Comparison of serum homocysteine levels in transfusion-dependent β-thalassemia patients with regular and irregular folic acid supplementation

Trishna Saha; Sreekanta Debnath; Tripti Moni Saha; Sourav Das; Farhana Munmun; Jannatul Ferdause; Umma Asma Saki; Rifat Hasan; Mohammad Abdul Kadir

doi:10.18203/2320-6012.ijrms20261332

Authors

Trishna Saha Department of Transfusion Medicine, National Institute of Kidney Diseases and Urology, Sher-E-Bangla Nagar, Dhaka, Bangladesh
Sreekanta Debnath Department of Medicine, Upazila Health Complex (UHC), Monoharganj, Cumilla, Bangladesh
Tripti Moni Saha Department of Pharmacology and Therapeutics, Bikrampur Bhuiyan Medical College, Munshiganj, Bangladesh
Sourav Das Department of Transfusion Medicine, National Centre for Control of Rheumatic Fever and Heart Diseases, Dhaka, Bangladesh
Farhana Munmun Department of Transfusion Medicine, Green Life Hospital, Dhaka, Bangladesh
Jannatul Ferdause Department of Ophthalmology, Mugda Medical College Hospital, Dhaka, Bangladesh
Umma Asma Saki Department of Transfusion Medicine, KPJ Specialized Hospital, Dhaka, Bangladesh
Rifat Hasan Department of Transfusion Medicine, National Institute of Burn & Plastic Surgery, Dhaka, Bangladesh
Mohammad Abdul Kadir Department of Medicine, Mugda Medical College Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20261332

Keywords:

β-thalassemia, Folic acid adherence, Transfusion-dependent thalassemia

Abstract

Background: Transfusion-dependent β-thalassemia (TDT) patients have increased folate requirements due to chronic erythropoietic stress. Inadequate folate intake may result in elevated serum homocysteine, a recognized risk factor for vascular complications. This study aimed to compare serum homocysteine levels between TDT patients with regular and irregular folic acid supplementation and to assess correlations with duration of supplementation and age.

Methods: This cross-sectional comparative study was conducted at the Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, between March 2023 and February 2024. Forty TDT patients were categorized into regular (n=20) and irregular (n=20) folic acid supplementation groups. Fasting serum homocysteine levels were measured using chemiluminescent immunoassay. Data were analyzed using SPSS version 27.0.

Results: Mean serum homocysteine was significantly lower in the regular supplementation group (5.19±1.04 µmol/l) compared with the irregular group (13.68±5.47 µmol/l; p<0.001). Hyperhomocysteinemia (≥15 µmol/l) was observed exclusively among irregularly supplemented patients (30%). A negative correlation was identified between duration of supplementation and homocysteine level, while age showed a modest positive trend with homocysteine among irregular users.

Conclusions: Irregular folic acid supplementation is associated with significantly elevated serum homocysteine levels in transfusion-dependent β-thalassemia patients. Sustained adherence to supplementation may reduce metabolic risk and should be emphasized in routine clinical management.

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