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Frontiers in Biology

ISSN 1674-7984

ISSN 1674-7992(Online)

CN 11-5892/Q

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Front. Biol.    2017, Vol. 12 Issue (6) : 442-447    https://doi.org/10.1007/s11515-017-1469-8
RESEARCH ARTICLE
Evaluation of protein Z plasma level in beta-thalassemia major patients in Ahvaz city in Iran
Mohammad Taha Jalali1(), Abdorrahim Absalan2, Alireza Mohseni3, Gholam Abbas Kaydani1, Zeinab Deris Zayeri4
1. Department of Laboratory Sciences, Hyperlipidemia Research Center, Diabetes Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran
2. Shefa Neuroscience Research Center, KhatamAlanbia Hospital, Tehran, Iran
3. Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
4. Golestan Hospital Clinical Research Development Unit, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Abstract

OBJECTIVES: Thrombotic episodes occurred frequently in beta-thalassemia major (BTM) patients, leading to hypercoagulability of plasma. Protein Z (PZ) is a vitamin-K-dependent anti-coagulation factor that plays a role in the human homeostatic process. The objective of the current study is to investigate the distribution pattern of PZ plasma concentrations between BTM patients and the normal population in Ahvaz city, the center of Khuzestan province, southwest of Iran.

MATERIAL and METHODS: Forty confirmed BTM patients and 40 healthy volunteers were evaluated for complete blood count (CBC) indices and PZ plasma levels. CBC samples were measured using an automated cell counter, and PZ was assayed with an immunoassay method. Statistical analysis was conducted using SPSS software. The ROC curve and binary logistic regression estimated the sensitivity, specificity, and Odd’s ratio for PZ measurement.

RESULTS: The mean±SD of the PZ plasma level in normal individuals was 1.68±0.63 µg/mL, and in BTM patients, it was 1.10±0.52 µg/mL. This shows a significant reduction of PZ in BTM patients statistically (CI= 0.99; p<0.001). Further, the mean±SD of the PZ plasma levels in BTM patients who received washed red blood cells was not significantly different from that of patients undergoing packed red blood cell therapy (CI= 0.95; p = 0.320). The area under the curve (AUC) for PZ was 0.759 (p = 0.00). The cut-off value= 1.4 µg/mL of the PZ plasma level had at least 70% sensitivity and specificity in BTM patients.

DISCUSSION: Several epidemiologic studies have shown thromboembolism episodes in BTM patients. In the current study, PZ was reduced significantly in BTMs.

CONCLUSION: We noticed that BTMs have lower plasma PZ concentration might be predisposed to BTM.
Keywords major beta-thalassemia      protein Z      thrombosis      immunoassay      anti-coagulation factor     
Corresponding Author(s): Mohammad Taha Jalali   
Online First Date: 29 December 2017    Issue Date: 10 January 2018
 Cite this article:   
Mohammad Taha Jalali,Abdorrahim Absalan,Alireza Mohseni, et al. Evaluation of protein Z plasma level in beta-thalassemia major patients in Ahvaz city in Iran[J]. Front. Biol., 2017, 12(6): 442-447.
 URL:  
https://academic.hep.com.cn/fib/EN/10.1007/s11515-017-1469-8
https://academic.hep.com.cn/fib/EN/Y2017/V12/I6/442
Fig.1  Comparative chart of proteinZ plasma levels in beta thalassemia major (BTM) patients and normalcontrols.
Hematological index Category (N =40) Mean±SD (µg/mL) p-value Odds ratio
WBC Case 8.19±3.10 0.075 0.86
(0.73, 1.02)
Control 7.06±2.44
Hb Case 8.22±1.22 0.000 130.86
(0.64, 26849.24)
Control 13.13±1.40
RBC Case 3.05±0.44 0.000 606.19
(19.79, 18571.33)
Control 4.71±0.45
HCT Case 23.96±3.53 0.000 3.53
(1.10, 11.34)
Control 38.78±3.72
MCV Case 78.68±4.54 0.000 1.23
(1.08, 1.40)
Control 82.44±4.66
MCH Case 26.93±2.17 0.036 1.29
(1.01, 1.64)
Control 27.91±1.92
MCHC Case 34.30±1.63 0.132 0.76
(0.52, 1.10)
Control 33.82±1.10
RDW-SD Case 47.53±5.99 0.000 0.51
(0.37, 0.68)
Control 40.66±2.34
Platelet Case 292.48±142.51 0.365 1.00
(0.99, 1.00)
Control 268.5±85.38
Protein Z Case 1.10±0.52 0.000 5.40
(2.20, 13.22)
Control 1.68±0.63
Tab.1  Hematologicalparameters of thalassemia patients and control individuals
Hematological index Category (N =40) Correlation values with protein Zplasma levels p-value
WBC Case 0.155 0.339
Control 0.318 0.046
Hb Case -0.008 0.962
Control -0.064 0.693
RBC Case 0.039 0.809
Control -0.102 0.530
HCT Case -0.087 0.595
Control -0.133 0.414
MCV Case -0.311 0.051
Control -0.049 0.762
MCH Case -0.067 0.682
Control 0.032 0.845
MCHC Case 0.251 0.117
Control 0.164 0.312
RDW-SD Case 0.332 0.036
Control -0.091 0.577
Platelet Case -0.037 0.820
Control 0.104 0.522
Duration of transfusion therapy Case 0.217 0.178
Tab.2  Correlation valuesbetween hematological indices and protein Z plasma levels
Fig.2  ROC curve of PZ plasma levelsplotted according to BTM patients and normal individuals. Area undercurve (AUC) for PZ was 0.759 (p = 0.00). Then, assessment of PZ could be valuable for BTM patients.
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