Quantitative Ultrasound Bone Densitometry in Children With Thalassaemia in North East India

Abstract

BACKGROUND Thalassaemic children who are on regular blood transfusion are at increased risk of hypothyroidism, growth hormone deficiency, hypoparathyroidism, diabetes mellitus and osteoporosis because of deposition of iron in various endocrine glands with age. Low bone mineral density is a significant problem in these children, which may lead to increased risk for fractures and suboptimal peak bone mass.The aim of the study is to determine the bone health status of children with thalassaemia using quantitative ultrasound densitometry. MATERIALS AND METHODSA case control study was done at Department of Paediatrics, Jorhat Medical College and Hospital, which included 32 regularly transfused thalassaemic children. Age and sex matched healthy controls were included. Quantitative ultrasound bone densitometry was done in both the groups and compared with each other. RESULTSBroadband Ultrasound Attenuation (BUA) and Speed of Sound (SOS) measurements were found to be independent of sex. BUA values in boys showed increasing trend with age, which was not observed in girls. SOS values did not show any increasing trend with age in both sexes. In both the groups, the BUA and SOS increased continuously with increasing age. The values of BUA were more in control group compared to case group while opposite was noticed with SOS values. BUA values were more when ferritin level was >2000 ng/dL and increased number of blood transfusion, whereas SOS values decreased with increase in serum ferritin level and number of transfusion, which was statistically significant (P=0.0125). Both BUA and SOS values decreased with increased severity of malnutrition, which was statistically significant for SOS (P=0.0266). CONCLUSIONQuantitative ultrasound bone densitometry can be used as a screening method to assess the bone health status in children, particularly those with thalassaemia, but requires further studies in large groups.