Assessment of biochemical bone markers of osteoporosis in children with thalassemia major

Abstract

Background Beta thalassemia major (β-TM) is a common cause of skeletal morbidity and is associated with increased bone fracture risk, particularly in inadequately transfused children. The aim of this study was to investigate some potential biochemical markers as possible early predictors of BMD variations in children with β-TM. Methods The study included 38 children with β-TM and 40 sex-age matched controls. All patients were subjected to BMD assessment by dual-energy X-ray absorptiometry (DEXA). Serum beta-crosslaps (beta-CTx), osteoprotegerin (OPG), receptor activator of nuclear factor-kappa B ligand (RANKL), urinary deoxypyridinoline (DPD) and ferritin levels were compared between the groups. Results Serum OPG levels were significantly lower in thalassemic children than in controls. The mean ratio of RANKL/OPG was significantly higher in the thalassemic patients than in the control group. Osteoporosis was detected in 10 (3 female and 7 male) of 38 patients (26.3%) according to the femur Z score and in 6 of them (4 male and 2 female) (15.8%) according to the spine Z score. Conclusions Serum OPG concentrations can be used as a biochemical marker in screening patients with beta-thalassemia major for the development of osteoporosis.

Estimation of Osteoprotgrin Level in B Thalassemia Children

“…The study results showed no statistically significant differences between the studied groups in age and sex, this agreed with the results of a previous study [16]. The study results showed no statistically significant differences between the studied groups in BMI, this agreed with the results of proved before [17] . However, the cases group had a statistically significantly lower hemoglobin level and higher levels of alanine transaminase and aspartate aminotransferase, in agreement with the recent Egyptian studies [18] [19].…”

“…However, the cases group had a statistically significantly lower hemoglobin level and higher levels of alanine transaminase and aspartate aminotransferase, in agreement with the recent Egyptian studies [18] [19]. There were no statistically significant differences between the groups in serum urea and creatinine levels reported [17].…”

“…Furthermore, the study found a significant correlation between serum OPG levels and bone mineral density (BMD), an indicator of bone mass, in thalassemia patients. Based on these findings, the study concluded that serum OPG could serve as a valuable biomarker for early detection of osteoporosis in thalassemia patients [7].…”

Regulation of Bone Tissue Metabism in Children Living in Radioactively Contaminated Territories After the CHNPP Accident

“…В дослідженні [11] показано, що рівні феритину та гепсидину в сироватці крові були прямо пов'язані з вітаміном D, прямо та опосередко вано з остеопорозом у пацієнтів з ревматоїдним арт ритом. У дітей, хворих на бета таласемію, які мали підвищені рівні феритину, спостерігалися патологічні зміни у структурі кісток і зниження ЩКТ [12]. Слід за уважити, що у третини дітей в ініціальному періоді гострої лейкемії був підвищений рівень заліза в ор ганізмі, який негативно впливав на стан кісток [13].…”

“…Serum ferritin and hepcidin levels are directly related to the vitamin D content [11]. Bone structure abnor malities and decreased BMD in children with beta thalassemia having the elevated ferritin levels are an example here [12]. Increased level of iron, which negatively affects the bones' state, is note worthy in the initial period of acute leukemia in every third pediatric patient [13].…”