The association between serum ferritin levels and aspartate aminotransferase to platelet ratio index score in thalassemia patients

Background: In thalassemia patients, routine transfusion is one of the given therapies, but this can lead to accumulation of iron which possibly leads to liver fibrosis. Serum ferritin levels are used to evaluate iron over load and correlate with liver iron concentration. Assessment of liver fibrosis, biopsy remains a gold standard, but the method is invasive. However, today many noninvasive methods are developed simple, one of which is the AST to platelet ratio index (APRI). Objectives: To analyze the association of serum ferritin levels and AST to platelet ratio index scores in thalassemia patients who received the chronic transfusion. Methods: Thalassemia patients who have had routine transfusions for more than 5 months or more than 10 bags regularly and no splenectomy has ever been performed. Serum ferritin levels were measured by the Enzyme-Linked Fluorescence Assay method, APRI scores were calculated using the formula (AST/threshold on normal AST value) x 100]/platelet count (10⁹/L). Statistical analysis of the relationship between serum ferritin and APRI score by using Spearman correlation test (p <0.05). Results: Most of the subjects were male (66.67%) and gained thalassemia beta major (61.11%) by age 26.14 ± 7.39 years. The results of measurement of serum ferritin 5011.49 ± 2595.33 ng/ml and APRI score 1.16 ± 1.10. Statistical analysis showed that there was a weak and significant positive correlation between serum ferritin level and APRI score in thalassemia patients with chronic transfusion (r = 0.355; p = 0.033). Conclussion: In this study, APRI scores have not been used to assess the presence of liver fibrosis that caused by elevated serum ferritin level.