was the most common subtype. Patients with mean serum ferritin ≥2,500 ng/mL had a higher estimated mortality risk than those with lower levels (HR 1.23; 95% CI 0.29–5.16), although the association was not statistically significant.
Co-Authors Anggia Widyasari Anna Mira Lubis Aryono Hendarto Damayanti Angelina Damayanti Sekarsari Pustika Amalia Wahidiyat Pustika Amalia Wahidiyat Stephen Diah Iskandar Stephen Diah Iskandar Teny Tjitra Sari Teny Tjitra Sari, Teny Tjitra