بررسی تراکم معدنی استخوانی و عوامل مرتبط در بیماران مبتلا به تالاسمی ماژور و اینترمدیا

Background and purpose: Osteopenia and osteoporosis are well known and common complications of beta thalassemia major (TM). This research was undertaken in order to find the prevalence and related factors and also effect of ongoing treatment on the conditions. Materials and methods: All medical records of patients older than 16 years were reviewed. Non transfusion dependent patients called as thalassemia intermediate. Demography of patients was extracted, the results of the BMD and Z-Score of femoral neck and lumbar vertebrae were reported comparing normal matched subjects. Z-Scores <-1, -1 to -2.5, and bigger than -2.5 were considered as normal, osteopenic and osteoporotic respectively. Results: 125 patients had at least one BMD measurement. 73(58%) patients were TM and the remainders were non transfusion dependent. Mean age was 24 ± 6 and F/M ratio was 3/1. According to Z-Scores, 17% , 61% and 17% were normal, osteopenic and osteoporotic respectively. Age and severity of pathology were correlated, and 7% reduction of BMD/ year was calculated (P<0.000). BMD of lumbar vertebra was worse in men (P<0.001). A negative significant correlation was detected between BMD and the mean of hematocrit in the last 5 years (P<0.005). Correlation of the age at starting transfusion and severity of BMD was not significant. Nineteen patients had 2 BMD measurements, 3 ± 1 years apart. Patients who had osteoporosis in the first measurements were using oral medicine (Alendronate). No significant improvement was noticed and in fact femoral BMD was worse in men (P<0.001). Conclusion: BMD measurements was less than anticipated. Osteopenia and even osteoporosis are common. Treatment duo to non compliance or inadequacy was not effective and more intensive treatment is needed.