Dual X Ray absorptiometry is superior in detecting bone mineral density alterations in adult patients with thalassaemia major compared to quantitative computed tomography

Evangelos Alexiou, Michael Diamantidis, Katerina Vassiou, Ioannis Fezoulidis, Marianna Vlychou

Abstract


Purpose: Patients with beta thalassaemia major are prone to develop osteoporosis during prolonged lifespan despite effective and regular chelation treatment. The present study aims to assess the bone mineral density in thalassaemic patients with dual x ray absorptiometry (DXA) and quantitative computed tomography (QCT), to assess the diagnostic performance of each method and correlate bone alterations with various clinical parameters and bone markers.

Material and Methods: The study included 75 homozygous thalassaemic adult patients (31 men, 44 women, age range 22-49 years) that were in regular transfusion and chelation therapy. All patients underwent DXA and QCT measurements and laboratory examinations. 

Results: First, we examined the relationship of lumbar Z scores at the lumbar spine between DXA and QCT measurements and there was no evidence of agreement between the two densitometric methods, in almost all cases. DXA measurements of the lumbar spine and femoral neck detected 24/75 patients (32%) and 10/75 patients (10%), respectively, below the expected range for age, indicative of diminished bone mineral density. Regarding bone markers and BMD, we found that ferritin has a statistically significant positive correlation with BMD of the femoral neck in both males and females. Similarly, osteocalcin has a statistically significant positive correlation with BMD of the femoral neck in male patients only.

Conclusions: Osteoporosis should be assessed only with DXA and should be taken into clinical consideration for monitoring and therapy in adult patients with thalassaemia.


Keywords


bone mineral density, dual x ray absorptiometry, quantitative computed tomography, thalassemia major

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References


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DOI: http://dx.doi.org/10.36162/hjr.v6i4.460

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