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Bone mineral density in transfusion-dependent thalassemia patients and its associated factors in Southern Iran

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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 gender-matched 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.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

The authors wish to thank Mr. H. Argasi at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for his invaluable assistance in editing this manuscript.

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Authors and Affiliations

  1. Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran

    Mohammadreza Bordbar, Sezaneh Haghpanah, Mehran Karimi & Omidreza Zekavat

  2. Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Gholamhossein Ranjbar Omrani & Forough Saki

Authors
  1. Mohammadreza Bordbar
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  2. Gholamhossein Ranjbar Omrani
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  3. Sezaneh Haghpanah
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  4. Forough Saki
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  5. Mehran Karimi
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  6. Omidreza Zekavat
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Contributions

1. Mohammadreza Bordbar: concept, design, data gathering, and preparing the manuscript

2. Gholamhossein Ranjbar Omrani: design, data gathering of the control group, and preparing the manuscript

3. Forough Saki: design, data gathering, preparing the manuscript, and the correspondence

4. Sezaneh Haghpanah: design, data analysis, and preparing the manuscript

5. Mehran Karimi: concept, design, and data gathering

6. Omidreza Zekavat: concept, design, and data gathering

Corresponding author

Correspondence to Forough Saki.

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Ethics approval

The local Ethics Committee of Shiraz University of Medical Sciences (SUMS) approved the study. Vice-chancellor of research at SUMS approved this study with ID: 98-01-32-21135. All participants signed an informed consent form.

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All patients signed a written informed consent form after explaining the aim, method, and goal of the study for participation.

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All patients signed a written informed consent form after explaining the aim, method, and goal of the study for publishing any data from their records.

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Bordbar, M., Omrani, G.R., Haghpanah, S. et al. Bone mineral density in transfusion-dependent thalassemia patients and its associated factors in Southern Iran. Arch Osteoporos 15, 148 (2020). https://doi.org/10.1007/s11657-020-00811-7

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