Comparison of DXA, QCT and trabecular structure in <i>β</i>‐thalassaemia

Mylona, Maria; Leotsinides, Michalis; Alexandrides, Theodore K.; Zoumbos, N.; Dimopoulos, Panagiotis

doi:10.1111/j.1600-0609.2005.00411.x

Cited by 31 publications

(25 citation statements)

References 34 publications

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“…In a study of 48 patients, the correlation coefficient between DXA BMD and QCT trabecular BMD was 0.545 (P Ͻ .001). The classification of patients into normal, osteopenia and osteoporotic categories, using QCT Z scores, was in better agreement with the assignment based on trabecular number (k ϭ 0.209, P ϭ .053) than the classification using DXA Z scores (k ϭ 0.145, P ϭ .12) (186). Another study employing peripheral QCT showed lower tibial trabecular volumetric BMD, cortical area, cortical bone mineral content, cortical thickness, periosteal circumference and section modulus Z-scores in thalassemic patients compared to controls (52).…”

Section: Peripheral Quantitative Computer Tomographymentioning

confidence: 91%

Bone Disease in Thalassemia: A Molecular and Clinical Overview

et al. 2016

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Thalassemia bone disease is a common and severe complication of thalassemia-an inherited blood disorder due to mutations in the α or β hemoglobin gene. In its more severe form, severe anemia is present, and treatment with frequent red blood cell transfusion is necessary. Because the body has limited capacity to excrete iron, concomitant iron chelation is required to prevent the complications of iron overload. The effects of chronic anemia and iron overload can lead to multiple end-organ complications such as cardiomyopathy, increased risks of blood-borne diseases, and liver, pituitary, and bone disease. However, our understanding of thalassemia bone disease is incomplete and is composed of a complex piecemeal of risk factors that include genetic factors, hormonal deficiency, marrow expansion, skeletal dysmorphism, iron toxicity, chelators, and increased bone turnover. The high prevalence of bone disease in transfusion-dependent thalassemia is seen in both younger and older patients as life expectancy continues to improve. Indeed, hypogonadism and GH deficiency contribute to a failure to achieve peak bone mass in this group. The contribution of kidney dysfunction to bone disease in thalassemia is a new and significant complication. This coincides with studies confirming an increase in kidney stones and associated accelerated bone loss in the thalassemia cohort. However, multiple factors are also associated with reduced bone mineral density and include marrow expansion, iron toxicity, iron chelators, increased bone turnover, GH deficiency, and hypogonadism. Thalassemia bone disease is a composite of not only multiple hormonal deficiencies but also multiorgan diseases. This review will address the molecular mechanisms and clinical risk factors associated with thalassemia bone disease and the clinical implications for monitoring and treating this disorder.

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Section: Peripheral Quantitative Computer Tomographymentioning

confidence: 91%

Bone Disease in Thalassemia: A Molecular and Clinical Overview

et al. 2016

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“…In a previous study aimed at comparing DXA and quantitative computed tomography (QCT), Mylona and colleagues observed a strong difference in the prevalence of osteopenia and osteoporosis in patients with β-thalassemia according to the technique used. In this study we observed a different prevalence of osteoporosis for DXA and QUS 15. The classification of our patient into normal, osteopenic, and osteoporotic categories is exclusively based on T score values.…”

Section: Discussionmentioning

confidence: 65%

The Ability of Lumbar Spine DXA and Phalanx QUS to Detect Previous Fractures in Young Thalassemic Patients With Hypogonadism, Hypothyroidism, Diabetes, and Hepatitis-B

Argentiero

Neglia

Peluso

et al. 2013

Journal of Pediatric Hematology/Oncology

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Background:Osteoporosis is a leading cause of morbidity in patients affected by β-thalassemia major or intermediate; we aimed to assess the association between demineralization observed in young thalassemic patients.Methods:A total of 88 patients with β-thalassemia were recruited at Microcitemia Center of Taranto Hospital under the Prevention Osteoporosis and Fractures research project from 2008 to 2010. All the patients were screened with both dual energy x-ray absorptiometry (DXA) and quantitative ultrasound (QUS). T score and Z score values were obtained for each subject.Results:The overall prevalence of demineralization was 84% with DXA and 70% with QUS, whereas normality was found in 16% of patients screened with DXA and in 30% of cases with QUS. Hypogonadism, hypothyroidism, diabetes mellitus, hepatitis-B, and the presence of previous fragility fractures were significantly associated with the demineralization status (lower T scores values) both with DXA and QUS.Conclusion:Our data confirm that DXA and QUS examinations are both useful for detecting bone demineralization in thalassemic patients.

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“…23,26,28 Present study showed that lower BMD values are associated with history of hypothyroidism, gonadal dysfunction or impaired puberty which reflects that low BMD values are found more commonly in the background of endocrinopathies. According to some authors [25][26][27]29 gonadal dysfunction probably has the most dominant role in the pathogenesis of bone disease in thalassemia major. So, for normal bone health can be attained by management of endocrine complications.…”

Section: Discussionmentioning

confidence: 99%

“…BMD Z-score significantly deteriorates with age, based on our study findings and those of others. 23,[25][26][27][28] There is possibility of having high prevalence of endocrine complications at an early age due to suboptimal transfusions and chelation therapy in patients with early age group. Quality of life is more strongly affected in older patients.…”

Section: Discussionmentioning

confidence: 99%

Low Bone Mineral Density in Thalassemia Major: Sanjay Gandhi Post Graduate Institute Experience and a Brief Focus on Underlying Factors behind the Cause

Singh

Agarwal

Gupta

2014

Thalassemia Reports

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Thalassemia major is a genetic disorder and blood transfusion is critical for survival in these patients. Over the course of the past three decades, hyper transfusion therapy in these patients has shown has dramatically extended life expectancy and improved quality of life. Unfortunately, this type of therapy also increased the incidence of complications due to iron overload. The aim of this study was to assess bone mineral density (BMD) in patients with β-thalassemia major and to determine their biochemical and hormonal profiles that may affect BMD. A cross-sectional study was carried out in Sanjay Gandhi -PGIMS, a tertiary care hospital over period of 3 years on all β-thalassemia major patients above 7 years receiving regular transfusion. Patients with transfusion dependent anaemia other than β thalassemia major were excluded. Physical examination, laboratory tests and bone density measurements were performed. Then, the data were analyzed. The total number of children over 7 years of age with β-thalassemia major receiving regular blood transfusions during the study period was 150. Mean hemoglobin was 7.8±0.6g/dL and the mean serum ferritin level 5295±2736 ng/mL. Short stature was seen in 54.7% boys and 28.7% of girls. Prevalence of lumbar osteoporosis and osteopenia were 42.5% and 37.5%. Femoral osteoporosis and osteopenia were present in 32.5% and 55% of the patients. Impaired puberty, hypothyroidism, diabetes mellitus, hypoparathyroidism were observed in 26%, 18%, 7%, and 15%, of patients, respectively. Nearly 75% of patients had low bone mineral density. Bone mineral density was significantly associated with short stature (P=0.002), hypogonadism (P=0.006), hypoparathyroidism (P=0.038), hypothyroidism (P=0.044) and vitamin D deficiency (P<0.001). High prevalence of complications among our thalassemics signifies the importance of more detailed studies along with therapeutic interventions.

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Comparison of DXA, QCT and trabecular structure in β‐thalassaemia

Cited by 31 publications

References 34 publications

Bone Disease in Thalassemia: A Molecular and Clinical Overview

Bone Disease in Thalassemia: A Molecular and Clinical Overview

The Ability of Lumbar Spine DXA and Phalanx QUS to Detect Previous Fractures in Young Thalassemic Patients With Hypogonadism, Hypothyroidism, Diabetes, and Hepatitis-B

Low Bone Mineral Density in Thalassemia Major: Sanjay Gandhi Post Graduate Institute Experience and a Brief Focus on Underlying Factors behind the Cause

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