Santra Soumya, Sharma Kunal, Dash Ipsita, Mondal Shaikat, Mondal Himel
Pharmacology, College of Medicine and JNM Hospital, Kalyani, IND.
Pharmacology, Government Medical College, Haldwani, IND.
Cureus. 2022 Jul 9;14(7):e26688. doi: 10.7759/cureus.26688. eCollection 2022 Jul.
Background and objective Patients suffering from thalassemia major are at higher risk of osteoporosis. Due to their decreased life expectancy, the number of adult patients is low. However, their bone health is rarely checked in developing countries like India. There is no data available in the literature on the bone mineral density (BMD) of adult (aged ≥18 years) thalassemia major patients in eastern India. In this study, we aimed to measure the BMD and serum calcium and vitamin D levels in adult thalassemia major patients and to compare them with healthy controls. Materials and methods We conducted this cross-sectional observational study at a tertiary care hospital in eastern India. We recruited adult thalassemia major patients who were not on calcium or vitamin D supplements. Their BMD was measured by dual-energy X-ray absorptiometry (DXA) on the lumbar spine (L1-L4). Venous blood was tested for serum calcium and vitamin D levels. We compared the parameters between the cases and controls by using the Mann-Whitney U test. Results A total of 31 (male = 19, female = 12) patients with a median age of 28 years comprised the case group. Age- and sex-matched controls showed similar height but higher weight and BMI. The serum calcium level was similar (p = 0.43) in the case and control groups but T-score (p = 0.0003) and vitamin D levels (p: <0.0001) were significantly lower in thalassemia major patients. Conclusion Based on our findings, adult thalassemia major patients have lower BMD and vitamin D levels. Although the serum calcium may be normal in these patients, they should still be screened both for BMD and vitamin D for prompt and early detection of risks and complications so that a proper management strategy can be implemented.
重型地中海贫血患者患骨质疏松症的风险更高。由于他们的预期寿命缩短，成年患者数量较少。然而，在印度等发展中国家，他们的骨骼健康很少得到检查。在文献中没有关于印度东部成年（≥18岁）重型地中海贫血患者骨密度（BMD）的数据。在本研究中，我们旨在测量成年重型地中海贫血患者的骨密度、血清钙和维生素D水平，并将其与健康对照组进行比较。
我们在印度东部的一家三级护理医院进行了这项横断面观察性研究。我们招募了未服用钙或维生素D补充剂的成年重型地中海贫血患者。通过双能X线吸收法（DXA）测量他们腰椎（L1-L4）的骨密度。检测静脉血中的血清钙和维生素D水平。我们使用Mann-Whitney U检验比较病例组和对照组之间的参数。
共有31例（男性=19例，女性=12例）患者，中位年龄为28岁，组成病例组。年龄和性别匹配的对照组身高相似，但体重和BMI更高。病例组和对照组的血清钙水平相似（p=0.43），但重型地中海贫血患者的T值（p=0.0003）和维生素D水平（p<0.0001）显著较低。
根据我们的研究结果，成年重型地中海贫血患者的骨密度和维生素D水平较低。尽管这些患者的血清钙可能正常，但仍应进行骨密度和维生素D筛查，以便及时早期发现风险和并发症，从而实施适当的管理策略。
