The Correlation of Vitamin D3 with Biochemical Markers in Transfusion Dependent β-Thalassemia Patients at Diwaniyah Thalassemia Center

Abstract

Background: Beta-thalassemia major (β-TM) is a severe hereditary disorder characterized by multi-system complications. Vitamin D deficiency is a common and critical comorbidity in these patients, and it is increasingly linked to the severity of hepatic and metabolic dysfunction. Aim: This study aimed to evaluate the serum levels of vitamin D3 in a cohort of Iraqi patients with β-TM and to investigate its correlation with a panel of key biochemical markers reflecting liver, metabolic, and mineral health. Methods: A cross-sectional study was conducted on 50 transfusion-dependent β-TM patients at the Diwaniyah Thalassemia Center in Iraq between April and July 2025. Serum vitamin D3 was measured using a chemiluminescence immunoassay (CLIA), while other biochemical markers, including liver enzymes, lipids, and minerals, were analyzed on a fully automated analyzer. Pearson correlation was used to assess the relationships between variables. Results: The study was conducted on 50 patients with major beta -beta -essentials between the ages of 3 and 23, and an average age of 14.4 ± 6.1 years, with a minor male dominance by 54%. A high prevalence of vitamin D deficiency or insufficiency was found, affecting 84% of the patients. Significant hepatic dysfunction was evident, with elevated AST (56%), ALP (82%), and universal hyperbilirubinemia (100%). Dyslipidemia was also common, with 94% of patients showing low total cholesterol. A statistically significant inverse correlation was established between serum vitamin D levels and Alanine Aminotransferase (ALT) (r = -0.371, p = 0.008). Conclusion: Vitamin D deficiency is highly prevalent among Iraqi β-TM patients and is significantly associated with liver injury, highlighting the importance of routine screening and management of this deficiency to mitigate disease-related complications.