open access

Vol 63, No 4 (2012)
Original papers
Published online: 2012-08-30
Submitted: 2013-02-15
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Bone mineral density in adult patients with major thalassaemia: our experience and a brief review of the literature

Sina Izadyar, Mohammadali Fazeli, Mina Izadyar, Peyman Salamati, Ali Gholamrezanezhad
Endokrynologia Polska 2012;63(4):264-269.

open access

Vol 63, No 4 (2012)
Original papers
Published online: 2012-08-30
Submitted: 2013-02-15

Abstract


Introduction: Metabolic bone disease represents a major cause of morbidity in patients with thalassaemia major. The aim of our study was to assess the prevalence and underlying contributory factors of osteopenia/osteoporosis in a randomly selected population of adult patients with thalassaemia major.
Patients and methods: The study population was selected using the random sampling method from the patients’ database of our thalassaemia clinic. Only transfusion-dependent beta-thalassaemia patients aged over 17 and with no history of treatment with bisphosphonates were included. BMD of lumbar spine and right femoral neck were measured by means of the calibrated dual energy X-ray absorption method. Independent factors likely to be associated with low bone mass were determined and included in the analysis to ascertain possible associations.
Results: Our study included 40 patients (19 female and 21 male; mean age: 23.0 ± 4.1). The mean Z score of the right femoral neck was –1.2 (95% CI: –0.9 to –1.5) and for lumbar spine was –2.1 (95% CI: –1.7 to –2.5). The prevalences of osteopenia and osteoporosis involving the right femoral neck were 37.5%, and 12.5%, respectively. The respective prevalence rates for lumbar spine were 47.5% and 37.5%. Our study showed patient’s weight, age, duration of the disease and history of hypogonadism or concurrent hypothyroidism are significant contributory factors or predictors of bone mineral loss.
Conclusions: Regarding the high prevalence of osteopenia/osteoporosis in patients with thalassaemia major, all patients should be screened periodically for bone disease. The uncertainty and disagreements as to the possible role of different factors indicate the necessity for further studies in order to recognise the pathophysiologic fundamentals of this serious complication of thalassaemia major.

Abstract


Introduction: Metabolic bone disease represents a major cause of morbidity in patients with thalassaemia major. The aim of our study was to assess the prevalence and underlying contributory factors of osteopenia/osteoporosis in a randomly selected population of adult patients with thalassaemia major.
Patients and methods: The study population was selected using the random sampling method from the patients’ database of our thalassaemia clinic. Only transfusion-dependent beta-thalassaemia patients aged over 17 and with no history of treatment with bisphosphonates were included. BMD of lumbar spine and right femoral neck were measured by means of the calibrated dual energy X-ray absorption method. Independent factors likely to be associated with low bone mass were determined and included in the analysis to ascertain possible associations.
Results: Our study included 40 patients (19 female and 21 male; mean age: 23.0 ± 4.1). The mean Z score of the right femoral neck was –1.2 (95% CI: –0.9 to –1.5) and for lumbar spine was –2.1 (95% CI: –1.7 to –2.5). The prevalences of osteopenia and osteoporosis involving the right femoral neck were 37.5%, and 12.5%, respectively. The respective prevalence rates for lumbar spine were 47.5% and 37.5%. Our study showed patient’s weight, age, duration of the disease and history of hypogonadism or concurrent hypothyroidism are significant contributory factors or predictors of bone mineral loss.
Conclusions: Regarding the high prevalence of osteopenia/osteoporosis in patients with thalassaemia major, all patients should be screened periodically for bone disease. The uncertainty and disagreements as to the possible role of different factors indicate the necessity for further studies in order to recognise the pathophysiologic fundamentals of this serious complication of thalassaemia major.
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Keywords

thalassaemia; bone mineral density; osteoporosis; osteopenia

About this article
Title

Bone mineral density in adult patients with major thalassaemia: our experience and a brief review of the literature

Journal

Endokrynologia Polska

Issue

Vol 63, No 4 (2012)

Pages

264-269

Published online

2012-08-30

Bibliographic record

Endokrynologia Polska 2012;63(4):264-269.

Keywords

thalassaemia
bone mineral density
osteoporosis
osteopenia

Authors

Sina Izadyar
Mohammadali Fazeli
Mina Izadyar
Peyman Salamati
Ali Gholamrezanezhad

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