Evaluation of osteopathy in thalassemia by bone mineral densitometry and biochemical indices.
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Date
2010-09
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Abstract
Objective To evaluate osteopathy in thalassemia by bone
mineral densitometry (BMD) and biochemical indices.
Methods Prospective review analysis with no follow up
from 2006 to 2007 of 42 regularly transfused thalassemics
aged 10–25 years (27 boys, 15 girls) was done. Anthropometry,
pubertal stage and symptomatology were noted.
Urinary C–terminal cross–linked telopeptide of type–1
collagen (Crosslaps) by ELISA; serum 25–OH vitamin D
and osteocalcin by RIA; parathyroid hormone (PTH) and
ferritin by chemiluminescence and IGF–1 by Enzyme
immunoassay were evaluated. Dual Energy X-ray Absorptiometry
(DEXA) of lumbar spine and femur was done on
Lunar prodigy system. Data was entered and analyzed
using the SPSS for Windows software. Mean comparisons
were done by ANOVA 1 and data was compared using
Chi–square test and p value<0.05 was taken as significant.
Results Of 42 patients, 81% had osteoporosis by Z–score of
DEXA. Urinary crosslaps was high in 55%; 36% had
increased osteocalcin; 62% had low vitamin D levels; 38%
had high parathyroid levels and IGF–1 was low in 52%.
Mean serum ferritin level was 5344±2855 ng/dl. There was
statistical significance (p=0.046) between chronological
age and BMD. All 42 cases were divided into two groups:
Group–1 (Normal DEXA), Group–2 (Abnormal DEXA)
and analysis of biochemical indices between two groups
showed no significant difference in any of the biochemical
parameters.
Conclusion This study revealed majority of thalassemics
with inadequate chelation have bone resorption with
advancing chronological age and BMD should be evaluated
regularly for early diagnosis to prevent morbidity.
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Keywords
DEXA, Osteoporosis, Thalassemia, Vitamin D
Citation
Merchant Rashid, Udani Amish, Puri Vipla, D'cruz Valentina, Patkar Deepak, Karkera Aarti. Evaluation of osteopathy in thalassemia by bone mineral densitometry and biochemical indices. Indian Journal of Pediatrics. 2010 Sept; 77(9): 987-991.