Bone mineral density in beta thalassemia syndrome in Mosul city

ABSTRACT
Objectives: To assess bone mineral density in - thalassemia major (TM) patients and its relation with gender, age, hemoglobin (Hb), calcium, ferritin, body mass index (BMI), chelation therapy, and splenectomy.
Patients and methods: Randomised cross-sectional study of 52 patients with beta thalassemia major (TM) from Thalassemia Center in Ibn-Alatheer Teaching Hospital (32 males and 20 females) with age between 3 and 30 years scanned for bone mineral density (BMD) at lumbar spine with dual-energy X-ray absorptiometry (DEXA) scan at DEXA unit in Ibn-Sena Teaching Hospital from September 2010 to December 2010. The information about chelation therapy and splenectomy were obtained from the patients with measurement of height and weight and blood samples for hemoglobin (Hb), calcium and ferritin were taken.
Results: All 52 patients had T-score in osteoporotic range (100%), however, Z-score osteoporosis was seen in 26 (50%) and osteopenia in 19 (36.5%). Bone density was normal in only 7 (13.4%). All patients had elevated ferritin levels (100%), 36 (69.2%) had low body mass index (BMI) and 32 (61.5%) had low hemoglobin (Hb) levels. Twenty six (50%) had low calcium levels and 2 (3.8%) were not using chelation therapy. Sixteen (30.7%) had delayed puberty and the rest 36 (69.2%) were in prepubertal stage. Twelve patients (23%) had splenectomy.
Conclusion: There is high incidence of low BMD in beta thalassemia (100% by T-score and 86.5% by Z-score) with significant association with age (P-value0.000), low BMI (P-value 0.038), low Hb (P-value 0.022), delayed sexual maturity (P-value 0.000), and splenectomy (P-value 0.000).