Short Research Communication: Predicting osteopathy among patients with thalassaemia major using selected clinical and biochemical information

Abstract

Objectives: This study assessed the prevalence and surrogate makers of osteopathy among patients with thalassemia major. Methods: Bone mineral densities (BMDs) were measured by dual-energy x-ray absorptiometry of the lumbar spine and total hip in 34 patients with thalassemia major. Postprandial glucose, serum ferritin, vitamin D levels 3 were also measured. Osteopathy was defined as the presence of either a low-energy fracture or BMD of at least one site; total spine or total hip, 2 standard deviations below the mean of age and sex-matched normal population (Z-score). Results: In 34 patients recruited median (inter-quartile range) disease period was 8.2 (5.6 - 12.5) years. Two patients had suffered low energy fractures previously while 12 patients (14/34, 41%) had osteopathy either in the total spine or total hip. Patients with osteopathy were heavier (29.7 kg vs 22.8 kg, P 0.045) and taller (130 cm vs 122cm, P 0.028) when compared to thalassaemics with no osteopathy. The liver span, number of blood transfusions, prevalence of splenomegaly, and body mass index were not significantly different between the patients with and without osteopathy. Postprandial glucose, serum ferritin and vitamin D were similar between the patients with and without osteopathy. When these variables were included in a logistic regression model, no significant clinical predictors were recognized. Conclusions: Osteopathy is a common complication of thalassaemia major and no clinical or biochemical predictors of osteopathy were recognized.