The probability of indicating Osteoprotegrin as a biomarker for osteoporosis in patient with thalassemia major

Background: Osteoporosis is one of the main causes of morbidity in patients with thalassemia major. Osteoprotegerin (OPG) is secreted by osteoblasts and osteogenic stromal stem cells and protects the skeleton from excessive bone reabsorption. In this study, the authors aimed to assess the relationship between OPG with osteoporosis and osteopenia in patients with thalassemia major. Materials and Methods: In this analytic cross-sectional study, 37 patients aged 8-18 years, with thalassemia major were enrolled. Biochemical markers including hemoglobin, ferritin, calcium, phosphorus levels, and MRI T2* heart and liver were assessed. A bone mineral densitometry (BMD) was performed as well. Statistical analysis was performed by the independent T-test and Chi-Square test using the SPSS 20. The Multiple linear regression analysis was used to investigate the association between the BMD Z-score and OPG by the effect modification. Results: The mean age of patients was 14.86±3.72 years. Normal bone density, osteopenia, and osteoporosis were noted in 2 (5.4%), 21 (56.8%), and 14 (37.08%) patients, respectively. The number of girls (P=0.042), mean age (P=0.045), and MRI T2* heart (P=0.033) in patients with osteopenia was significantly higher than patients with osteoporosis. The BMD Z-score was not significantly associated with OPG regarding the total number of participants, whereas in patients with osteoporosis, this association was significant (P=0.001). In all effect modified models, BMD remained statistically non-significant except for body mass index modification (P=0.046). Conclusion: Based on the results, it seems that further complicated studies are needed to be performed on this issue.