Bone mineral density (BMD) of patients with beta thalassemia, Thalassemia Research Center, 2007

Background and Ôsteopenia and osteoporosis are well known and common complication of beta thalassemia major (TM).Ïn order to find the prevalence and related factors and also effect of ongoing treatment this study was done. Âll medical records of patients older than 16 years old were reviewed. Non transfusion dependent patients called as thalassemia intermediate. Demography of patients was extracted as well as, the result of the BMD by Nor land machine as Z-Score of femoral neck and lumbar vertebrate were reported comparing normal matched population. Z-Scores down to -1, -1 to -2.5, and less than -2.5 were considered as normal, osteopenic and osteoporotic respectively. Spss soft ware was used and Ôdds ratio and its 95% ÇÏ was calculated. BMD of TM and Ïntermediate patients was done by Mann-Whitney Ü test. Before and after BMD were compared by Wilcoxon Rank test. P<0.05 was considered statistically significant. 125 patients had at least one BMD measurement. Regarding the eligible patients approximately for one in every 4-5 patients there was a BMD. 73(58%) of patients were TM and reminder were not transfusion dependent. Mean age was 24 ± 6 and regarding gender, F/M ratio was 3/1. Âccording to Z-Scores, 17%, 61% and 17% were normal, osteopenic and osteoporotic respectively. Âge and severity of pathology were correlated and, and 7% reduction of BMD/ year was calculated (P<0.000). BMD of lumbar vertebra was worse in men (P<0.001). Â negative significant correlation was detected between BMD and the mean of hematocrite in the ast 5 years (P<0.005).Çorrelation 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 (Âlendronate). No significant improvement was noticed and in fact femoral BMD was worse in men (P<0.001).Çonclusion: BMD measurements was less than anticipated. Ôsteopenia and even osteoporosis are common. Treatment duo to non compliance or inadequacy was not effective and more aggressive treatment is needed.