Evaluation of Liver Enzyme Alterations and Serum Ferritin Levels in Beta Thalassemia Patients

Abstract

Background: Beta thalassemia is a prevalent hereditary anemia requiring frequent transfusions, leading to iron overload and potential hepatic dysfunction. There is a critical need to clarify the relationship between liver enzyme alterations and serum ferritin in this population, as existing literature reports inconsistent associations. Objective: This study aimed to assess liver enzyme (ALT, AST, ALP) alterations and serum ferritin concentrations in beta thalassemia patients, evaluating the impact of disease type and iron overload on hepatic function. Methods: In this cross-sectional observational study, 80 beta thalassemia patients aged 5–18 years were recruited from the Awam Dost Thalassemia Center, Kasur, using defined inclusion and exclusion criteria. Blood samples were analyzed for ALT, AST, ALP, and serum ferritin using standardized automated assays. Demographic and clinical data were collected, and outcome measures included mean enzyme and ferritin levels and their inter-relationships. Ethical approval was obtained from The Superior University Lahore, with all procedures conducted according to the Declaration of Helsinki. Statistical analyses were performed with SPSS version 27.0, employing descriptive statistics, t-tests, and Pearson correlations as appropriate. Results: Mean ALT, AST, and ALP values were 35.10 ± 16.51 IU/L, 38.52 ± 20.85 IU/L, and 88.12 ± 24.49 IU/L, respectively, while serum ferritin averaged 801.71 ± 320.20 ng/mL. Minimal differences in enzyme levels were observed between thalassemia major and minor groups. Weak correlations were found between serum ferritin and liver enzymes (r = 0.085 for ALT, r = 0.030 for AST), indicating multifactorial influences on hepatic dysfunction. Severe liver damage was present in 10% of patients. Conclusion: Beta thalassemia is associated with consistently elevated serum ferritin and modest liver enzyme abnormalities, highlighting the ongoing risk of hepatic complications. Regular monitoring and tailored iron chelation are vital for optimal care. These findings underscore the need for comprehensive, individualized management strategies to improve long-term hepatic health in thalassemia patients.