Prevalence of Osteoporosis among Thalassemia Patients from Zafar Adult Thalassemia Clinic, Iran

Abstract

Background: The advances in treatment regimes for thalassemic patients have increased the survival among them therefore osteoporosis has emerged as an important cause of morbidity. The aim of this study was to determine the prevalence of osteoporosis and osteopenia in patients with thalassemia from Zafar Adult Thalassemia Clinic, Tehran, Iran. Patients and Methods: In this cross sectional investigation, we studied 239 patients with β thalassemia major and 87 patients with thalassemia intermedia with a mean age of 29±8 years. All demographic data including age, weight, height, sex, age at diagnosis, age at blood transfusion initiation, chelating agent therapy and serum ferritin level were obtained from patients’ history. Bone mineral density of the lumbar spine (L1-L4) and femoral neck was determined using dual-energy X-ray absorptiometry (DEXA). Results: The prevalence of osteoporosis was 65.6% (214 out of 326 patients). Osteoporosis was present in 10.7%, 11% and 43.9% of patients in the lumbar spine alone (L1-L4), femoral neck alone and both places, respectively. In the rest of patients 18.7% showed osteopenia and only 15.7% were normal. Osteoporosis was more prevalent in patients with thalassemia intermedia compared to thalassemia major (p<0.001). Also higher age of patients, longer duration of transfusion and longer intervals between transfusions had a positive correlation with osteoporosis. Conclusion: The prevalence of osteoporosis among Iranian thalassemia patients is similar to prevalence reported elsewhere. Bone Mineral density is a good index of bone status in patients with thalassemia and recommended to be done for thalassemic patients annually. Key words: Thalassemia, bone mineral density, osteoporosis, DEXA.