Bone metabolic disorders among patients with major β thalassemia: A cross-sectional study from Iran

Objectives: One of the chronic complications associated with β-thalassemia major is bone metabolic disorder. The present study was designed to assess the prevalence of bone metabolic disorders and associated risk factors among the patients.
Methodology: A cross-sectional study was conducted. The study population consisted of major β-thalassemia patients. Levels of several serum elements were measured. Bone mineral density (BMD) of lumbar spine and the neck of the femur were also assessed. All collected data were analyzed to determine the frequency of bone metabolic disorders and the related risk factors.
Results: Fifty-two patients with mean age of 22.46 ±3.36 years entered the study. The mean height of participants was 162.35±9.75 Cm and 21% of them were short stature. Regarding blood biochemical factors, ferritin in 14 (26.9%), 16 (30.8%), and 22 (42.3%) subjects were <1000, 1000-2000, and >2000 ng/ml, respectively. Hypophosphatemia was observed in 28.8% and 3.8% of participants had hypocalcemia. Vit D3 insufficiency was frequently reported in the participants (57.7%). Concerning BMD values, more than 75% of participants showed degrees of bone mineral disorders. Analysis of data showed that sex was a significant factor affecting femur (p=0.003) and spine BMD status (p=0.039). No relationships were observed between BMD status and measured serum elements (p>0.05). 
Conclusion: The findings of present study revealed that β-thalassemia patients were at great risk of bone metabolic disorders. Although the results showed no correlations between BMD levels and several blood biochemical factors, β-thalassemia major patients should be monitored for potential blood biochemical imbalance and their associated long-term consequences.