AbstractObjectives:  Hypocholesterolemia has been previously described in patients affected by thalassemia. In this study we retrospectively evaluated the cholesterol level in two groups of patients affected by either thalassemia major (TM) or thalassemia intermedia (TI), with the aim of establishing factors correlated to hypocholesterolemia within both populations.Methods:  All patients referring to our Unit of Thalassemia were considered. Observation time, defined as the interval between the first and last set of laboratory test, was 2 yr (January 2005–December 2006).Results:  We found that patients with TI had significantly lower cholesterol and hemoglobin level as compared with TM patients. In addition there was no correlation between groups with identical genotype and cholesterol levels in both populations. However, within the TI group, lower values of cholesterol were found in patients with more severe genotype and lower body mass index.Conclusions:  Our data support the hypothesis that, independently from single genotype involved, the reduced level of cholesterol in patients with TI are sustained by active erythropoiesis which increases cholesterol requirement.