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Relation between BMD and biochemical, transfusion and endocrinological parameters in pediatric thalassemic patients
Fariba Mohseni1, Mohammad Reza Mohajeri-Tehrani, Bagher Larijani
1Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Pediatric beta-thalassemia major patients often experience low bone density and short stature. Early monitoring in late childhood and early teenage years is recommended for these complications.
Area of Science:
- Pediatric Endocrinology
- Hematology
- Bone Metabolism
Background:
- Beta-thalassemia major is associated with low bone mineral density (BMD) and increased fracture risk.
- Endocrinological and biochemical parameters are often affected in these patients.
Purpose of the Study:
- To investigate the relationship between BMD and various biochemical, transfusion, and endocrinological parameters in pediatric beta-thalassemia major patients.
- To identify the prevalence of complications such as short stature, hypogonadism, subclinical hypothyroidism, and impaired fasting glucose.
Main Methods:
- A cohort of 30 pediatric beta-thalassemia major patients (14 males, 16 females) was studied.
- Data collected included demographic, anthropometric, and medical histories, alongside serum levels of key biochemical and hormonal markers.
- Bone mineral density (BMD) of the spine and femur was assessed using dual-energy X-ray absorptiometry (DXA).
Main Results:
- Prevalence rates were observed for low spinal BMD (3.3%), low femoral BMD (10%), short stature (33%), hypogonadism (16.6%, exclusively in boys), subclinical hypothyroidism (6.6%), and impaired fasting glucose (26.6%).
- Age and transfusion duration showed positive correlations with both spinal and femoral BMD, but negative correlations with their respective Z-scores.
- Patients with short stature and hypogonadism were significantly older than their counterparts.
Conclusions:
- Age is a primary factor associated with reduced bone mineral density Z-scores in pediatric beta-thalassemia major.
- The findings underscore the importance of early and regular monitoring for endocrine and growth-related complications in these patients during late childhood and early adolescence.
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.
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