Bone mineral density in transfusion-dependent thalassemia patients and its associated factors in Southern Iran
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ORIGINAL ARTICLE
Bone mineral density in transfusion-dependent thalassemia patients and its associated factors in Southern Iran Mohammadreza Bordbar 1 & Gholamhossein Ranjbar Omrani 2 Mehran Karimi 1 & Omidreza Zekavat 1
&
Sezaneh Haghpanah 1
&
Forough Saki 2
&
Received: 26 February 2020 / Accepted: 25 August 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary 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 gendermatched 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. Keywords Bone mineral density . Thalassemia . Iran . Endocrinopathy . Cholecystectomy . Splenectomy
Introduction Transfusion-dependent thalassemia (TDT) is a hereditary hemoglobinopathy that can lead to ineffective erythropoiesis, anemia, and iron overload [1, 2]. Over the past decades, * Forough Saki [email protected] Gholamhossein Ranjbar Omrani [email protected] 1
Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran
2
Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
managing patients with TDT has improved significantly, using regular blood transfusion and chelation therapy. However, there are still growing concerns regarding longterm complications [3–5]. Osteopathy and bone loss are significant issues among the
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