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Updated: Dec 8, 2025
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Bone mineral density in transfusion-dependent thalassemia patients and its associated factors in Southern Iran
Mohammadreza Bordbar1, Gholamhossein Ranjbar Omrani2, Sezaneh Haghpanah1
1Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran.
Insights
Low bone mass is common in transfusion-dependent thalassemia (TDT) patients. Insufficient physical activity and hypogonadism are key factors, alongside diabetes mellitus and low sun exposure, contributing to this complication.
Area of Science:
- Endocrinology
- Bone Metabolism
- Hematology
Background:
- Transfusion-dependent thalassemia (TDT) management has improved, but long-term complications remain a concern.
- Low bone mass is a significant and prevalent complication in TDT patients.
Purpose of the Study:
- To investigate the prevalence of low bone mass in TDT patients.
- To identify associated factors contributing to low bone mass in this population.
Main Methods:
- A cross-sectional study involving 615 TDT patients and a control group.
- Assessment of bone mineral density, serum biochemical tests, physical activity, and sun exposure.
- Clinical examination by an endocrinologist.
Main Results:
- The prevalence of low bone mass was high in TDT patients (48.3% femoral, 74.6% lumbar).
- Common endocrinopathies included hypogonadism (49.8%) and diabetes mellitus (17.2%).
- Low bone mass was associated with insufficient physical activity, hypogonadism, diabetes mellitus, and inadequate sun exposure.
Conclusions:
- Low bone mass is highly prevalent in transfusion-dependent thalassemia patients in Southern Iran.
- Insufficient physical activity and hypogonadism are primary associated factors, with diabetes mellitus and low sun exposure also contributing.
Abstract:
Despite the significant improvements in the management of thalassemia, there are growing concerns regarding their long-term complications. We showed that low bone mass is one of the most prevalent complications among these patients. Insufficient physical activity and hypogonadism are the main possible associated factors followed by DM and insufficient sun exposure.
Purpose:
Despite the significant improvements in the management of transfusion-dependent thalassemia (TDT), there are growing concerns regarding their long-term complications.
Methods:
This cross-sectional study included 615 TDT patients who were registered and followed in a comprehensive thalassemia clinic in Southern Iran. We measured serum biochemical tests and bone mineral density in all patients. We recorded physical activity and sun exposure subjectively, and an endocrinologist visited and examined all the patients. A group of age- and gender-matched healthy volunteers participated in the study as the control group.
Results:
The mean age of the studied population was 28.4 ± 7.7 years, and 55.8% were female. The prevalence of vitamin D deficiency was 45.6% and 54.4% in TDT patients and the control group. A portion of TDT patients suffered from different endocrinopathies, which included hypogonadism (49.8%), diabetes mellitus (17.2%), hypoparathyroidism (14.6%), and hypothyroidism (6.3%). The prevalence of low bone mass in patients with TDT was 48.3 and 74.6% in the femoral and lumbar bones, respectively. Low physical activity, insufficient sun exposure, diabetes mellitus, and hypogonadism were associated with low bone mass.
Conclusion:
Low bone mass is highly prevalent among TDT patients in Southern Iran. Insufficient physical activity and hypogonadism are the main possible associated factors, followed by DM and insufficient sun exposure.
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