Probable sarcopenia and bone health in transfusion-dependent beta thalassemia patients

Low bone mass    is common in adults with transfusion-dependent thalassemia (TDT). While sarcopenia contributes to frailty, studies examining its association with falls and fractures in TDT remain limited. This study aimed to determine the prevalence of probable sarcopenia in adults with transfusion-dependent thalassemia and to identify related risk factors.

This cross-sectional study included 45 adult TDT patients followed at Bursa City Hospital Hematology Clinic between September 2023 and September 2024, and 40 age- and sex-matched healthy controls. Bone mineral density (BMD) was assessed per Turkish Endocrinology Osteoporosis Guidelines and classified as normal, osteopenia, or osteoporosis. Probable sarcopenia was evaluated according to EWGSOP2 criteria based on handgrip strength measurements[14]. Anthropometric data and biochemical parameters were recorded.

Eighty-five participants (52.9% TDT, 47.1% controls) were evaluated. The mean BMI was 21.6 ± 1.99 kg/m². No significant differences were observed in calcium, vitamin D levels (p = 0.492, p = 0.068, p = 0.911, respectively).     Handgrip strength was significantly lower in TDT patients (24.96 ± 12.75 kg) than in controls (33.9 ± 15.39kg; p = 0.004). Probable sarcopenia was identified in 13.3% of patients and in none of the controls (p = 0.027).

Routine screening for probable sarcopenia should be incorporated into fracture prevention strategies for TDT, particularly among osteoporotic individuals. Therefore, the findings of this study should be interpreted as exploratory observations rather than confirmatory evidence.

Probable sarcopenia was identified in a subset of adult patients with TDT based on reduced handgrip strength according to EWGSOP2 criteria. Future longitudinal and multicenter studies incorporating muscle mass and functional performance measurements are required to confirm these findings.