Relation between BMD and biochemical, transfusion and endocrinological parameters in pediatric thalassemic patients.

UNLABELLED Low BMDs, short stature, hypogonadism, subclinical hypothyroidism, and IFG are found in 3.3, 10, 33, 16.6, 6.6, and 26.6 % of 30 pediatric β thalassemia major patients, respectively. Age is related with low Z-scores. Short stature and hypogonadism patients were older. These patients' monitoring in late childhood and early teenage for these complications is recommended. BACKGROUND Beta-thalassemia major patients frequently have low BMD and increased fracture risk. We tried to determine the relation between BMD and biochemical, transfusion, and endocrinological parameters in pediatric patients. METHODS Thirty beta-thalassemia major patients entered the study. Male to female ratio was 14/16. Physicians collected demographic; anthropometric; menstrual; transfusion and treatments histories; and serum levels of calcium, phosphorus, alkalin phosphatase, FBS, Hb, Ferritin, T3, T4, TSH, LH, FSH, testosterone (for boys), and estradiol (for girls). BMD of the spine and femur was measured using a DXA Norland XR-46 device. RESULTS Prevalence of "low bone density" (Z-score < -2) in the spine and femur was 3.3 and 10 %, respectively. Short stature (Z-score < -2.5) and hypogonadism was seen in 33 and 16.6 % of patients, respectively. Hypogonadism was found only in boys. Subclinical hypothyroidism and impaired fasting glucose were found in 6.6 and 26.6 % of our patients, respectively. Age and transfusion duration was positively related with spinal BMD (P values, <0.001 and <0.001, respectively), and both related negatively with spinal Z-score (P values, 0.014 and 0.043, respectively). Age and transfusion duration related positively with femoral BMD (P values 0.030 and 0.017, respectively), and both related negatively with femoral Z-score (P values, 0.015 and 0.041, respectively). Mean age of short stature and hypogonadism patients were significantly higher than those who were normal (P values, 0.007 and 0.044, respectively). CONCLUSION The main factor related with lower Z-scores of the femur and spine was age. Short stature and hypogonadism patients were significantly older. So, we recommend early monitoring of thalassemia patients (in their late childhood and early teenage) for these complications.