open access
Bone mineral density in adult patients with major thalassaemia: our experience and a brief review of the literature
open access
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.
Keywords
thalassaemia; bone mineral density; osteoporosis; osteopenia


Title
Bone mineral density in adult patients with major thalassaemia: our experience and a brief review of the literature
Journal
Issue
Article type
Original paper
Pages
264-269
Published online
2012-08-30
Page views
632
Article views/downloads
1694
Bibliographic record
Endokrynol Pol 2012;63(4):264-269.
Keywords
thalassaemia
bone mineral density
osteoporosis
osteopenia
Authors
Sina Izadyar
Mohammadali Fazeli
Mina Izadyar
Peyman Salamati
Ali Gholamrezanezhad