Aims: Low vitamin D levels may contribute to the pathogenesis of bone disease in thalassaemia major patients. Our haematology department serves one of the UKs largest populations of thalassaemia patients. We evaluated our thalassaemia major patients vitamin D levels and other serum bone markers.
Methods: Blood specimens were collected from all thalassaemia major patients under active follow-up in March and April 2010 and serum 25-OH-vitamin D, calcium, phosphate, alkaline phosphatase, parathyroid hormone levels were measured. The correlation of 25-OH vitamin D with these serum markers, patient demographics and markers of iron overload was assessed. Vitamin D deficiency was defined as serum 25-OH-vitamin D <25 nmol/l, sufficiency as 2575 nmol/l and normal as 75250 nmol/l.
Results: Blood specimens were collected from 74 thalassaemia major adults (38 females, 36 males) with median age of 35.5 years (range 1758 years).
Prevalence of vitamin D deficiency was 21.6%, vitamin D insufficiency 66.2% and normal vitamin D levels 12.2%. Median serum 25-OH-vitamin D levels was 39 nmol/l (range 13113 nmol/l).
Serum calcium levels, alkaline phosphatase and parathyroid hormone were not independently associated with vitamin D levels. The only serum marker which was significantly associated with vitamin D levels was phosphate (P=0.04), but the correlation was poor (Spearman correlation coefficient −0.243). No independent association between age or ethnic origin and vitamin D status was observed. No marker of iron overload was significantly associated to vitamin D status.
Conclusions: Most thalassaemia major patients have low serum vitamin D levels. This potentially has a significant impact on their bone health, which is already a major problem in patients with thalassaemia major. We would recommend regular measurement of vitamin D levels in all thalassaemia major patients and subsequent appropriate replacement therapy.