The cutoff of ferritin for evaluation of osteoporosis in patients with Thalassemia Major: A cross-sectional analytic study

This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patients with Thalassemia Major (TM).

This analytic cross-sectional study was conducted in17 Shahrivar children's hospital, Rasht, Iran, from November 2017 to November 2018. The inclusion criteria were indicated as the presence of  TM in patients aged 12-19 years old with records of their regular visits. The exclusion criteria were noted as the presence of any chronic bone diseases such as osteomalacia or osteogenesis imperfecta, delayed puberty, hypothyroidism, parathyroid dysfunction, renal failure, liver failure, and growth hormone deficiency. Ferritin level was assessed, and bone densitometry was performed for all patients with TM.

In this study, 53 females (54.6%) and 44 males (43.4%) were enrolled. Results showed that 36 (37.1%), 49 (50.5%), and 12 (12.4%) patients had a normal bone density, osteopenia, and osteoporosis, respectively. Comparing these three groups showed that despite higher mean serum level of ferritin in TM patients with osteoporosis than patients with osteopenia and normal bone density, no significant statistical difference was noted in these three groups (P >0.05). Besides, the mean ferritin level in patients with abnormal bone densitometry (osteopenia and osteoporosis) was higher than in patients with normal ones. A significant difference was noted between abnormal and normal densitometries (p=0.03). The Area under the Curve for ferritin was 0.708, and the cutoff point was indicated for ferritin was 2006 ng/ml.

  Regarding the results, there was a high frequency of osteoporosis and osteopenia in teenagers with TM. As bone density abnormality formation is time-consuming, and prevention is the primary strategy for management, it is highly recommended to assess bone mineral density regularly starting from early childhood.