[Home ] [Archive]   [ فارسی ]  
:: Main :: About :: Current Issue :: Archive :: Search :: Submit :: Contact ::
Main Menu
Home::
Journal Information::
Articles archive::
For Authors::
For Reviewers::
Subscription::
Contact us::
Site Facilities::
Webmail::
::
Search in website

Advanced Search
..
Receive site information
Enter your Email in the following box to receive the site news and information.
..
Journal Citation Index

 

Citation Indices from GS

AllSince 2020
Citations101355549
h-index3926
i10-index259136

 

..
Central Library of Kurdistan University of Medical Sciences
AWT IMAGE
..
Vice-Chancellery for Research and Technology
AWT IMAGE
..
SCImago Journal & Country Rank
:: Volume 29, Issue 3 (Scientific Journal of Kurdistan University of Medical Sciences 2024) ::
SJKU 2024, 29(3): 67-77 Back to browse issues page
Evaluation of Bone Mineral Density in Patients with Thalassemia in Kurdistan in 2021
Bahar Moassesghafari1 , Siamak Derakhshan2 , Borhan Moradvaisi3 , Farima Zakaryaei4 , Mohammad Aziz Rasouli5
1- Department of Radiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran & Department of Radiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
2- Department of Radiotherapy and Nuclear medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran & Department of Radiotherapy and Nuclear medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran , siamakderakhshan@yahoo.com
3- Department of Pediatrics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran & Department of Pediatrics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
4- Department of Emergency Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran & Department of Emergency Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
5- Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran & Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
Abstract:   (964 Views)
Background and Aim: Patients with beta-thalassemia need frequent blood transfusions and bone disorders are common in these patients. The objective of this study was to evaluate bone mineral density (BMD) in these patients.
Material and Methods: In this cross-sectional study, seventy-nine patients, with intermediate and major thalassemia who had referred for bone mineral densitometry to Kowsar Hospital in Sanandaj in 2021, were assessed. The patients were divided into two groups: group A including 20 patients (9 males, 11 females) who were less than 20 years of age, and group B including 59 patients (32 males and 27 females) that were equal to or older than 20 years old. In both groups, bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) method. Total body less head (TBLH) and lumbar spine BMDs were measured in group A. In group B, total hip, femoral neck and lumbar spine BMDs were measured.
Results: In 55.7 % of the patients, the Z-score was below the expected range for the age. Prevalence of the abnormal Z-score in the two groups showed no statistically significant difference (P value=0.942). Gender and history of fracture showed no statistically significant relationship with abnormal Z-score (P values 0.069 and 0.066, respectively).  The mean lumbar spine Z-score in group A was lower (-1.7±1.5) than that in group B (-1.6±1.2) but the difference was not statistically significant (P value= 0.639). The mean lumbar spine Z-score was lower than the mean Z-score of TBLH (0.7±1.7) in group-A patients. Likewise, in group B patients, the mean lumbar spine Z-score was lower than the mean Z-scores of total hip (-0.9±1.0) and femoral neck (-0.5±1.0).
Conclusions: Low bone mineral density was common in the thalassemia patients. Measurement of lumbar spine BMD was more reliable than TBLH, total hip and femoral neck BMDs for evaluation of bone mass in these patients.
Keywords: Bone mineral density, Low bone density, Osteoporosis, Thalassemia
Full-Text [PDF 570 kb]   (198 Downloads)    
Type of Study: Original Research | Subject: Medicine - Nuclear Medicine
Received: 2022/10/29 | Accepted: 2023/06/26 | Published: 2024/09/18
References
1. Munkongdee T, Chen P, Winichagoon P, Fucharoen S, Paiboonsukwong K. Update in Laboratory Diagnosis of Thalassemia. Front Mol Biosci. 2020 May 27;7:74. doi: 10.3389/fmolb.2020.00074. PMID: 32671092; PMCID: PMC7326097 [DOI:10.3389/fmolb.2020.00074] [PMID] []
2. Mahachoklertwattana P, Sirikulchayanonta V, Chuansumrit A, Karnsombat P, Choubtum L, Sriphrapradang A, et al. Bone histomorphometry in children and adolescents with beta-thalassemia disease: iron-associated focal osteomalacia. J Clin Endocrinol Metab. 2003 Aug;88(8):3966-72. doi: 10.1210/jc.2002-021548. PMID: 12915694. [DOI:10.1210/jc.2002-021548] [PMID]
3. Wong P, Fuller PJ, Gillespie MT, Milat F. Bone Disease in Thalassemia: A Molecular and Clinical Overview. Endocr Rev. 2016 Aug;37(4):320-46. doi: 10.1210/er.2015-1105. Epub 2016 Jun 16. PMID: 27309522. [DOI:10.1210/er.2015-1105] [PMID]
4. Yu U, Chen L, Wang X, Zhang X, Li Y, Wen F, et al,. Evaluation of the vitamin D and biomedical statuses of young children with β-thalassemia major at a single center in southern China. BMC Pediatr. 2019 Oct 23;19(1):375. doi: 10.1186/s12887-019-1744-8. PMID: 31646984; PMCID: PMC6813046. [DOI:10.1186/s12887-019-1744-8] [PMID] []
5. Toumba M, Skordis N. Osteoporosis syndrome in thalassaemia major: an overview. J Osteoporos. 2010 May 26;2010:537673. doi: 10.4061/2010/537673. PMID: 20976089; PMCID: PMC2957233. [DOI:10.4061/2010/537673] [PMID] []
6. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int. 1994 Nov;4(6):368-81. doi: 10.1007/BF01622200. PMID: 7696835. [DOI:10.1007/BF01622200] [PMID]
7. Ehlers KH, Giardina PJ, Lesser ML, Engle MA, Hilgartner MW. Prolonged survival in patients with beta-thalassemia major treated with deferoxamine. J Pediatr. 1991 Apr;118(4 Pt 1):540-5. doi: 10.1016/s0022-3476(05)83374-8. PMID: 2007928. [DOI:10.1016/S0022-3476(05)83374-8] [PMID]
8. Shah S, N. Shah J, R. Vyas B. Assessment of bone mineral density in multi-transfused thalassemia patients in a tertiary care hospital. Pediatric Rev: int j pediatrics res;7(1):32-8. DOI: https://doi.org/10.17511/ijpr.2020.i01.06 [DOI:10.17511/ijpr.2020.i01.06.]
9. Angastiniotis M, Pavlides N, Aristidou K, Kanakas A, Yerakaris M, Eracleous E, et al,. Bone pain in thalassaemia: assessment of DEXA and MRI findings. J Pediatr Endocrinol Metab. 1998;11 Suppl 3:779-84. PMID: 10091146.
10. Moradvaeisi B, Rostami N, Derakhshan S, Roshani D. The frequency of osteoporosis and osteopenia in the paitents with beta thalassemia major and correlation of biochemical markers with bone densitometry results in these patients in Sanandaj. Scientific Journal of Kurdistan University of Medical Sciences. 2016 Dec 10;21(5):1-7.
11. Meena MC, Hemal A, Satija M, Arora SK, Bano S. Comparison of Bone Mineral Density in Thalassemia Major Patients with Healthy Controls. Adv Hematol. 2015;2015:648349. doi: 10.1155/2015/648349. Epub 2015 Dec 31. PMID: 26880923; PMCID: PMC4735999. [DOI:10.1155/2015/648349] [PMID] []
12. Hamidpour M, Jafari F, Mehrpouri M, Azarkyvan A, Bashash D, Maboudi AA. Evaluation of relationship between biochemical parameters and osteoporosis in patients with β-thalassemia major. Iran J Ped Hematol Oncol. 2022; 12(1): 41-48 DOI: https://doi.org/10.18502/ijpho.v12i1.8360 [DOI:10.18502/ijpho.v12i1.8360.]
13. Nakavachara P, Weerakulwattana P, Pooliam J, Viprakasit V. Bone mineral density in primarily preadolescent children with hemoglobin E/β-thalassemia with different severities and transfusion requirements. Pediatr Blood Cancer. 2022 Sep;69(9):e29789. doi: 10.1002/pbc.29789. Epub 2022 Jun 2. PMID: 35652568. [DOI:10.1002/pbc.29789] [PMID]
14. Lewiecki EM, Watts NB, McClung MR, Petak SM, Bachrach LK, Shepherd JA, et al,. International Society for Clinical Densitometry. Official positions of the international society for clinical densitometry. J Clin Endocrinol Metab. 2004 Aug;89(8):3651-5. doi: 10.1210/jc.2004-0124. PMID: 15292281. [DOI:10.1210/jc.2004-0124] [PMID]
15. Bordbar M, Omrani GR, Haghpanah S, Saki F, Karimi M, Zekavat O. Bone mineral density in transfusion-dependent thalassemia patients and its associated factors in Southern Iran. Arch Osteoporos. 2020 Sep 21;15(1):148. doi: 10.1007/s11657-020-00811-7. PMID: 32955681. [DOI:10.1007/s11657-020-00811-7] [PMID]
16. Piriyakhuntorn P, Tantiworawit A, Phimphilai M, Srichairatanakool S, Teeyasoontranon W, Rattanathammethee T, et al. Prevalence and risk factors of low bone mineral density and fractures of young thalassemia patients. Blood. 2018 Nov 29;132:3636. https://doi.org/10.1182/blood-2018-99-113465 [DOI:10.1182/blood-2018-99-113465.]
17. Mahmoodi Nesheli H, Farahanian E. Relation between bone mineral density and serum ferritin levels in patients with thalassemia major. Caspian J Pediatr Sep 2016; 2(2): 158-63.
18. Zarei T, Haghpanah S, Parand S, Moravej H, Dabbaghmanesh MH, Omrani GR, et al. Evaluation of bone mineral density in patients with hemoglobin H disease. Ann Hematol. 2016 Aug;95(8):1329-32. doi: 10.1007/s00277-016-2708-9. Epub 2016 Jun 3. PMID: 27256348. [DOI:10.1007/s00277-016-2708-9] [PMID]
19. De Sanctis V, Soliman AT, Elsedfy H, Yassin M, Canatan D, Kilinc Y, et al. I-CET (International Network on Growth Disorders and Endocrine Complications in Thalassemia). Osteoporosis in thalassemia major: an update and the I-CET 2013 recommendations for surveillance and treatment. Pediatr Endocrinol Rev. 2013 Dec;11(2):167-80. PMID: 24575552.
20. Voskaridou E, Terpos E. Pathogenesis and management of osteoporosis in thalassemia. Pediatr Endocrinol Rev. 2008 Oct;6 Suppl 1:86-93. PMID: 19337161.
21. Vogiatzi MG, Macklin EA, Fung EB, Cheung AM, Vichinsky E, Olivieri N, et al. Thalassemia Clinical Research Network. Bone disease in thalassemia: a frequent and still unresolved problem. J Bone Miner Res. 2009 Mar;24(3):543-57. doi: 10.1359/jbmr.080505. PMID: 18505376; PMCID: PMC3276604. [DOI:10.1359/jbmr.080505] [PMID] []
22. Gaudio A, Morabito N, Catalano A, Rapisarda R, Xourafa A, Lasco A. Pathogenesis of Thalassemia Major-associated Osteoporosis: A Review with Insights from Clinical Experience. J Clin Res Pediatr Endocrinol. 2019;11(2):110-117. doi:10.4274/jcrpe.galenos.2018.2018.0074 [DOI:10.4274/jcrpe.galenos.2018.2018.0074] [PMID] []
23. Manolopoulos PP, Lavranos G, Mamais I, Angouridis A, Giannakou K, Johnson EO. Vitamin D and bone health status in beta thalassemia patients-systematic review. Osteoporos Int. 2021 Jun;32(6):1031-1040. doi: 10.1007/s00198-021-05821-w. Epub 2021 Jan 9. PMID: 33423084. [DOI:10.1007/s00198-021-05821-w] [PMID]
24. Thiagarajan NR, Kumar CGD, Sahoo J, Krishnamurthy S. Effect of Vitamin D and Calcium Supplementation on Bone Mineral Content in Children with Thalassemia. Indian Pediatr. 2019 Apr 15;56(4):307-310. PMID: 31064900. [DOI:10.1007/s13312-019-1520-8] [PMID]
25. Valizadeh N, Farrokhi F, Alinejad V, Said Mardani S, Valizadeh N, Hejazi S, et al. Bone density in transfusion dependent thalassemia patients in Urmia, Iran. Iran J Ped Hematol Oncol. 2014;4(2):68-71. Epub 2014 Apr 20. PMID: 25002928; PMCID: PMC4083203.
26. Baldini M, Marcon A, Ulivieri FM, Seghezzi S, Cassin R, Messina C, et al. Bone quality in beta-thalassemia intermedia: relationships with bone quantity and endocrine and hematologic variables. Ann Hematol. 2017 Jun;96(6):995-1003. doi: 10.1007/s00277-017-2959-0. Epub 2017 Mar 20. PMID: 28321531. [DOI:10.1007/s00277-017-2959-0] [PMID]
27. Meloni A, Pistoia L, Maffei S, Ricchi P, Casini T, Corigliano E, et al. Bone status and HCV infection in thalassemia major patients. Bone. 2023 Apr;169:116671. doi: 10.1016/j.bone.2023.116671. Epub 2023 Jan 6. PMID: 36623757. [DOI:10.1016/j.bone.2023.116671] [PMID]
28. Piriyakhuntorn P, Tantiworawit A, Phimphilai M, Srichairatanakool S, Teeyasoontranon W, Rattanathammethee T, et al. Prevalence and risk factors of low bone mineral density and fractures of young thalassemia patients. Blood. 2018 Nov 29;132:3636.http://dx.doi.org/10.1182/blood-2018-99-113465. [DOI:10.1182/blood-2018-99-113465]
29. Alexiou E, Diamantidis M, Vassiou K, Fezoulidis I, Vlychou M. Dual X Ray absorptiometry is superior in detecting bone mineral density alterations in adult patients with thalassaemia major compared to quantitative computed tomography. Hellenic Journal οf Radiology. 2021 Dec 28;6(4).
30. Karimi M, Ghiam AF, Hashemi A, Alinejad S, Soweid M, Kashef S. Bone mineral density in beta-thalassemia major and intermedia. Indian Pediatr. 2007 Jan;44(1):29-32. PMID: 17277428.
31. Shamshirsaz AA, Bekheirnia MR, Kamgar M, Pourzahedgilani N, Bouzari N, Habibzadeh M, et al. Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran. BMC Endocr Disord. 2003 Aug 12;3(1):4. doi: 10.1186/1472-6823-3-4. PMID: 12914670; PMCID: PMC194672. [DOI:10.1186/1472-6823-3-4] [PMID] []
32. Mohajeri-Tehrani MR, Darvishian N, Arab F, Salemkar S, Mohseni F, Larijani B, Hamidi Z. The role of using different reference population in the prevalence of low BMD in the thalassemia patients. J Diabetes Metab Disord. 2019 Nov 14;19(1):431-435. doi: 10.1007/s40200-019-00455-6. Erratum in: J Diabetes Metab Disord. 2019 Dec 23;19(1):663. PMID: 32550194; PMCID: PMC7270311. [DOI:10.1007/s40200-019-00455-6] [PMID] []
33. Farmakis D, Porter J, Taher A, Domenica Cappellini M, Angastiniotis M, Eleftheriou A. 2021 Thalassaemia International Federation Guidelines for the Management of Transfusion-dependent Thalassemia. Hemasphere. 2022 Jul 29;6(8):e732. doi: 10.1097/HS9.0000000000000732. PMID: 35928543; PMCID: PMC9345633. [DOI:10.1097/HS9.0000000000000732] [PMID] []
Send email to the article author

Add your comments about this article
Your username or Email:

CAPTCHA

Ethics code: IR.MUK.REC.1400.008



XML   Persian Abstract   Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Moassesghafari B, Derakhshan S, Moradvaisi B, Zakaryaei F, Rasouli M A. Evaluation of Bone Mineral Density in Patients with Thalassemia in Kurdistan in 2021. SJKU 2024; 29 (3) :67-77
URL: http://sjku.muk.ac.ir/article-1-7641-en.html


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 29, Issue 3 (Scientific Journal of Kurdistan University of Medical Sciences 2024) Back to browse issues page
مجله علمی دانشگاه علوم پزشکی کردستان Scientific Journal of Kurdistan University of Medical Sciences
مجله علمی دانشگاه علوم پزشکی کردستان Scientific Journal of Kurdistan University of Medical Sciences
Persian site map - English site map - Created in 0.05 seconds with 43 queries by YEKTAWEB 4710