Hemostatic system parameters and level of magnesium in patients with beta-thalassemiа

Abstract

Aim. To study the hemostatic system parameters and magnesium levels in patients with beta-thalassemia.

Methods. The object of the study was the blood serum of 96 women with beta-thalassemia: 46 patients with intermediate beta-thalassemia and 50 patients with beta-thalassemia minor, without clinical manifestations of hypercoagulation. The blood serum of 30 healthy donors was used as the control group. It was studied hemostasis system parameters: platelet count activated partial thromboplastin time (aPTT), prothrombin time, plasma fibrinogen level, D-dimer level, euglobulin clot lysis time, antithrombin III activity. The serum magnesium level and risk of deficiency were determined using the MDQ questionnaire.

Results. In patients with intermediate beta-thalassemia, an increase in the level of thrombinemia marker D-dimer (>500 ng/ml) was revealed. Patients with intermediate beta-thalassemia were divided into two groups according to the revealed level of D-dimer: 14 (30.4±6.8%) patients with latent hypercoagulation in group 1 and 32 (69.6±6.8%) patients without latent hypercoagulation in group 2. It was found that in the group with a high levels D-dimer, fibrinogen level was increased (p <0.05), fibrinolysis time was prolonged (p <0.05), activated partial thromboplastin time was shortened (p <0.05), and antithrombin III activity was slightly reduced (p >0.05). The serum magnesium level in patients of the first group was lower (t=7.3; p <0.001), and the risk of deficiency in the questionnaire was higher than in patients of the second group (r=–0.785, p <0.05). Hemostasis and magnesium levels in patients with beta-thalassemia minor did not differ from the control group (p >0.05).

Conclusion. One-third of patients with intermediate beta-thalassemia have a pre-thrombotic state for hemostasis — latent hypercoagulation and magnesium deficiency which can be predictors of clinical signs of thrombosis.

Keywords

beta-thalassemia / latent hypercoagulation / D-dimer / magnesium deficiency

References

[1] Cappellini M.D., Musallam K.M., Taher A.T. Тhalassemia as a hypercoagulable state. US Oncol. Hematol. 2011; 7: 157‒160. DOI: 10.17925/OHR.2011.07.2.157.

[2] Cappellini M.D., Motta I., Musallam K.M., Taher A.T. Redefining thalassemia as a hypercoagulable state. Ann. NY Acad. Sci. 2010; 120: 231‒236. DOI: 10.1111/j.1749-6632.2010.05548.x.

[3] Vorobev A.I., Vasilev S.A., Qorodezkij V.M. et al. Hypercoagulation syndrome: classification, pathogenesis, diagnostics, and therapy. Gematoloqiya i transfuziologiya. 2016; (3): 116–122. (In Russ.) DOI: 10.18821/0234-5730-2016-61-3-116-122.

[4] Воробьёв А.И., Васильев С.А., Городецкий В.М. и др. Гиперкоагуляционный синдром: классификация, патогенез, диагностика, терапия. Гематол. и трансфузиол. 2016; (3): 116–122. DOI: 10.18821/0234-5730-2016-61-3-116-122.

[5] Momot A.P. The problem of thrombophilia in clinical practice. Rossijskij zhurnal detskoj gematologii i onkologii. 2015; (1): 36–48. (In Russ.) DOI: 10.17650/2311-1267-2015-1-36-48.

[6] Момот А.Р. Проблема тромбофилии в клинической практике. Рос. ж. детской гематол. и онкол. 2015; (1): 36–48. DOI: 10.17650/2311-1267-2015-1-36-48.

[7] Kopina M.N., Gaevskij Yu.G. Hypercoagulability disorders in patients with newly diagnosed iron deficiency anemia. Vestnik Novgorodskogo gosudarstvennogo universiteta. 2013; 1 (71): 21–24. (In Russ.)

[8] Копина М.Н., Гаевский Ю.Г. Гиперкоагуляционные нарушения гемостаза у больных впервые выявленной железодефицитной анемией. Вестн. Новгородского гос. ун-та. 2013; 1 (71): 21–24.

[9] Kerimov A.A. Latent hypercoagulability disorders. Sovremennye dostizheniya azerbajdzhanskoj mediciny. 2014; (4): 116–122. (In Russ.)

[10] Керимов А.А. Латентные гиперкоагуляционные нарушения гемостаза. Современные достижения азербайджанской медицины. 2014; (4): 116–122.

[11] Gromova O.A., Kalacheva A.G., Torshin I.Yu. et al. Magnesium deficiency — a significant risk factor for comorbidity: results of large-scale screening of magnesium status in russian regions. Farmateka. 2013; (6): 16–28. (In Russ.)

[12] Громова О.А., Калачёва А.Г., Торшин И.Ю. и др. Недостаточность магния — достоверный фактор риска коморбидных состояний: результаты крупномасштабного скрининга магниевого статуса в регионах России. Фарматека. 2013; (6): 16–28.

[13] Kerimov A., Alieva N., Mamedova T., Qafarova S. The value of the level of magnesium in hemostasis patients beta-thalassemia. Biomedisina (Baku). 2016; (1): 15–19. (In Russ.)

[14] Керимов А., Алиева Н., Мамедова Т., Гафарова С. Значение уровня магния в гемостазе больных бета-талассемией. Биомедицина (Баку). 2016; (1): 15–19.

[15] Andriadze N.A., Kobalava M.A. Increased risk of platelet thrombosis stimulated by hypomagnesiemia in acute myocardial infarction. Rossijskij kardiologicheskij zhurnal. 2004; (6): 14–17. (In Russ.) DOI: 10.15829/1560-4071-2004-6-14-17.

[16] Андриадзе Н.А., Кобалава М.А. Повышение ­риска стимуляции тромбоцитзависимого тромбоза низким уровнем магния в плазме крови при остром инфаркте мио­карда. Рос. кардиол. ж. 2004; (6): 14–17. DOI: 10.15829/1560-4071-2004-6-14-17.

[17] Barkagan Z.S., Momot A.P. Diagnostics and controlled therapy of violations of a hemostasis. Moscow: Nyu-Diamed. 2008; 292 р. (In Russ.)

[18] Баркаган З.С., Момот А.П. Диагностика и контролируемая терапия нарушений гемостаза. M.: Нью-Диамед. 2008; 292 р.

[19] Serov V.N., Blinov D.V., Zimovina U.V., Dzhobava E.M. Results of an investigation of the prevalence of magnesium deficiency in pregnant women. Aku­sherstvo i ginekologiya. 2014; (6): 33–40. (In Russ.)

[20] Серов В.Н., Блинов Д.В., Зимовина У.В., Джобава Е.М. Результаты исследования распространённости дефицита магния у беременных. Акушерство и гинекол. 2014; (6): 33–40.

[21] Gromova O.A., Kalachova A.G., Torshin I.Y. On the diagnosis of magnesium deficiency. Part 1. Arxiv vnutrenney meditsini. 2014; (2): 5–10. (In Russ.) DOI: 10.20514/2226-6704-2014-0-2-5-10.

[22] Громова O.A., Калачёва A.Г., Торшин И.Ю. О диагностике дефицита магния. Часть 1. Арх. внутренней мед. 2014; (2): 5–10. DOI: 10.20514/2226-6704-2014-0-2-5-10.

[23] Cappelini M.D., Poggiali E., Taher S. et al. Hypercoagulolity in beta-thalassemia — a status quo. Expert. Rev. Hematol. 2012; 5: 505–512. DOI: 10.1586/ehm.12.42.

RIGHTS & PERMISSIONS

Aliyeva N.R.