<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.0902.383_s_005_w2aab3b7b6b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Bone complications are common in patients with thalassemia.</p></sec><sec id="j_1905-7415.0902.383_s_006_w2aab3b7b6b1b6b1aab1c16b2Aa"><h3>Objectives</h3><p>To assess risk factors for osteoporosis in patients with nonmajor thalassemia and its prevalence in randomly selected adult patients in Thailand.</p></sec><sec id="j_1905-7415.0902.383_s_007_w2aab3b7b6b1b6b1aab1c16b3Aa"><h3>Patients and methods</h3><p>We included 190 adult patients (58 men and 132 women) with thalassemia intermedia or minor in this cross-sectional study. Patients with untreated hypogonadism, untreated hypothyroidism, menopause, and with a history of treatment with medications that have effects on skeletal or bone metabolism were excluded. Bone mass density (BMD) of the femoral neck was measured by calibrated dual-energy X-ray absorptiometry. Independent factors likely to be associated with osteoporosis were determined and included in the analysis to ascertain possible associations.</p></sec><sec id="j_1905-7415.0902.383_s_008_w2aab3b7b6b1b6b1aab1c16b4Aa"><h3>Results</h3><p>Mean age was 35.48 ± 14.11 years (range 18–87 years). The mean Z score of femoral neck was − 0.86 ± 1.14 (range −3.7–2.40). Prevalence of osteoporosis was 22/190 (11.6%). Correlation between the pretransfusion hemoglobin level and BMD score was <italic>r</italic> = 0.192, <italic>P</italic> = 0.008. Univariate analysis found low BMI was a risk factor for osteoporosis (OR = 3.09, 95% CI 1.09–8.76, <italic>P</italic> = 0.039) and iron chelation therapy was a protective factor (OR = 0.24, 95% CI 0.09–0.69, <italic>P</italic> = 0.005). Multivariate analysis did not find these factors to be significant.</p></sec><sec id="j_1905-7415.0902.383_s_009_w2aab3b7b6b1b6b1aab1c16b5Aa"><h3>Conclusions</h3><p>All patients with thalassemia at risk of osteoporosis should be screened periodically for bone disease. The uncertainty and disagreements as to the potential role of different factors indicate the necessity for further studies to recognize the pathophysiological basis of this serious complication of thalassemia.</p></sec></abstract>

BackgroundBone complications are common in patients with thalassemia.ObjectivesTo assess risk factors for osteoporosis in patients with nonmajor thalassemia and its prevalence in randomly selected adult patients in Thailand.Patients and methodsWe included 190 adult patients (58 men and 132 women) with thalassemia intermedia or minor in this cross-sectional study. Patients with untreated hypogonadism, untreated hypothyroidism, menopause, and with a history of treatment with medications that have effects on skeletal or bone metabolism were excluded. Bone mass density (BMD) of the femoral neck was measured by calibrated dual-energy X-ray absorptiometry. Independent factors likely to be associated with osteoporosis were determined and included in the analysis to ascertain possible associations.ResultsMean age was 35.48 ± 14.11 years (range 18–87 years). The mean Z score of femoral neck was − 0.86 ± 1.14 (range −3.7–2.40). Prevalence of osteoporosis was 22/190 (11.6%). Correlation between the pretransfusion hemoglobin level and BMD score was r = 0.192, P = 0.008. Univariate analysis found low BMI was a risk factor for osteoporosis (OR = 3.09, 95% CI 1.09–8.76, P = 0.039) and iron chelation therapy was a protective factor (OR = 0.24, 95% CI 0.09–0.69, P = 0.005). Multivariate analysis did not find these factors to be significant.ConclusionsAll patients with thalassemia at risk of osteoporosis should be screened periodically for bone disease. The uncertainty and disagreements as to the potential role of different factors indicate the necessity for further studies to recognize the pathophysiological basis of this serious complication of thalassemia.

Risk factors for osteoporosis and the relationship between osteoporosis and hemoglobin level in adult patients with thalassemia in Rajavithi hospital

Department of Anaesthesiology, Faculty of medicine

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundBone complications are common in patients with thalassemia.ObjectivesTo assess risk factors for osteoporosis in patients with nonmajor thalassemia...

Parameter	Osteoporosis (Yes)	Osteoporosis (No)	Crude OR	95%CI	P
Age
≥35 years	11	87
<35 years	11	81	0.93	0.38–2.26	0.875
Sex
Female	14	118
Male	8	50	1.30	0.08–2.53	0.53
Thalassemia type
Intermedia	19	119
Minor	3	49	0.38	0.11–1.36	0.2
Blood transfusion
Dependent	9	42
Independent	13	126	0.48	0.19–1.21	0.11
Ferritin
≥1000 ng/ml	16	94
<1000 ng/ml	6	73	2.07	0.83–5.93	0.14
Iron Chelation
Yes	5	92
No	17	76	0.24	0.09–0.69	0.005*
Body mass index (kg/m²)
Low (<20)	17	88
Normal (≥20)	5	80	3.09	1.06–7.15	0.027*
Splenectomy
Yes	8	49
No	14	119	1.33	0.59–3.00	0.49
Physical activity
Low (<600 METs-minutes/week)	12	63
Normal (≥600)	10	105	1.84	0.84–4.04	0.12
Vitamin D level
Low (<20ng/ml)	9	58
Normal	13	110	1.27	0.57–2.82	0.56
Daily calcium intake
Low (<800 mg/d)	18	138
Sufficient	4	30	0.98	0.31–3.10	0.97

Parameter	Adjusted OR	95%CI	P
Age: ≥35 years old	0.90	0.31–2.59	0.84
Sex: female/male	0.97	0.34–2.79	0.96
Hemoglobin level: ≤10 mg/mL	0.71	0.16–3.21	0.65
Type of Thal.: int. vs. minor	1.78	0.40–7.94	0.45
Splenectomy: yes	0.52	0.17–1.61	0.26
Blood transfusion: dependent	1.54	0.52–4.59	0.44
Ferritin: ≥1000 ng/mL	0.72	0.22–4.21	0.60
Iron chelation: yes	0.32	0.08–1.14	0.076*
BMI: low (<20 kg/m²)	2.92	0.9–9.34	0.070*
Physical activity: low	2.33	0.84–6.43	0.10
Vitamin D level: low	1.26	0.46–3.36	0.66
Daily Ca intake: low	0.81	0.14–4.60	0.81

Risk factors for osteoporosis and the relationship between osteoporosis and hemoglobin level in adult patients with thalassemia in Rajavithi hospital

Article Category: Brief communication (Original)

Published Online: Jan 31, 2017

Page range: 169 - 174

DOI: https://doi.org/10.5372/1905-7415.0902.383

Keywords
Bone mineral density, hemoglobin level, osteoporosis, thalassemia intermedia, thalassemia minors

© 2017 Chajchawan Nakhakes, Somluk Jaruluxananan, Yuthana Saengsuda, Sureerat Saengsuda

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Univariate analysis for risk factors of osteoporosis

Adjusted OR for risk factors of osteoporosis in multivariate model

Risk factors for osteoporosis and the relationship between osteoporosis and hemoglobin level in adult patients with thalassemia in Rajavithi hospital

Article Category: Brief communication (Original)

Published Online: Jan 31, 2017

Page range: 169 - 174

DOI: https://doi.org/10.5372/1905-7415.0902.383

KeywordsBone mineral density, hemoglobin level, osteoporosis, thalassemia intermedia, thalassemia minors

© 2017 Chajchawan Nakhakes, Somluk Jaruluxananan, Yuthana Saengsuda, Sureerat Saengsuda

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Univariate analysis for risk factors of osteoporosis

Adjusted OR for risk factors of osteoporosis in multivariate model

Keywords
Bone mineral density, hemoglobin level, osteoporosis, thalassemia intermedia, thalassemia minors