Rahmadi Andri Reza, Rachman Febi Ramdhani, Susandi Evan, Dewi Sumartini, Hamijoyo Laniyati, Prasetya Dimmy, Wijaya Indra, Ghozali Mohammad, Fucharoen Suthat, Panigoro Ramdan
Doctoral Study Program, Faculty of Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Jl. Pasteur No. 38, Bandung, West Java 40161 Indonesia.
Internal Medicine Department, Faculty of Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, West Java 40161 Indonesia.
Indian J Hematol Blood Transfus. 2025 Apr;41(2):306-314. doi: 10.1007/s12288-024-01864-1. Epub 2024 Sep 12.
The survival of patients with transfusion-dependent thalassemia has increased with optimal blood transfusion. In adult patients with thalassemia, iron toxicity due to repeated blood transfusion is the main contributing factor causing decreased bone density and leads to mechanical disruption in the bone structure. This study aimed to analyze the variables affecting bone mineral density (BMD) in patients with thalassemia major. We enrolled patients with transfusion-dependent thalassemia who visited the Hasan Sadikin Hospital Bandung outpatient clinic. Participants underwent anthropometric measurement, laboratory, and BMD examination. Bivariate analysis was performed to determine the correlation between clinical data and BMD by Pearson or Rank-Spearman depending on data distribution. Multivariate analysis was performed to determine the most influential variables using linear regression analysis. < 0.05 was considered statistically significant. Overall, 59 participants were included. BMD was significantly correlated with body mass index (BMI), sex, average pre-transfusion hemoglobin level, blood transfusion volume, and vitamin D, with coefficient r values of 0.47, 0.34, - 0.27, and - 0.28 ( < 0.05), respectively. BMI was the variable that most influenced BMD, with 0.39 coefficient value, an adjusted coefficient value of 0.32 (0.01-0.04), and = 0.04. Receiver operating characteristic analysis showed BMI had the highest area under the curve (AUC) in all examination areas, especially in the hip area, with 0.800 AUC. 77.8% sensitivity, and 71.7% specificity. BMD was correlated with BMI, sex, average pre-transfusion hemoglobin level, blood transfusion volume, and vitamin D, with BMI being the most influential factor affecting BMD.
The online version contains supplementary material available at 10.1007/s12288-024-01864-1.
随着最佳输血治疗，依赖输血的地中海贫血患者的生存率有所提高。在成年地中海贫血患者中，反复输血导致的铁毒性是导致骨密度降低的主要因素，并导致骨骼结构的机械破坏。本研究旨在分析影响重型地中海贫血患者骨矿物质密度（BMD）的变量。我们纳入了在万隆哈桑·萨迪金医院门诊就诊的依赖输血的地中海贫血患者。参与者接受了人体测量、实验室检查和骨密度检查。根据数据分布，采用Pearson或秩Spearman进行双变量分析，以确定临床数据与骨密度之间的相关性。采用线性回归分析进行多变量分析，以确定最具影响力的变量。P < 0.05被认为具有统计学意义。总体而言，共纳入59名参与者。骨密度与体重指数（BMI）、性别、输血前平均血红蛋白水平、输血量和维生素D显著相关，系数r值分别为0.47、0.34、-0.27和-0.28（P < 0.05）。BMI是对骨密度影响最大的变量，系数值为0.39，调整系数值为0.32（0.01 - 0.04），P = 0.04。受试者工作特征分析表明，BMI在所有检查部位的曲线下面积（AUC）最高，尤其是在髋部区域，AUC为0.800，敏感性为77.8%，特异性为71.7%。骨密度与BMI、性别、输血前平均血红蛋白水平、输血量和维生素D相关，其中BMI是影响骨密度的最主要因素。
在线版本包含可在10.1007/s12288-024-01864-1获取的补充材料。
