Haematological and electrophoretic characterisation of β-thalassaemia in Yunnan province of Southwestern China

BMJ Open. 2017 Jan 31;7(1):e013367. doi: 10.1136/bmjopen-2016-013367.

Abstract

Objectives: β-Thalassaemia is widely found in Southwestern China. Characterisation of β-thalassaemia can improve screening and prenatal diagnosis for at-risk populations.

Design: A retrospective study.

Methods: In this study, the levels of haemoglobin alpha 2 (HbA2) and haemoglobin alpha (HbA) were analysed by gender for a total of 15 067 subjects screened by capillary electrophoresis. The cut-off value with the highest accuracy was established to identify β-thalassaemia in 723 patients suspected to have this disease. Haematological and electrophoretic characterisation of eight common types of β-thalassaemia were analysed in 486 β-thalassaemia subjects.

Results: HbA levels were significantly higher in men than in women, but there was no significant difference on HbA2 levels. A new cut-off value for the diagnosis of β-thalassaemia (HbA2≥4.0%) with the highest accuracy was proposed for the studied populations. Haemoglobin (Hb) was significantly higher in men compared with women (p<0.05), whereas no statistically significant differences were found for mean cell volume (MCV), mean cell haemoglobin (MCH), HbA and HbA2. The haemoglobin E (HbE) group showed comparatively higher values for haematological indices (Hb, MCV and MCH) than the other genotypes in heterozygous β-thalassaemia groups (p<0.05), and -28 (A>G) (HBB (β-globin):c.-78A>C) had significantly higher HbA2 values compared with other β-thalassaemia.

Conclusions: Ethnic groups have diversified β-globin gene mutations and considerable haematological variations. Our study will lay the foundation for screening programmes and clinical management of thalassaemia in Southwestern China.

Keywords: capillary electrophoresis; cut-off value; hematological and biochemical parameter values; mutation; thalassemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Blood Protein Electrophoresis
  • China
  • Erythrocyte Indices / genetics
  • Female
  • Hemoglobin A / metabolism*
  • Hemoglobin A2 / metabolism*
  • Hemoglobin E / metabolism
  • Heterozygote
  • Humans
  • Male
  • Middle Aged
  • ROC Curve
  • Retrospective Studies
  • Sex Factors
  • Young Adult
  • beta-Globins / genetics*
  • beta-Thalassemia / blood*
  • beta-Thalassemia / diagnosis
  • beta-Thalassemia / ethnology
  • beta-Thalassemia / genetics*

Substances

  • beta-Globins
  • Hemoglobin A
  • Hemoglobin A2
  • Hemoglobin E